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Biomedical subjects

R D Halpert

Publications and source records attributed to R D Halpert.

At least 19 recordsLinked to original sources
PubMed1993

Preoperative evaluation of patients for liver resection. Appropriate CT imaging.

OBJECTIVE: The authors determined which combination of computed tomography scans is most helpful for preoperative assessment of patients with liver tumors. SUMMARY BACKGROUND DATA: Multi-institutional studies have shown that the most important prognostic factors for selection of patients with metastatic colorectal cancer considered for liver resection are: Dukes' stage of primary tumor, the number of hepatic metastases if greater than 3, the presence of extrahepatic cancer, and the ability to resect tumors with an adequate margin (> 1 cm.) Therefore the ability to predict the presence of extrahepatic disease and the number and location of hepatic tumors are important in these patients. METHODS: One hundred and nine consecutive patients with evidence of hepatic tumors were evaluated by computed tomography with arterial portography (CTAP) and abdominal computed tomography after a 4-hour delay (CT-D). Results of these studies and conventional computed tomography (CT-C) were compared with findings at operation. RESULTS: CTAP proved to be the most sensitive test for assessing distribution of intrahepatic disease. CT-D was no more sensitive than CT-C for the detection of hepatic or extrahepatic disease. CONCLUSIONS: CT-C in concert with CTAP provides the most reasonable CT evaluation of patients considered for operation for the treatment of hepatic tumors.

Humans↗
PubMed1993

Abdominal complications in organ transplant recipients.

A variety of intraabdominal complications are associated with organ transplantation. These include inflammatory changes involving the bowel, liver, and pancreas and range from technical complications associated with the surgery to organ rejection, opportunistic infections, and an increased risk of de novo malignancy in transplantation patients.

Bone Marrow Transplantation↗
PubMed1990

Adenocarcinoma of the appendiceal stump.

We have reported the case of a 58-year-old woman with nonspecific abdominal complaints in whom barium enema and subsequent colonoscopy showed a 3 cm lobulated adenocarcinoma within a villous adenoma arising from the appendiceal stump. Because such appendiceal malignancies have no specific clinical signs, symptoms, or radiologic features, preoperative diagnosis is extremely difficult, and colonoscopy may be required to clarify radiologically demonstrated irregularities.

Adenocarcinoma↗
PubMed1989

Rectal diverticulosis: a case report and review of the literature.

The occurrence of rectal diverticulosis is rare. We report the incidental finding of a large rectal diverticulum in a patient receiving an air-contrast barium enema. The presence of uncomplicated rectal diverticulosis is probably of little clinical significance. However, there can be associated complications such as inflammation and perforation, and potential confusion with rectal carcinoma.

Aged↗
PubMed1988

Digital radiography of the gastrointestinal tract.

The gastrointestinal tract lends itself quite well to digital imaging. Since fluoroscopy is already employed, the images can easily be obtained in digital format and several manufacturers have now developed systems for commercial use. Because of the type of pathology as well as the inherent subject contrast, it would appear the resolution requirements for digital imaging of the gastrointestinal tract are less than in other organ systems. The necessary resolution level is already technically available and feasible without significant cost. Digital imaging also holds promise of at least a modest reduction in radiation dose to the patient, as well as a reduction in costs, although these factors are operator dependent. However, digital imaging provides a latitude in performing the examination that is not available with screen-film systems. Finally, there is promise that by acquiring gastrointestinal images in digital format, manipulation of the images may help increase diagnostic accuracy by improving both technical and perceptive components of diagnosis. Not only will simple image manipulation be helpful but there is even potential for computer-assisted evaluation of gastrointestinal images.

Colitis, Ulcerative↗
PubMed1987

Limiting overhead views in double-contrast colon examinations does not affect diagnostic accuracy.

A prospective study was undertaken to evaluate whether reducing overhead (technician-performed) films in double-contrast colon examinations had any effect on diagnostic accuracy. Only 4 overhead films were obtained routinely: supine, both decubitus, and prone cross-table rectal views. A high detect rate was maintained, comparable to our accuracy when 7 or 8 overhead films were obtained. Our study confirms that with double-contrast colon examinations, the need for overhead films is diminished. A significant decrease in cost, radiation exposure, and examination time can be obtained. We continued to use this method without any noticeable decrease in diagnostic accuracy.

Barium Sulfate↗
PubMed1987

Toxic dilatation of the colon.

Toxic dilatation of the colon represents the most serious complication of colonic inflammatory diseases. It is an acute transmural extension of severe inflammation resulting in decreased tissue cohesion and an increased tendency for bowel perforation. The process is characterized by dilatation and apparent radiologic thickening and nodularity of the bowel wall. Cases of toxic megacolon without dilatation occur infrequently.

Antidiarrheals↗
PubMed1986

Retrograde ileography: value of glucagon.

Many gastrointestinal diseases have a predilection for the terminal ileum. Retrograde ileography is a valuable technique for evaluating this region. However, this procedure necessitates reflux of barium (with or without air) into the terminal ileum. This does not often spontaneously occur during a barium enema study. The use of glucagon in double-contrast studies of the colon has been recommended for various reasons, one of which is to facilitate reflux of barium into the terminal ileum. This randomized, double-blind trial confirms that glucagon does promote reflux. Multiple regression analysis indicates that the independent variables of patient age, weight, and sex have little effect on the frequency of reflux. It is concluded that glucagon can facilitate examination of the distal small bowel during a double-contrast colon examination.

Female↗