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Biomedical subjects

R Churchill

Publications and source records attributed to R Churchill.

At least 19 recordsLinked to original sources
PubMed1994

Fibrodysplasia (myositis) ossificans progressiva.

Fibrodysplasia ossificans progressiva (FOP) is a rare hereditary connective tissue disorder. Patients with FOP develop progressive ossification of muscle and connective tissue associated with pain and disability. Onset is typically in childhood, and congenital anomalies of the feet are an early sign of this condition. Pain and stiffness of the spine or an inflammatory mass are common presenting features of FOP. Involvement of the spine often leads to complete fusion mimicking ankylosing spondylitis. Studies of twins and families suggest that FOP is a genetically inherited autosomal dominant trait with complete penetrance but variable expressivity. While radionuclide imaging and computed tomography are very sensitive for new bone formation and greatly assist the diagnosis of FOP, unfortunately, effective therapy is unavailable. We present twins with FOP and review the clinical, radiographic, and genetic manifestations of this disorder.

Adult↗
PubMed1986

Radiologic diagnosis of an intra-abdominal abscess. Do multiple tests help?

A review was made of the charts of 94 patients who underwent ultrasonography (US), computed tomography (CT), and gallium citrate Ga 67 (Gall) scan to rule out intra-abdominal abscesses. Of all the clinical and laboratory data, only the presence of pain and tenderness differentiated patients with and without abscesses. A review of radiologic data showed that CT was superior to US, and that US was superior to Gall scan with regard to sensitivity, specificity, accuracy, and positive and negative predictive values. When multiple radiologic tests were performed, results agreed in 72% of cases; therefore, the additional tests were essentially redundant. When radiologic test results disagreed, accuracy rates were CT, 0.86; US, 0.00; and Gall scan, 0.44. These findings suggest that, except to rule out pelvic abscesses in the presence of pelvic inflammatory disease, CT is usually the only special radiologic test that should be performed to localize a suspected intra-abdominal abscess.

Abdomen↗
PubMed1984

The radiologic diagnosis of complications following gynecologic surgery: radiography, computed tomography, sonography, and scintigraphy.

673,000 hysterectomies were done in the United States in 1981. The mortality rate of 16.4/100,000 was less than that for appendectomy. Gynecologic surgery, however, is the most common surgical cause of complications related to the urinary tract with the reported incidence varying from less than 1 to 10%. We reviewed the charts of 1403 patients who had 736 abdominal, 315 vaginal and 143 radical or modified radical hysterectomies. Seventy (5%) patients had complications. Thirty-two (2.2%) patients had 35 complications related to the urinary tract. Complications directly related to surgery were grouped into ureteral injuries (13), fistulas (10), post surgical fluid collections (13), and hydronephrosis following radical hysterectomy. Characteristic images obtained by radiography, sonography (US), computed tomography (CT), and nuclear medicine (NM) are presented, and their use in each group of complications is summarized in the conclusion.

Ascites↗
PubMed1984

Intravenous contrast bolus in computed tomography investigation of mass lesion.

Using bolus intravenous contrast (25-75 Renografin 60) and 5-second scanning capability, better definition of vascular anatomy as well as the vascular nature of mass lesions in the chest and abdomen could be demonstrated. The immediate higher concentration of iodine in vessels and organs following initial bolus, improves visualization of these structures dramatically when compared to drip-infusion technique. A description of the technique and examples are shown.

Abdominal Neoplasms↗
PubMed1983

Chronic stridor in a child: CT diagnosis of pulmonary vascular sling.

A child without chronic stridor and tracheal narrowing was considered to have a primary tracheal abnormality. Computed tomography (CT) identified an aberrant left pulmonary artery originating from the right pulmonary as the cause of the tracheal abnormality. The advantages of CT over conventional studies are discussed.

Child↗
PubMed1982

Incidental asymptomatic adrenal masses detected by computed tomographic scanning. Is operation required?

Until recently, adrenal masses came to clinical attention either from local symptoms due to massive enlargement or from manifestations of excess hormones production. During the last year, an adrenal mass was identified as an incidental finding in nine patients undergoing abdominal computed tomographic (CT) scanning for unrelated problems. These five men and four women ranged in age from 41 to 73 years. Eight were hypertensive. After the CT scan, each was evaluated for catecholamine or steroid hypersecretion. Only one had clearly elevated urinary vanillylmandelic acid, metanephrine, and catecholamine levels. Equivocal evidence of catecholamine excess was seen in five patients who had slight elevation of one urinary metabolite or of plasma epinephrine or norepinephrine levels. Three patients had no evidence of medullary or cortical hyperfunction on repeated testing. Eight patients were good operative risks and underwent unilateral adrenalectomy without complication. Masses ranging in size from 1 to 4 cm were found in each. These included four cortical adenomas, two adrenal cysts, one adrenal lipoma, and one pheochromocytoma. The pheochromocytoma occurred in the patient with strong biochemical evidence of disease. With wider application of CT imaging, increasing numbers of asymptomatic adrenal masses will be detected. Care in interpreting the clinical significance of these masses and caution in recommending treatment are required.

Adenoma↗
PubMed1981

Diagnosis of dissecting aortic aneurysm by computed tomography.

Computed tomography (CT) of the torso combined with simultaneous intravenous bolus injection of contrast media was used in sixteen patients suspected of having dissected their aorta. All patients had subsequent correlative percutaneous aortography within 24 h of the CT examination. Four patients proved to be normal, one had an aneurysm of the thoracic aorta, and eleven had aortic dissection (five type I, six type III dissection). All eleven patients with aortic dissections were diagnosed by CT and angiography; nine had spontaneous dissections and two had iatrogenic injuries to the aorta. Limitations of this imaging procedure include; inability to detect aortic valvular dysfunction and failure to provide an adequate perspective of aortic branch involvement. Potential benefits include: avoidance of aortogram in some cases, relative non-invasiveness, rapidity and ease of procedure, and less expense, radiation, contrast media, and discomfort to the patient. Early experience with CT-enhancement technique has reliably demonstrated normal as well as abnormal aortic wall morphology. It may have a place as an alternative to the conventional aortogram.

Adult↗
PubMed1981

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Cholecystitis↗
PubMed1979

Computed tomography staging of renal carcinoma.

The ability of fast thire-and fourth-generation scanning devices to supply images of sufficient quality to delineate the kidney, its vascular supply, and surrounding fascial envelope has provided a modality which permits preoperative staging of tumors of the kidney with an accuracy of about 90% in limited series of 20 specimen cases. The unreliability of bolus injection to evaluate tumor extension to the renal vein accounted for two errors.

Adenocarcinoma↗
PubMed1977

Radiology of cysticercosis of the central nervous system including computed tomography.

Cysticercosis is a parasitic disease in which man serves as the intermediate host of Taenia solium, the pork tapeworm. The larvae have a predilection for the central nervous system and can cause a variety of neurologic and psychiatric symptoms. Areas of involvement are classified as intraventricular, parenchymal, arachnoidal, and mixed. The diagnosis is made primarily by roentgenographic and spinal fluid examinations. The authors reviewed 232 cases of cysticercosis involving the central nervous system. It was found that computed tomography is a useful tool in assessing this illness.

Adolescent↗
PubMed1977

Radiology of invasive amebiasis of the colon.

Entamoeba histolytica is a protozoan that is endemic in various parts of the world, including some areas of the United States. It may live in the large bowel in its cyst form without harming the host (commensalism) or, for as yet poorly understood reasons, invade the tissues as a trophozoite producing invasive amebiasis of the colon. In a review of over 3,000 cases of invasive amebiasis, the clinico-pathologic forms of the disease were: ulcerative rectocolitis (95%), typhloappendicitis (3%), ameboma (1.5%), and fulminating colitis and toxic megacolon (0.5%). Different radiographic patterns are seen in each clinical form with varying degrees of specificity. It is vitally important that this disease be included in the differential diagnosis of large bowel pathology even in nonendemic areas. Several referral patients who have received inappropriate therapy for inflammatory bowel disease with near disastrous results are seen at one of our institutions (Loyola) each year.

Colitis↗