Biomedical subjects
R Rosenblatt
Publications and source records attributed to R Rosenblatt.
Postmenopausal tubo-ovarian abscess: sonographic considerations and clinical significance.
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Utero-vaginal hypoplasia. Sonographic, embryologic and clinical considerations.
Congenital absence of hypoplasia of the uterus is a cause of primary amenorrhea in approximately 15% of cases. Ultrasound is often employed as an early imaging modality in the evaluation of patients with primary amenorrhea. Demonstration of total absence or marked hypoplasia of the uterus in the presence of normal ovaries during pelvic ultrasound examination, suggests the diagnosis of congenital uterine aplasia or hypoplasia. Sonography may obviate the need for laparoscopy and for other imaging modalities. A case report of uterovaginal hypoplasia in association with anal atresia and recto-vaginal fistula is presented, and the value of ultrasound in the diagnosis of this entity is discussed. The embryology and clinical features of this anomaly are also reviewed.
Sonographic appearance and significance of arcuate artery calcification.
During routine pelvic ultrasonography, we observed calcification of the arcuate branches of the uterine artery in eight patients. Calcification was manifest as symmetric, hyperechoic foci with acoustic shadowing in the periphery of the uterine myometrium. Uterine arterial calcification is important to recognize, as patients often have severe underlying systemic disease. Arcuate artery calcification can be differentiated from other pathologic causes of calcification in the uterus.
Reversible symptomatic biliary obstruction associated with ceftriaxone pseudolithiasis.
Ceftriaxone, a third-generation cephalosporin, has been associated with the development of sludge or stones in the gallbladders of some patients treated with this medication. Such precipitates, which are usually reversible upon discontinuation of the drug, sometimes cause symptoms, have simulated acute cholecystitis, and have even led to cholecystectomy in some cases. We report the first known instance of biliary obstruction and secondary pancreatitis in association with reversible ceftriaxone-induced pseudolithiasis.
Time-related increase in hematocrit on chronic hemodialysis: uncertain role of renal cysts.
We studied the long-term changes in hematocrit in 283 center hemodialysis patients. Mean duration of dialysis (+/- SD) was 53.8 +/- 43.4 months, with a range of 6 to 176 months. The correlations of hematocrit with clinical factors, laboratory values, and renal cystic changes were investigated. Time on dialysis was the strongest single predictor of hematocrit for the whole group (r = 0.351, P less than 0.001) and for men and women analyzed separately. Longitudinal 5-year (n = 83) and 10-year (n = 21) data showed a continuous increase in hematocrit levels over time (r = 0.414, P less than 0.001 over 10 years). Patients at the dialyzer reuse center (n = 224) had higher hematocrit levels than those at the center that did not reuse (n = 59). Although time on dialysis was strongly correlated with increasing extent of renal cystic change (r = 0.387, P less than 0.001), the correlations of cyst extent and time on dialysis with hematocrit were not independent by multiple regression analysis. We conclude that hematocrit increases progressively over time in patients on chronic hemodialysis. The mechanisms responsible for this do not seem to involve cystic transformation of the kidneys and remain unclear.
Renal peripelvic multicystic lymphangiectasia.
Renal peripelvic multicystic lymphangiectasia is an unusual benign peripelvic fluid collection. The sonographic appearance, etiology, and differential diagnosis of peripelvic fluid collections are reviewed.
Prostatic carcinoma metastasis to the kidney: diagnosis by thin needle aspiration biopsy.
Renal metastasis of prostatic origin is uncommon. The routes of metastatic spread are discussed. The efficacy and safety of thin needle aspiration biopsy in obtaining a premortem diagnosis are stressed.
Social functioning in chronic pain patients.
Although investigators have explored the effects of chronic illnesses on social functioning during the course of treatment, much less is known about the impact of treatment outcome on social functioning. In this study we examine whether the outcome of treatment for chronic pain in a pain clinic exerts a significant effect on the eventual social functioning. The findings indicate that a more favorable outcome is associated with increased marital satisfaction, a heightened desire for sex, and an increased desire and ability for recreational activities. These findings have implications for family practitioners as they assess social functioning after treatment for chronic pain.
Needle aspiration cytology of tumors at various body sites.
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Uterine perforation and embedding by intrauterine device: evaluation by US and hysterography.
Uterine perforation and deep embedding by an intrauterine device (IUD) require exact determination of its location as a necessary step to safe and effective retrieval. Six cases of uterine perforation and four of embedding by an IUD were studied with ultrasonography (US) and hysterography. While US findings suggested the correct diagnosis of perforation in five of the six cases, hysterography yielded more exact diagnostic information. Deep embedding could only be diagnosed with hysterography. A classification of the types of perforation and an algorithm for diagnosing ectopic IUD are presented. Undue reliance on the sonographic appearance of an IUD in the center of the uterine image may lead to hazardous attempts at transvaginal removal of a device that is partly intramural. In this study, hysterography offered the most precise diagnostic information.
Sonographically guided percutaneous renal interventional procedures.
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The role of ultrasonography in the diagnosis of the renal mass and impaired renal function.
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The role of technetium-99m iminodiacetic acid (IDA) cholescintigraphy in acute acalculous cholecystitis.
Technetium-99m iminodiacetic acid (IDA) cholescintigraphy was performed in 15 patients with acute acalculous cholecystitis. Fourteen of the 15 patients with acute disease had positive findings, indicating the presence of cystic duct or common duct obstruction. One case in which the gallbladder was visualized failed to respond to sincalide stimulation; this was classified as a suggestive finding of disease. The diagnostic accuracy of 99mTc-IDA cholescintigraphy was far superior to the other imaging studies used (8 sonograms, 1 intravenous cholangiogram, 3 oral cholecystograms, 1 percutaneous transhepatic cholangiogram). The 99mTc-IDA study is recommended as the imaging procedure of choice for examining patients with suspected acute acalculous cholecystitis.
Uremic renal cystic disease: value of sonographic screening.
A high incidence of bilateral cystic disease occurs in patients who have uremia of chronic renal disease that is being treated by intermittent hemodialysis. Complications of uremic cysts include cyst rupture, cyst hemorrhage, and the development of solid adenomatous or adenocarcinomatous lesions. Obtaining screening sonograms of the native kidneys of patients who have undergone transplantation and of the kidneys of patients who are receiving treatment by hemodialysis may be justified as a baseline for the routine monitoring of these high risk patients.
The sonographic appearance of segmental polycystic kidney.
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A new method for massive fluid resuscitation in the trauma patient.
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