PubMed Health⌕ Search

Biomedical subjects

S Somers

Publications and source records attributed to S Somers.

At least 55 records · Page 3Linked to original sources

Cow's milk protein/soy protein allergy: gastrointestinal imaging.

Positive radiologic findings were identified in the small and large bowels in three infants with various gastrointestinal manifestations of cow's milk protein/soy protein allergy, which was diagnosed on the basis of clinical features and histologic findings. Small bowel findings were thickened valvulae conniventes (plicae circulares), a ribbon-like ileum, and a thickened bowel wall. Narrowing, thumbprinting, and spasm were seen in the large bowel. These cases were seen at intervals far enough apart to exclude an endemic infection. The diagnosis of food protein allergy should be considered when diffuse small bowel disease or colitis is identified in an infant.

Dietary Proteins↗

Pain during angiography: a randomized double-blind trial comparing ioxaglate and diatrizoate.

We performed a randomized, double-blind prospective study comparing pain experienced during peripheral and aortic angiography with two different contrast agents. Sixty patients, receiving a total of 107 injections, were randomized to receive either ioxaglate (Hexabrix) or sodium-meglumine diatrizoate (Renografin-76). Subjects scored the pain they experienced on a 10-point visual analog scale, and the physician also scored their discomfort on a five point scale. Hemodynamic parameters were monitored during the procedure in all patients, and subsequent hematology, serum chemistry, and urinalysis were performed in 19 of the 60 patients. There was a significant reduction in the degree of pain experienced by the Ioxaglate group compared to the reference group (p less than 0.001). The patients in the Hexabrix group had a mean pain score of 1.3 compared to the patients in the Renografin-76 group who had a mean pain score of 6.1. The two groups did not differ in their hemodynamic responses to the contrast agents, and no significant differences were noted in the subsequent laboratory measures.

Adult↗

Comparison of endoscopy and barium swallow with marshmallow in dysphagia.

Forty-four patients with dysphagia were examined both by endoscopy and by barium swallow with a marshmallow bolus. In these patients 36 stenoses were found: 34 by radiology and 30 by endoscopy. The radiologic criteria for stenosis included arrest of the marshmallow in a manner to support a column of barium and reproduction of the patient's symptoms at the time this occurred. Radiologic false negative findings were partly due to an inability by patients to swallow an adequate marshmallow bolus; endoscopic failures were associated with small endoscopes and mild stenoses.

Barium Sulfate↗

Adult polycystic horseshoe kidney.

Abdominal computed tomography and ultrasonography revealed a horseshoe kidney in a patient with renal failure caused by adult polycystic kidney disease.

Humans↗

Rectal biopsy as a cause of rectal ulceration.

We report three patients in whom the performance of a rectal biopsy produced an ulcer that was found during a subsequent examination (two at double-contrast barium enema examinations and one at colonoscopy). In each case, the iatrogenic ulcers presented an unusual appearance and resulted in the performance of inappropriate follow-up studies.

Adolescent↗

Benign gastric ulcer: a reliable radiologic diagnosis?

A review of 7,600 double-contrast barium-meal studies performed between 1975 and 1981 revealed 221 gastric ulcers reported as benign. The follow-up for 199 of these was adequate and detected no case of carcinoma. The widespread practice of immediate endoscopy and biopsy for all cases of radiologically benign gastric ulcer represents a misuse of expensive medical resources. When a gastric ulcer is demonstrated clearly as benign on double-contrast examination, there is no need for endoscopic confirmation of the diagnosis.

Adult↗

Opportunistic gastritis in graft-versus-host disease.

Two patients underwent bone marrow transplantation and subsequently developed graft-versus-host disease. Barium examination showed a gross nodular pattern in the stomach in one patient, an appearance not previously described. Both patients developed characteristic changes in the small bowel and in one the colon was also affected. The dramatic rise in the patient's cytomegaloviral titers (CMV) and the presence of viral inclusion bodies in gastric cells suggest that the changes in the stomach may be due to a CMV gastritis.

Adult↗

Distribution of gastric ulcers by double contrast barium meal with endoscopic correlation.

The double contrast barium meals and endoscopic examinations of 246 patients with 264 benign gastric ulcers were reviewed with regard to the location of these ulcers. Seventy-four per cent of ulcers were found in the antral portion of the stomach within 7 cm of the pyloric canal. A similar study in the United Kingdom revealed that the majority of ulcers were in the upper body of the stomach. Since true gastric ulcers almost always arise in a pyloric type of mucosa, or in the zone of transition from pyloric to body type mucosa, perhaps this junction zone lies higher in a United Kingdom population than in North Americans. Possibly the higher transition zone and the documented higher frequency of gastric malignancy in the United Kingdom are related.

Barium Sulfate↗

Cigarette smoking and duodenal coating with barium.

A review of two hundred and fifty-eight double contrast barium meal examinations was carried out in a single blind study of the relationship between smoking and the ability to visualize gastric and duodenal mucosal detail. A strong correlation was found between poor duodenal visualization and smoking in the period immediately prior to the examination. Patient compliance with a typed instruction sheet forbidding smoking was found to be poor. It may be possible to improve compliance by including, in the written instructions, an explicit statement that smoking shortly before barium meal examination may cause lesions to be missed.

Barium Sulfate↗

Hypercalcaemia in hospital patients. Clinical and diagnostic aspects.

The relative importance of different causes of hypercalcaemia was studied, and diagnostic tests were evaluated as predictors of the cause of hypercalcaemia. In one year, hypercalcaemia was identified in 166 hospital inpatients. Serum-calcium was below 3.00 mmol/l in 63%. Among 153 patients investigated the commonest cause of hypercalcaemia was malignancy (89 cases), especially breast and bronchial tumours. 75% of the 89 patients had obvious metastases at presentation. 51 patients had primary hyperparathyroidism: their symptoms were non-specific and only 20% had renal stones. Other causes of hypercalcaemia were rare (9% of patients seen). Of patients with no diagnosis initially, 64% had hyperparathyroidism and 32% malignancy, but this was demonstrated early in the illness. Serum phosphate and chloride and acid/base status were unsatisfactory as diagnostic tests; multivariate analysis was more discriminating overall, but incorrect classification was still a significant problem.

Calcium↗

Inaccuracy of radiographic measurements of colon polyps.

Polyp size is one of the main determinants of the surgical management of polyps in areas without colonoscopy services. We reviewed 47 patients with 59 polyps at two hospitals. Polyp dimensions were measured directly from air contrast barium enema radiographs, and again after resection and fixation. In over 95% of polyps the radiographic size exceeded the pathologic size by 10 to 100%. Since surgery may be decided on the basis of polyp size, an inaccurate measurement may result in unnecessary colonoscopy or laparotomy. We therefore recommend a correction factor derived from measuring a rectal tube of known diameter.

Colonic Neoplasms↗

Evaluation of double contrast barium enemas performed by radiographic technologists.

This study was undertaken to see if radiographic technologists could be trained to perform double contrast barium enemas of a quality comparable to that produced by gastrointestinal radiologists and radiology residents. One technologist was from a remote rural hospital and the other from a university gastrointestinal radiology department. After initial training the two technologists continued to produce work of high quality. Analysis of the films showed that there was no significant difference between those films produced in the rural hospital and in the university centre. We recommend more widespread training of radiographic technologists in this work.

Barium Sulfate↗

Changing patterns of neonatal necrotizing enterocolitis.

In a 4 year and 4 month period 80 patients with necrotizing enterocolitis were treated. Review of the mode of clinical presentation, radiological features, management, mortality, and complications showed that there have been considerable changes over this period. The disease is now frequently diagnosed clinically prior to the development of paralytic ileus. Scalloping of the bowel wall and separation of the bowel loops are probably the earliest radiological signs. The management has become a more aggressive medical approach with more limited and well-defined surgical indications. These changes have been associated with a marked decrease in mortality and a concomitant increase in the number of late complications.

Enterocolitis, Pseudomembranous↗

Strictures and other late complications of neonatal necrotising enterocolitis.

Eighty infants have been treated for neonatal necrotising enterocolitis within a period of five years. Twenty-five per cent developed strictures of the small or large intestine. Four cases of atresia including two with multiple cyst formation were seen. Four patients developed severe malabsorption requiring hyperalimentation with slow recovery of small bowel function in two survivors. The radiological features of these complications is illustrated and the role of radiology in the management of these patients is discussed.

Constriction, Pathologic↗

Preliminary studies with the sensitive cytochemical assay for parathyroid hormone.

A modification of the cytochemical assay for parathyroid hormone (PTH) is described which permits the measurement of as little as 0.1 fg ml-1. Using this assay circulating concentrations in normal humans range between 1 and 30 pg ml-1 using a bovine PTH standard. Elevated values are found in hyperparathyroidism with reduced concentrations in hypoparathyroidism. Where detectable, PTH concentrations measured by radioimmunoassay are on average fourteen-fold higher than by cytochemical assay. No cross reactivity was found with AVP, calcitonin and 1,25 dihydroxy vitamin D in concentrations normally found in health or disease.

Adult↗