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S G Gerzof

Publications and source records attributed to S G Gerzof.

53 records · Page 3Linked to original sources

Further observations on the medical efficacy of computed tomography of the chest and abdomen.

A review of 262 consecutive 2-second CT scans (101 thoracic and 161 abdominal) revealed that 36% contributed information critical to diagnosis, prognosis or therapy. As a result of CT-derived data, major surgery was cancelled in 16 cases and planned surgery modified in 11. Similarly, CT contributed to treatment planning in 20 instances. Forty-four per cent of the studies produced new information but did not have definite clinical impact. Marked improvement in efficacy is noted when these data are compared to our previous study of 2 1/2-minute CT examinations. The improvement is ascribed to better imaging (faster scan speed), improved diagnostic skill, better patient selection, and improved credibility of CT-derived data.

Adenoma, Islet Cell↗

Percutaneous catheter drainage of abdominal abscesses guided by ultrasound and computed tomography.

Ultrasonography and computed tomography were used to diagnose, localize, and guide the percutaneous drainage of 24 intraabdominal and retroperitoneal abscesses in 23 surgical and medical inpatients 16 of whom had abscess formation as a postoperative complication. On the basis of anatomic detail from sectional imaging, safe percutaneous drainage routes similar to surgical approaches were defined. After confirmation by needle aspiration, one of two methods of percutaneous catheter introduction were used: (1) a modified Seldinger technique for placement of an 8 French pigtail catheter and (2) a trocar catheter technique for placement of a 12 or 16 French catheter. Once in position, the catheters were managed as a surgically placed drain. In 22 of 24 cases, percutaneous catheter drainage was curative with no surgery required. There were no deaths or recurrences with an average follow-up period of 12 months ranging from 1 week to 3 years. Percutaneous aspiration and drainage should be considered as an alternative to surgery in the treatment of intraabdominal or retroperitoneal abscess.

Abdomen↗

Morphology and pathogenesis of adrenal cysts.

Adrenal cysts represent a rare condition (approximately 250 cases have been reported). We report two additional cases: the first involved a huge lesion removed surgically and thoroughly studied preoperatively; the second was an incidental autopsy finding. Detailed ultrastructural studies have been made of both cases. We think that the basic cell of origin of the cyst is an endothelial cell lining lymphatic channels. We speculate that the pseudocysts, which have been described as having a fibrous lining, probably were at one time also lymphendothelial but, perhaps due to trauma or repeated bleeding, the major portion of the endothelial lining became replaced by collagen. The primary and secondary cystic malignancies and cases of cysts due to parasites should be classified separately from the adrenal cysts of lymphendothelial origin which probably represent a benign tumor-like overgrowth.

Adrenal Gland Diseases↗

Computed tomography in the diagnosis and management of abdominal abscesses.

Computed tomography (CT) is effective in demonstrating abdominal abscesses and their relation to surrounding structures. The CT signs of abscess are not unlike those demonstrable radiographically and include an abnormal mass, obliteration and displacement of surrounding organs, inappropriate gas, and peripheral enhancement after intravenous contrast. Axial imaging permits selection of safe approaches through which percutaneous needle aspiration can be performed for diagnosis and therapy. When techniques similar to those employed in angiography are used, a catheter can be inserted, the abscess evacuated, and the catheter left in place as a drain. Combined with intravenous antibiotics, this method of abscess drainage has been successful in curing abscesses without surgery. Representative examples are shown.

Abscess↗

Observations on the medical efficacy of computed tomography of the chest and abdomen.

In a retrospective study of 687 computed tomographic (CT) examinations of the chest and abdomen performed over a 1 year period, 16% of the examinations produced information not otherwise available which altered patient diagnosis, prognosis, or therapy. Sixteen thoracotomies and 18 laparotomies were avoided as a result of information available only from CT examinations. CT was of particular value in the evaluation of mediastinal masses, in the assessment of suspected or proven lung cancer, and in the evaluation of pleural and extrapleural masses. It was of notable clinical value in evaluating patients with intraabdominal abscesses, pancreatic disease, staging of malignancies for radiation therapy and surgery, and excluding the presence of suspected masses.

Abdomen↗

Drip infusion urography with meglumine iodamide.

In a double-blind study of 283 patients (140 given iodamide and 143 diatrizoate), meglumine iodamide 24% produced a significantly greater degree of opacification than meglumine diatrizoate 30% (P less than 0.01 to P less than 0.001) in the renal calyces during the early phase of drip infusion pyelography. The agents were infused at a dose of 4.5 ml/kg, up to a maximum volume of 300 ml, over a period of about 10 min. The incidence and nature of laboratory abnormalities and clinical adverse reactions produced by the drugs were similar. No severe reactions occurred. The apparent superiority of the iodamide solution in the early stage of excretion, despite its lower iodine content, may be due to the partial secretion of iodamide by the renal tubules, as observed in other studies.

Adolescent↗

Benign transient eosinophilia following intravenous urography.

Eosinophilia, a component of the allergic response, may occur after the use of iodinated radiographic contrast media for intravenous urography. A benign transient elevation in differential eosinophil count was seen in 21 of 101 patients following the injection of iodinated contrast agents for that purpose.

Diatrizoate↗

New applications of old radiographic techniques applied to computed tomography.

Established techniques of routine radiography can be applied to a computed tomography (CT) examination of the body. The planned use of various positive and negative contrast agents placed intravascularly and intraluminally can yield important information not otherwise obtainable. When purposefully combined with selected positions, these agents allow the radiologist to tailor a CT examination to a specific clinical problem. Several combinations of these modalities which have been found useful in CT of the body, are described.

Aortic Aneurysm↗

Double-blind comparison of meglumine iodamide and Renografin-60 for excretory urography.

A double blind comparison of meglumine iodamide and Renografin-60 in bolus intravenous pyelography, using 50 ml of contrast or less, was conducted in 78 patients. Meglumine iodamide produced more dense opacifications, but it also produced a greater number of laboratory abnormalities. All were transient and mild. No serious abnormalities resulted from the use of either agent.

Adult↗

Relationships between computed tomography tissue areas, thicknesses and total body composition.

Computed tomography (CT) scanning was evaluated for its potential application to body-composition research. Three cross-sections (upper leg, abdomen, chest including upper arms) were scanned in 41 healthy men (mean age 57.6 years). Subcutaneous fat thicknesses measured at specific sites on the CT scans were correlated with the total area of fat from the same scans. For the chest and leg cross-sections, correlations were highly significant. Subcutaneous fat thicknesses at the abdomen were relatively poorer correlates of total abdomen fat area, because they were unrelated to intra-abdominal fat. Correlation analyses were performed between fat areas of each cross-section and total fat weight (by 40K counting), and the abdomen yielded the highest correlations. Multiple regression was used to predict abdomen fat area from external anthropometry, and abdomen circumference plus one skinfold provided excellent prediction of total abdomen fat area (R2 = 0.79). Subcutaneous or intra-abdominal fat areas separately were not predicted as well by external measurements. When lean body weight was predicted by multiple regression, leg lean area was the best predictor of any anatomical cross-section.

Adipose Tissue↗

CT appearance of appendicitis and its local complications.

During evaluation for occult fever or nonspecific abdominal pain CT will occasionally identify inflammatory disease of the appendix as the underlying cause. In these cases CT may also provide useful information about the presence of associated mesenteric inflammation, abscess, or perforation. Five cases are presented in which CT provided clinically useful information supplementing that gained from barium studies and clinical presentation. When a periappendiceal lesion is found, the extent and nature of inflammatory changes are shown directly rather than inferentially.

Abscess↗

Problems in CT diagnosis of ruptured abdominal aortic aneurysms.

In a review of 17 cases in which the CT diagnosis of abdominal aortic aneurysm rupture was prospectively made and for which surgical correlation was available the CT diagnosis was correct in 10 and incorrect in seven. Two of the false positives were retrospectively reinterpreted as negative for rupture. Characteristics of 10 surgically confirmed cases revealed a spectrum of appearances not always in agreement with prior published reports, probably due to the age and magnitude of the aortic leaks at the time of diagnosis. The most common characteristic of aneurysm leak (eight of 10 cases) was an abnormal soft tissue collection located adjacent to the posterior aspect of the aneurysm, a sign not previously emphasized in other reports. Renal displacement was also a valuable sign but was present in only three cases, all of which had large hemorrhages. Other characteristics of aortic rupture such as density of the collection and sharpness of its margins were not found to be generally useful.

Aorta, Abdominal↗