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Biomedical subjects

R S Shapiro

Publications and source records attributed to R S Shapiro.

At least 127 records · Page 7Linked to original sources
PubMed1965

Pollen and mold spores. An atmospheric and field survey in Los Angeles.

A two-year survey of pollen and mold spores by the gravity slide method revealed that there are no clear-cut tree, grass or weed pollen seasons in California. Pollen counts should be correlated with field studies to distinguish the various plants whose pollen have a similar appearance. Spores of Alternaria and Hormodendrum, whose importance in allergic disease of the respiratory tract has been well established for many years, were found all during the year. More hormodendrum spores were collected than the total of all other pollens combined.

California↗
PubMedDate not supplied

Abscess formation as a late complication of dropped gallstones.

We describe a case of abscess formation 1.5 years postoperatively in a patient with dropped gallstones from laparoscopic cholecystectomy. The entity was initially recognized on computed tomography (CT) and the diagnosis was confirmed with ultrasound. Although this is a rare complication of laparoscopic cholecystectomy, it should be recognized as a potential source of abscess formation even in a patient presenting months after the procedure.

Cholecystectomy, Laparoscopic↗
PubMedDate not supplied

Cryotherapy of metastatic carcinoid tumors.

BACKGROUND: To describe the use of hepatic cryotherapy to treat patients with symptomatic carcinoid metastates. METHODS: Hepatic cryotherapy was performed on five patients with carcinoid syndrome resulting from metastatic carcinoid tumors. Intraoperative ultrasound was used to guide the cryotherapy and to assess the adequacy of freezing. RESULTS: All five patients had relief of the carcinoid syndrome after treatment. In four of the five patients, the relief was prolonged (>3 months); in one patient, the relief of symptoms was transient (2 months). Four of five patients had a transient reduction in hormonal tumor markers (the fifth patient did not have hormonal-level follow-up). During a follow-up period of 2.5 years, four of the five patients died. The 6-month survival rate was 80%, the 1-year survival rate was 60%, the 2-year survival rate was 40%, and the 2.5-year survival was 20%. One patient is alive 30 months after treatment. CONCLUSION: Hepatic cryotherapy can provide symptomatic relief for patients with hepatic metastates producing the carcinoid syndrome.

Aged↗
PubMedDate not supplied

Liver transplant rejection: value of hepatic vein Doppler waveform analysis.

BACKGROUND: To determine whether abnormal hepatic vein Doppler tracings can be used to predict liver transplantation rejection. METHODS: A total of 158 hepatic vein Doppler tracings were obtained on 93 postliver transplant patients (63 patients without rejection and 30 patients with biopsy-proven rejection). Hepatic vein Doppler tracings were scored according to an established grading system (0 = normal triphasic waveform, 1 = dampened waveform, with loss of flow reversal, 2 = completely flat waveform). The hepatic vein Doppler tracings were then correlated with biopsy findings. RESULTS: In the group of 63 patients without rejection, 124 Doppler examinations were performed and graded as follows: 0 = 87 (70%), 1 = 31 (25%), and 2 = 6 (5%). In the group of 30 patients with biopsy-proven rejection, 34 Doppler examinations were performed and graded as follows: 0 = 16 (47%), 1 = 14 (41%), and 2 = 4 (12%). The sensitivity of abnormal hepatic vein Doppler tracings for detection of rejection was 53% and the specificity was 70%. The positive predictive value of an abnormal hepatic vein Doppler tracing was 33% and the negative predictive value of a normal Doppler tracing was 84%. CONCLUSIONS: Abnormal hepatic vein Doppler tracings are observed in patients with and without liver transplant rejection. Abnormal tracings cannot be used to predict liver transplant rejection.

Adolescent↗
PubMedDate not supplied

Portal vein velocities measured by ultrasound: usefulness for evaluating shunt functioning following TIPS placement and TIPS revision.

BACKGROUND: To assess the usefulness of following portal vein velocities by Doppler ultrasound in evaluating shunt functioning after transhepatic intrajugular portosystemic shunt (TIPS) placement and revision. METHODS: We retrospectively analyzed 39 patients who underwent a TIPS procedure in the preceding 4 years. Portal vein (PV) velocities were measured by Doppler ultrasound before and after TIPS insertion and revision and were correlated with portosystemic gradients (PSG) measured at angiography. RESULTS: Mean PV velocities increased from 18 +/- 6 cm/s before TIPS placement to 50 +/- 21 cm/s (p < 0.001) after TIPS placement, with corresponding decrease of mean PSG from 20 +/- 6 to 8 +/- 3 mmHg (p < 0.001). Mean PV velocities significantly increased from 24 +/- 6 to 43 +/- 14 cm/s after TIPS revision (p < 0.02), with decrease of PSG from 17 +/- 6 to 9 +/- 5 mmHg (p < 0.05). A significant correlation was found between all PV velocities and their corresponding PSG (Spearman r < 0.61, p < 0.001). CONCLUSION: PV velocities significantly correlate with changes in PSG. Following portal vein velocities by ultrasound is useful for early evaluation of shunt functioning following TIPS.

Angiography↗
PubMedDate not supplied

Hepatic mass in Budd-Chiari syndrome: CT and MRI findings.

We describe a case of Budd-Chiari syndrome, secondary to a hypercoagulable state, which produced a mass lesion on computerized tomography (CT) and magnetic resonance imaging (MRI) examinations. The mass simulated a tumor, but proved to be an area of hemorrhagic necrosis upon biopsy. The finding of a space occupying lesion may not always indicate a tumor in a patient with the Budd-Chiari syndrome. The causes, pathologic changes, and radiologic findings of Budd-Chiari syndrome are discussed.

Adult↗
PubMedDate not supplied

Transjugular intrahepatic portosystemic shunt: correlation of portal vein velocity measurements and portosystemic pressure gradients.

To assess the relationship between portal vein velocity measurements and portosystemic gradients, color Doppler sonography was performed on 12 patients before and after transjugular intrahepatic portosystemic shunt placement. An additional patient was examined before and after shunt modification. The average maximum portal vein velocity increased from 15.7 cm s-1 before shunt placement to 43.5 cm s-1 after shunt placement, while the average portosystemic gradient decreased from 22.0 mm Hg before shunt placement to 7.9 mm Hg after shunt placement. Flow was observed within the shunt in 11 of the 12 cases. Shunt velocity was measurable in nine patients, with an average value of 115.7 cm s-1. Reversal of intrahepatic portal vein flow was observed in 10 cases following shunt placement. Color Doppler sonography is a useful non-invasive tool in the evaluation of intrahepatic portosystemic shunts, and changes in portal vein velocity correlate well with changes in the portosystemic gradient.

Blood Flow Velocity↗
PubMedDate not supplied

A 24 year follow up of an isolated lymphangioma of the kidney.

Renal lymphangioma is a rare benign tumor of the kidney. An example is presented which was initially identified by excretory urography, angiography and biopsy. A 24 year follow up included computed tomography. The radiographic findings, pathogenesis and natural history of this unusual tumor are discussed.

Aged↗
PubMedDate not supplied

Case report: MRI of extrapancreatic gastrinoma.

Islet cell tumors are a relatively rare group of neuroendocrine tumors that are often difficult to image preoperatively. We present the magnetic resonance imaging characteristics of an uncommon and unusually large extrapancreatic gastrinoma.

Adult↗
PubMedDate not supplied

Abdominal aortic coarctation: CT, MRI, and angiographic correlation.

Abdominal aortic coarctation is an uncommon entity in the elderly. We present a case of abdominal aortic coarctation with computed tomography (CT), magnetic resonance imaging (MRI) and conventional angiographic correlation. CT and MR imaging detected an abnormal abdominal aorta distal to the origin of the celiac axis with the diagnosis of abdominal aortic coarctation confirmed by conventional angiography. Clinical presentation and diagnostic imaging findings depend on the level of the coarctation and its relationship to the renal vessels.

Aorta, Abdominal↗
PubMedDate not supplied

Renal lymphoma in Castleman's disease.

An unusual case of renal lymphoma occurring in a patient with Castleman's disease is presented. The radiographic features and the relationship to the lymphoproliferative disorders, Castleman's disease, and multicentric angiofollicular lymph node hyperplasia are described.

Adult↗
PubMedDate not supplied

Intrahepatic gas formation without abscess after hepatic artery thrombosis in the setting of liver transplantation.

We present a case in which intraparenchymal hepatic gas was observed in the absence of an abscess. This occurred following hepatic artery thrombosis in the setting of liver transplantation. An analogy is drawn to the postinfarction syndrome seen following therapeutic embolization and intrauterine fetal death. The unique features of the liver transplant and how they relate to the mechanisms of gas formation are discussed.

Adult↗