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Biomedical subjects

R E Latchaw

Publications and source records attributed to R E Latchaw.

116 records · Page 7Linked to original sources
PubMedDate not supplied

Iohexol vs. metrizamide: study of efficacy and morbidity in cervical myelography.

A double-blind study was conducted in 60 patients undergoing either cervical or more complete myelography via C1-C2 puncture. Patients received either iohexol or metrizamide at a 300 mg l/ml concentration. The contrast media were equally efficacious in the production of high-quality radiographs and CT scans. However, the incidence of adverse reactions differed markedly. Of patients receiving metrizamide, 68% had some type of adverse reaction, whereas only 26% receiving iohexol had symptoms. The incidence of headache (metrizamide, 34%; iohexol, 26%) was not statistically different, but the quality of the headache differed: half of the metrizamide headaches were moderate or severe, whereas all iohexol headaches were mild. Nausea (31%) and vomiting (28%) were common with metrizamide but unusual (3% nausea) with iohexol. Of the metrizamide patients, 21% had overt psychologic changes that did not occur in the iohexol group.

Adult↗
PubMedDate not supplied

Normal pituitary gland: 1. Macroscopic anatomy-CT correlation.

To improve the radiologic recognition of pituitary microadenomas that have subtle or no mass effect, the appearance of the normal pituitary gland on computed tomographic (CT) images was studied. Thirteen autopsy specimens of the pituitary gland and sella turcica were examined by coronal CT and histologically sectioned in similar coronal planes. The CT and histologic findings were correlated, then compared with the coronal CT images of 30 normal pituitary glands in vivo, most of which were contrast-enhanced. The normal pituitary gland had a nonhomogeneous CT appearance with a variety of frequently predictable patterns. This heterogeneity was in part the result of gross anatomic structural interrelations between the anterior lobe, para intermedia, and posterior lobe.

Adenoma↗
PubMedDate not supplied

Normal pituitary gland: 2. Microscopic anatomy-CT correlation.

Pituitary microadenomas may present with subtle or no mass effect. They may appear lucent, dense, or heterogeneous on computed tomographic (CT) images. The normal pituitary gland may also have a nonhomogeneous CT appearance with intermingled lucent and dense areas. This heterogeneity is related in part to microscopic variation within the anterior and posterior lobes. Thirteen autopsy specimens of the pituitary gland were examined by coronal CT and histologically sectioned in similar coronal planes. The CT-lucent and CT-dense areas of the anterior and posterior lobes were correlated with corresponding areas on microscopic examination. To determine the effects of contrast infusion during CT, density measurements of lucent and dense areas in the anterior lobes of 26 normal contrast-enhanced pituitary glands in vivo were compared with density measurements of adjacent vascular structures at the time of scanning. Microscopic features corresponding to increased CT density in the anterior lobe included increased tissue compactness and increased cellular granularity, both of which usually occurred together in areas composed of tightly compacted and heavily granulated acidophilic cells. Conversely, microscopic features corresponding to decreased CT density in the anterior lobe included decreased tissue compactness and decreased cellular granularity, both of which frequently occurred together in areas containing chromophobic and/or mildly to moderately granulated basophilic cells. The degree of contrast enhancement within the anterior lobe appeared primarily to depend on vascularity, which in turn often depended on the degree of tissue compactness. In the posterior lobe, CT-lucent areas appeared to correspond to less compact and/or less vascular neurohypophyseal tissue.

Adenoma↗
PubMedDate not supplied

Cerebellar venous angioma: "benign" entity?

Four patients with bleeding venous angiomas in the cerebellar hemispheres are reported. All of the hemorrhages were subacute; three were recurrent. A literature review substantiated venous angioma as a recognized source of spontaneous cerebellar hemorrhage. Cerebellar venous angiomas may be more prone to bleed than venous angiomas in other locations. Their natural history seems to be similar to that of arteriovenous malformations. Though a minority bleed, the hemorrhagic event can be acute or subacute, recurrent, or catastrophic. Thus the clinical course is not always innocuous.

Adult↗
PubMedDate not supplied

Computed tomography and myelography of the postoperative lumbar spine.

Postoperative myelographic changes in the thecal sac, epidural tissues, and bony canal, as well as nerve roots, may be difficult to interpret. A series of 32 postoperative patients, all of whom had a metrizamide myelogram and subsequent lumbar computed tomogram, was reviewed to examine the ability of computed tomography to recognize abnormalities when the myelogram is equivocal or uninterpretable. Criteria to distinguish recurrent herniated disk from postoperative changes are presented, including the demonstration of mass densities similar to and in continuity with the intervertebral disk. In 12 reoperated cases, five recurrent herniated disks and two new herniated disks were diagnosed and confirmed. In 20 nonreoperated cases, no recurrent herniated disks were identified, although two new herniated disks were found at levels not believed clinically significant. Computed tomography after metrizamide myelography appears to be a reliable technique for distinguishing abnormalities in the postoperative spine.

Adult↗
PubMedDate not supplied

Neuroblastoma presenting as central nervous system disease.

Neuroblastoma may be extremely difficult to recognize, particularly when the tumor presents as a primary central nervous system disease. Central nervous system involvement may be considered as primary intracerebral neuroblastoma, metastases to the cranium from an occult primary, primary intraorbital neuroblastoma originating in the ciliary ganglion, metastatic intraorbital neuroblastoma from an occult primary, primary intraspinal neuroblastoma originating in dorsal root ganglia, intraspinal metastatic disease, and distant effects such as myoclonic encephalopathy. Primary neuroblastoma within the ciliary ganglion and primary intraspinal neuroblastoma are extremely rare entities. Illustrative cases the demonstrate the broad spectrum of neurologic presentations are offered. The second known report of neuroblastoma in association with primary pulmonary hypoventilation (Ondine curse) is included.

Brain Neoplasms↗