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Biomedical subjects

S K Teplick

Publications and source records attributed to S K Teplick.

At least 73 records · Page 4Linked to original sources
PubMed1984

Diffuse lymphoid follicles of the colon associated with colonic carcinoma.

In four patients aged 59-75 years, colonic carcinoma was associated with diffuse lymphoid follicles in the colon. In one case, the prominence and distribution of the lymphoid follicles corresponded to the progression and regression of the tumor bulk. It is extremely unusual to demonstrate lymphoid follicles, particularly diffuse, on barium enema in patients in this age range. The colonic carcinomas and lymphoid follicles are directly related, possibly representing an immune response.

Aged↗
PubMed1983

Use of computed tomography to assess mediastinal complications after median sternotomy.

Thirty computed tomographic (CT) scans from 27 patients who had undergone median sternotomy were reviewed. A control group of 15 asymptomatic patients was studied either early (within 21 days) or late (46 days to 22 years) after sternotomy. Twelve patients with symptoms ranging from sternal click to obvious mediastinitis also were studied within 30 days of sternotomy. The CT findings were correlated with the patient's clinical course. Imperfect sternal closure (sternal step-offs and gaps) was found in 10 of the 15 asymptomatic patients. Focal retrosternal fluid collections, air, and hematomas were seen in more than 75% of the asymptomatic patients. Retrosternal abscess, presternal abscess, and sternal disruption were noted in 3 symptomatic patients. Computed tomography correctly diagnosed the extent of mediastinal abscess in all patients. In the 3 patients in whom there was a discrepancy between the CT scan and the clinical findings, the scan ultimately was shown to be correct. These results indicate that computed tomography is a valuable tool in diagnosing wound problems after sternotomy because it accurately depicts the extent and depth of the wound infection.

Adult↗
PubMed1983

CT Identification of postlaminectomy pseudomeningocele.

A postlaminectomy pseudomeningocele is a spherical, fluid-filled space with fibrous capsule lying dorsal to the thecal canal in the laminectomy opening that occasionally develops after surgery. Eight cases were found in 400 symptomatic postlaminectomy patients undergoing computed tomographic examination. The contents are of cerebrospinal fluid density and may or may not have demonstrable communication with the subarachnoid space. Whether they are the cause of symptoms is conjectural; none of these eight patients had surgical removal.

Adult↗
PubMed1983

Computed tomography of the normal sternum.

The normal CT anatomy of the sternum was studied in 35 patients. In addition to the normal appearance of the sternum, normal variants that may mimic disease were often noted. In the manubrium, part of the posterior cortical margin was unsharp and irregular in 34 of 35 patients. Part of the anterior cortical margin was indistinct in 20 of the 35 patients. Angulation of the CT gantry to a position more nearly perpendicular to the manubrium improved the definition of the cortical margins. The body of the sternum was ovoid to rectangular and usually had sharp cortical margins. Sections through the manubriosternal joint and xyphoid often demonstrated irregular mottled calcifications and indistinct margins again simulating bony lesions. The rib insertions, sternal clavicular joints, and adjacent soft-tissue appearance also were evaluated.

Adolescent↗
PubMed1983

Complications of median sternotomy: computed tomographic evaluation.

Complications of median sternotomy are infrequent (0.5%-5%) but have a very high mortality and morbidity. Conventional radiographic techniques are of limited value in assessing these complications. Twenty sternotomy patients without problems and 12 with clinical problems were studied with CT. In the control group, focal edema, focal hematomas, and minor sternal irregularities were universal. In the problem group, CT was able to distinguish the six patients without significant infection from the six with major infections. In the latter group, CT was of great value in determining whether the infection was limited to the presternal tissues, the anterior mediastinum, or both.

Abscess↗
PubMed1983

Computed tomography in acute cardiopulmonary disease.

This article reviews how CT will supplement or replace other diagnostic studies and evaluate patients with postoperative problems, posttraumatic problems, acute medical disorders, and iatrogenic complications.

Acute Disease↗
PubMed1983

Multiple infectious esophageal fistulae.

Acquired fistulous communication between the respiratory tract and the esophagus in the adult are most often posttraumatic or secondary to malignant disease. Infectious fistulae, although uncommon, have been described secondary to primary esophageal, mediastinal, or pulmonary processes. Because of better mucosal definition, double contrast esophagography may help determine the origin of the communication and therefore aid in the differential diagnosis. In addition, near-maximal esophageal distension may demonstrate additional fistulae, which if widely separated, suggest an infectious etiology. To our knowledge, no examples of multiple esophagopulmonary communications have been reported in the English literature. We report two such cases in which the barium study correctly predicted an infectious etiology.

Adult↗
PubMed1982

Percutaneous nephrostomy in a child with obstructive uropathy.

The advantages of percutaneous nephrostomy include (1) achieving rapid, safe drainage of an obstructed collecting system with use of local anesthesia and sedation rather than general anesthesia, and (2) facilitating use of antegrade pyelography under fluoroscopic guidance to determine the cause of the obstruction. In addition, during temporary diversion the functional status of the obstructed kidney can be evaluated. If function is adequate, a pyeloplasty or reimplantation of a ureter may supplant nephrectomy. Use of percutaneous nephrostomy is a relatively new technique for treatment of obstructive uropathy in children. In the case reported here of an 8-year-old girl with a duplicated right collecting system and distal obstruction of the upper pole ureter, the procedure offered a rapid and safe alternative to surgical insertion of a nephrostomy tube.

Child↗
PubMed1982

The right mid-lung window.

On conventional chest radiographs, an area of diminished vascularity usually indicates focal disease. On CT scans of the chest, however, there is often a focal vascular deficiency in the right mid-lung that appears to be normal. In a study of 50 patients, diminished vascularity was noted at the level of the bronchus intermedius on 92% of the scans. The anatomical basis for this finding is discussed.

Adolescent↗
PubMed1982

Iatrogenic esophageal-pleural fistula: subtlety of diagnosis in the absence of mediastinitis.

Seven patients with iatrogenic esophageal-pleural fistulas are described, and the differences in radiographic and physical findings in these patients and in patients with esophageal perforation with mediastinitis are emphasized. Radiographic findings in patients with esophageal pleural fistulas are pneumothorax, hydropneumothorax and localized pneumonitis. These fistulas can mimic other inflammatory supradiaphragmatic or infradiaphragmatic processes. Clinical and radiographic signs may be subtle, and active investigation is needed to establish the diagnosis of esophageal-pleural fistula in patients who have undergone esophageal manipulation.

Adult↗
PubMed1982

In vitro dissolution of gallstones: comparison of monooctanoin, sodium dehydrocholate, heparin, and saline.

A new gallstone solvent, monooctanoin, was tested in vitro on gallstones from 43 patients and compared with heparin, sodium dehydrocholate, and saline. Monooctanoin proved to be an excellent solvent, far superior to the other agents. It can completely dissolve or substantially reduce the size of most gallstones (except those composed of bilirubinate) in a relatively short time. Monooctanoin has been used on the bile duct stones in humans with favorable results. It can often eliminate the need for basket extraction of retained bile duct calculi. Potentially, it may be used to dissolve bile duct or gallbladder calculi in patients who are poor surgical risks.

Caprylates↗
PubMed1982

Glycogenic acanthosis of the esophagus.

A nodular appearance of the esophageal mucosa was observed in 28.3% of 300 consecutive double-contrast esophagrams. This most commonly appeared as numerous uniformly sized, usually less than 3 mm, subtle, round elevations involving the entire esophageal surface. When carefully performed, endoscopy will almost always confirm these findings. Endoscopic biopsies performed in 10 patients demonstrated the nodules to represent glycogenic acanthosis--a combination of cellular hyperplasia and increased cellular glycogen. The radiographic appearance of these nodules, while usually characteristic, may vary and they may simulate pathologic processes, particularly moniliasis. Distinction can usually be made by clinical and radiologic criteria. Although the etiology is unknown, this seems to be of no clinical significance.

Adult↗