R F Gochman | PubMed Health

PubMed1991

Use of portable ultrasound to assist urine collection by suprapubic aspiration.

STUDY OBJECTIVE: To determine whether portable ultrasound can improve the success rate of suprapubic aspiration (SPA). DESIGN: Patients were randomly assigned to either ultrasound or no ultrasound groups. In the ultrasound group, patients underwent SPA if ultrasound revealed urine in the bladder: if no urine was present, patients underwent catheterization instead of SPA. In the no-ultrasound group, SPA was attempted without ultrasound. All unsuccessful SPAs were followed by catheterization and measurement of urine volume. SETTING: Children's hospital-based pediatric emergency department. PARTICIPANTS: Children less than 2 years old who required SPA. INTERVENTIONS: Ultrasound versus no ultrasound. RESULTS: Thirty-five patients were randomized to the ultrasound group, and 31 were randomized to the no-ultrasound group. SPA was successful in 79% of attempts in the ultrasound group compared with 52% in the no-ultrasound group (P = .04). The sensitivity and specificity of ultrasound were 90% and 86%, respectively. CONCLUSION: Portable ultrasound can significantly improve the success rate of SPA and limit nonproductive attempts at SPA.

Cost-Benefit Analysis↗

PubMed1981

Three-dimensional myocardial and ventricular shape: a surface representation.

To date, a detailed three-dimensional (3D) analysis of cardiac shape and size has not been available. Accordingly, we developed a method for such an analysis using sectioned hearts and a computer-based 3D description of the epi- and endocardial surfaces of the left and right ventricles (LV and RV) and the interventricular septum. The accuracy of this analysis as a function of section thickness (hs) was evaluated and reference axes for the LV, RV, and myocardium determined in eight canine hearts. After diastolic arrest, the RV, LV, and their atria were fixed in formaldehyde solution at pressures of 6 and 12 cmH2O, respectively. The hearts were then cast (plastic or gelatin) and sectioned, and the surfaces were digitized. We found that 1) accurate 3D computer reconstructions and computed volumes of the LV, RV, and myocardium were obtained then hs less than or equal to 5 mm, 2) the apex-to-base circumference and cross-sectional area relations could be approximated provided hs less than 10 mm, and 3) the section centers of gravity for the LV, RV, and myocardium defined three distinct vertical lines. Thus, an accurate description of 3D configuration is obtainable by a 5-mm section thickness. The centers of gravity provide a set of geometrical references for the study of shape in normal and diseased hearts.

Animals↗