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Biomedical subjects

S Kaminsky

Publications and source records attributed to S Kaminsky.

At least 19 recordsLinked to original sources
PubMed2000

Amniocentesis for selection before rescue cerclage.

OBJECTIVE: To determine whether diagnostic amniocentesis should be part of evaluations of women under consideration for rescue cerclage. METHODS: We reviewed the obstetric records of 25 candidates for rescue cerclage seen between June 30, 1995, and July 1, 1997. Rescue cerclage was defined as a procedure on a cervix with an internal os dilated at least 2 cm and 50% effaced, with membranes visible at the external os. Transabdominal amniocentesis was offered as part of the preoperative evaluation, and amniotic fluid (AF) was sent for glucose and lactate dehydrogenase level determinations, Gram staining, and culture for aerobic and anaerobic bacteria. Placentas were examined for histopathologic evidence of inflammation. The women were divided into three groups. Eleven women had rescue cerclage after amniocentesis, seven had rescue cerclage after declining amniocentesis, and seven had amniocentesis but were treated conservatively because of AF markers of infection. Analysis of variance and chi(2) statistics were used. RESULTS: The group that had rescue cerclage after amniocentesis had a significantly longer mean admission-to-delivery interval, higher mean gestational age at delivery, higher mean birth weight, and higher neonatal survival rate than did the group that had rescue cerclage without amniocentesis and the group that had no cerclage after amniocentesis (P <.001). CONCLUSION: Amniocentesis before rescue cerclage placement identified women with subclinical chorioamnionitis who would not benefit from cerclage.

Abortion, Spontaneous↗
PubMed1997

Is ultrasonography a reliable way to confirm the diagnosis of Morton's neuroma?

The diagnosis of Morton's neuroma is based on patient history and clinical findings. Occasionally, however, the diagnosis still remains in doubt despite careful examination. While magnetic resonance imaging (MRI) has been used to evaluate such cases, its specificity remains unproven and its availability is not universal. Ultrasonography may offer a reasonable alternative to MRI. Eight patients clinically diagnosed with neuromas who had not responded to conservative care underwent ultrasonography. Sonography in each demonstrated a round or oval echogenic mass where a neuroma was believed to be present. Sonography on a control group of 10 asymptomatic patients (20 feet) revealed no such mass. Pathologic inspections of surgically resected specimens confirmed the diagnosis of Morton's neuroma. With no false positive results, this preliminary study indicates ultrasonography may be a specific diagnostic test for Morton's neuroma.

Adult↗
PubMed1994

[A comparison of positive and negative enteral contrast media for the magnetic resonance tomography of the abdomen].

Following oral administration of a buffered gadopentetate-dimeglumine solution (Magnevist enteral, 1 mmol/l, 6-17 ml/kg) T1-, proton-density- and T2-weighted spin-echo images of abdominal and retroperitoneal lesions were acquired (0.5 T). Gadopentetate is a signal-enhancing, positive MR contrast agent, intraluminal air served as a model of a signal-free, negative agent. In 21 patients contrast/noise ratios of gadopentetate and air versus lesions and fat were compared quantitatively (t-test). In T1- and T2-weighted images contrast/noise ratios of gadopentetate versus lesions were significantly higher than those of air. In proton-density images there was no significant difference. In T1- and proton-density images contrast/noise ratios of air versus abdominal fat were significantly higher than those of gadopentetate, in T2-weighted images gadopentetate had a significantly higher contrast/noise ratio than air. Signal-enhancing positive contrast agents seem advantageous over signal-free negative enteral MR contrast agents.

Abdomen↗
PubMed1993

A treatment algorithm for neuropathic (Charcot) midfoot deformity.

Forty-nine feet in 47 patients with midfoot neuropathic foot deformity were referred for care to a comprehensive foot salvage clinic and followed for an average of 3.6 years. Twenty-three initially presented without open ulcers. Two underwent elective Syme's ankle disarticulation amputation, and the others were kept ambulatory with a combination of periods of nonweightbearing cast immobilization, accommodative extra-depth shoes with custom orthotics, and ankle-foot orthoses. Twenty-six of the feet initially presented for care with open ulcers and/or chronic osteomyelitis. Twenty-two of these patients underwent 32 surgical procedures. Sixteen underwent debridement of the infected bone and surrounding soft tissues. Excision of large, nonaccommodative boney prominence, termed exostectomy, was performed in eight. Partial excision of the deformed midfoot combined with boney stabilization and attempted arthrodesis, termed partial tarsectomy, were performed in seven. All surgical patients were managed postoperatively with long-term custom accommodative bracing. Follow-up at an average of 3.6 years revealed that all but one of the patients remained ambulatory. Six walk with accommodative shoe gear and persistent stable chronic open ulcers. None required below-knee amputation. Five amputations were performed, three at the Syme's ankle disarticulation level, one at the Chopart's hind-foot level, and one at the mid-foot level.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Oral contrast media for the magnetic resonance tomography of the abdomen. A clinical trial of the tolerance for gadolinium-DTPA].

Safety and efficacy of gadopentetate-dimeglumine (Gd-DTPA) as a MR bowel contrast agent were determined in 133 patients with CT-proved abdominal and retroperitoneal mass lesions using a buffered formulation (1 mmol/l Gd-DTPA, 15 g/l mannitol, 25 mmol/l sodium-citrate, 6-17 ml/kg). Short-lived gastrointestinal side effects were noted in 32% of patients. Gd-DTPA provided uniform, hyperintense bowel labelling and contrast enhancement in the region of interest in 81% of patients. Among 78 patients with pre- and postcontrast images lesion delineation was improved in 62%. In 55 studies with postcontrast images only, Gd-DTPA proved useful in 65%. In 105 of 109 cases IV injection of scopolamine or glucagon eliminated image artifacts arising from peristalsis of opacified bowel. The authors conclude that Gd-DTPA is a safe and effective MR bowel contrast agent.

Abdomen↗
PubMed1992

[Bladder tumors--Magnevist-assisted magnetic resonance tomography].

Magnetic resonance imaging (MRI, Magnetom 0.5 Tesla) using a high-resolution surface coil was performed on 10 healthy volunteers, 16 patients with bladder tumours, 2 patients with cystitis and 15 patients with bladder tumours and cystitis. Lesion delineation versus urine, bladder wall and surrounding organs was evaluated in plain and contrast-enhanced (IV Magnevist, 0.1 mmol/kg) T1-weighted, plain proton-density and T2-weighted spin-echo images. Surface-coil MRI proved very sensitive since all lesions were found in plain scans. Cystitis and 27 of 31 tumours exhibited contrast enhancement, however, differentiation of tumours and cystic lesions was not improved. Plain T2 and contrast-enhanced T1-weighted images demonstrated bladder wall disruption and perivesical tumour spread with equal sensitivity. Post-contrast images permitted unequivocal visualisation of perivesical tumour spread in surrounding peritoneal fat. The authors conclude that T2-weighted imaging may be restricted to non-enhancing bladder tumours thus significantly reducing imaging time.

Aged↗
PubMed1991

[Gadolinium-DTPA as an oral contrast medium for magnetic resonance tomography of the pancreas].

52 patients with normal pancreas, pancreatitis and pancreatic tumors were examined by magnetic resonance imaging (Magnetom 0.5 T). Using T1-, proton density- and T2-weighted spin-echo sequences images were obtained before and after oral administration of Gadolinium-DTPA (Gd-DTPA, 1 mM, 15 g/l Mannit, 5-13 ml/kg). Gd-DTPA resulted in hyperintense labeling of small bowel in all sequences and improved visualization of pancreatic head, body and tail in 15, 14 and 7 of 27 patients with normal pancreas and in 17, 8 and 6 of 25 patients with diseased pancreas. Better delineation of pseudocysts and tumorous gut wall invasion were diagnostically profitable. With regard to motion artifact reduced MRI of the intestine using fast sequences Gd-DTPA may be a suitable oral contrast agent to improve the imaging of the pancreas.

Administration, Oral↗
PubMed1991

Gadopentetate dimeglumine as a bowel contrast agent: safety and efficacy.

To determine the safety and efficacy of gadopentetate dimeglumine as a bowel contrast agent, magnetic resonance (MR) imaging (0.5 T) was performed with a formulation of gadopentetate dimeglumine (1.0 mmol/L of gadopentetate dimeglumine, 15 g/L of mannitol, 6-17 mL/kg) in 133 patients with intraabdominal mass lesions. Mostly short-lived gastrointestinal side effects were noted in 32% of patients. Gadopentetate dimeglumine provided uniform hyperintense marking of the bowel and contrast enhancement in the region of interest in 81% of patients. Among 78 patients with images obtained both before and after administration of contrast material, post-contrast improvement of lesion delineation was found in 62%. Among 55 patients with only postcontrast images, gadopentetate dimeglumine proved useful in 65%. Intravenous injection of scopolamine or glucagon effectively eliminated "ghost" images of the opacified bowel in 105 of 109 cases. The authors conclude that gadopentetate dimeglumine is a safe and effective bowel contrast agent for MR imaging.

Adolescent↗
PubMed1991

Effects of maternal undernutrition and uterine artery ligation on placental lipase activities in the rat.

Lipase activities measured at pH 4 and 8 were determined in the placentas of rats subjected to undernutrition or uterine artery ligation. The fetal lipid content following maternal undernutrition was also determined. The placental lipase activity (per gram placenta) measured at pH 8 (placental lipoprotein lipase) remained unchanged, whilst the activity of the intracellular lipase (per gram placenta) measured at pH 4 was significantly less than in the control group (21% lower in maternal undernutrition and 16% lower after uterine artery ligation). Although placentas and fetuses were significantly lighter in both situations as compared to controls (well-nourished or sham operated, respectively), fetal lipid content in maternal undernutrition was only reduced to a degree concomitant with the decrease in fetal weight. We therefore conclude that the intracellular lipase may not have an important role in the provision of free fatty acids in undernutrition.

Animals↗
PubMed1991

The effects of diabetes on placental lipase activity in the rat and human.

Lipase activities were measured at pH 4 and pH 8 in the placentas of rats made diabetic by streptozotocin treatment and also in the placentas of women classified as having 1) impaired glucose tolerance or type 2 diabetes, 2) type 1 diabetes with no associated vascular complication, and 3) type 1 diabetes with associated vascular disease. In both sets of experiments, the placentas were compared with normal control groups. The placental lipase activity measured at pH 8 was not significantly different in either streptozotocin-treated rats or impaired glucose tolerance/diabetic women as compared with controls, whereas the lipase activity measured at pH 4 increased significantly as compared with controls in both species. Furthermore, in the women there was a significant correlation between placental lipase activity at pH 4 and birth weight in impaired glucose tolerance/type 2 diabetes. It is suggested that the increased placental lipase activity may contribute to the increased fetal weight in human diabetic pregnancy, by contributing to the increased fat transfer across the placenta from mother to fetus.

Animals↗
PubMed1991

[Value of magnetic resonance tomography in gastroenterological diagnosis].

The value of magnetic resonance imaging (MRI) in the gastrointestinal tract has not yet been determined. In neoplastic disease, MRI has a high sensitivity in the detection of liver metastases secondary to colorectal cancer. MRI is superior to CT in differentiating recurrent rectal cancer from fibrosis. The high sensitivity of MRI in the detection of fistulae in Crohn's disease and the differentiation from fibrosis represents an advantage over other modalities in imaging of inflammatory bowel disease. Further development of MRI and the use of contrast media for both oral and intravenous administration may offer new perspectives of MRI in diseases of the gastrointestinal tract.

Gastroenteritis↗
PubMed1989

[Gadolinium-DTPA as an oral contrast medium in magnetic resonance tomography].

80 patients with tumorous or inflammatory abdominal diseases were investigated with the paramagnetic MRT contrast medium Gadolinium-DTPA (Gd-DTPA, 1 mM, 15 g/l mannitol, 6-16 ml per kg body weight) at 0.5 Tesla with T1-, proton density and T2-weighted SE- and gradient-echo sequences. 53 patients were investigated also before the contrast medium was given. Gd-DTPA showed hyperintense labelling of the intestinal loops that was detectable with all excitation sequences and was constant over all phases of the passage. In 35 of the 53 patients investigated before and after application of Gd-DTPA lesions were better imaged while diagnostic improvements, especially for smaller lesions, were achieved in 5 of 80 patients. One third of the patients reported slight meteorism and diarrhoea after the mannitol-containing suspension.

Administration, Oral↗
PubMed1988

[Oral contrast media for magnetic resonance tomography of the abdomen. III. Initial patient research with gadolinium-DTPA].

32 patients with abdominal tumours or inflammatory abdominal diseases were examined by MRI (0.5 T) prior to and after oral administration of gadolinium-DTPA (Gd-DTPA). T1- and T2-weighted sequences were employed. 10 ml/kg body weight of a Gd-DTPA formulation were administered (1.0 mmol/l, 15 g mannitol/l). Gd-DTPA provided markedly hyperintensive opacification of the gastrointestinal tract. In 19 of 32 studies Gd-DTPA-enhanced scans showed improved delineation of abdominal pathologies. In most cases Gd-DTPA-enhanced T1-weighted multislice gradient echo images provided the most useful diagnostic result. Meteorism and diarrhea were recorded in 13 patients.

Abdomen↗
PubMed1988

Human gastric lipase. Effects of fatty acid and bovine serum albumin on in vitro activity.

Lipase activity was determined in gastric juice obtained from newborn babies who were fed formula milk (180 ml/kg/day). Samples of gastric juice collected 3 h after a feed were pooled and incubated with bovine serum albumin (BSA). The incubation mixtures containing milk fatty acids (750 nmol/tube) and BSA (0-5%) showed maximal lipase activity (as measured by the liberation of radiolabelled fatty acid from radiolabelled triglyceride) with 1.87% BSA in the first 60 min, but at subsequent time intervals higher enzyme activities were observed with 2.5 and 5% BSA. After extracting milk fatty acids from gastric juice the effects of BSA and sodium oleate on lipase activity were studied. The addition of BSA appeared to inhibit the enzyme, but when sodium oleate was included in the incubating system there was either stimulation or inhibition of lipase activity. A dual effect of BSA (i.e. stimulatory or inhibitory) was observed depending on the relative amounts of BSA and fatty acid present in the incubation tube. It is suggested that 1.87-5% is the optimum concentration range of BSA for the determination of lipase activity in gastric juice, in the presence of 250-500 nmol of fatty acid.

Animals↗
PubMed1988

[Visualization of multiple neurofibromas using gadolinium-DTPA assisted MRT: a case report].

Although magnetic resonance imaging has a high sensitivity for cerebral and spinal tumors, demonstration of small lesions can be difficult. In a patient with multiple extra- and intraspinal tumors due to neurofibromatosis generalisata, the use of the MRI contrast agent Gadolinium-DTPA resulted in a better differentiation especially of small lesions. High tumor contrast facilitated a safe localisation of the widespread disease using a fast imaging sequence (FLASH).

Adult↗
PubMed1987

[Oral contrast media for magnetic resonance tomography of the abdomen. 1. Comparative animal studies of positive and negative contrast media].

Beagle dogs were investigated by MRI (Siemens Magnetom, 0.35 T) after oral administration of aqueous solutions of Gd-DTPA (n = 4), ferric ammonium citrate (n = 1), and magnetite dextran (n = 2). High signal intensity of the GI-tract versus adjacent structures was obtained with Gd-DTPA and ferric ammonium citrate. Magnetite showed negative contrast versus adjacent structures. However, magnetite displayed lower contrast relative to liver, muscle and gut wall compared to Gd-DTPA and ferric ammonium citrate. In relatively T2-weighted sequences labeling of poorly filled bowel loops was significantly better with Gd-DTPA and ferric ammonium citrate. For GI-tract contrast enhancement we conclude that positive contrast media are of higher diagnostic value compared to negative contrast agents.

Abdomen↗