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Biomedical subjects

T C Demos

Publications and source records attributed to T C Demos.

At least 19 recordsLinked to original sources
PubMed1995

Herniation of the transverse colon: an unusual complication of pedicled omentoplasty.

Pedicled omentoplasty is frequently used in chest reconstruction and treatment of sternal infection. The procedure is effective, but it is associated with several postoperative complications. The authors describe a 49-year-old man in whom sternal infection after heart surgery was successfully treated by sternectomy and omentoplasty. Several months later, the transverse colon herniated into the transposed omentum. To the authors' knowledge, this complication has not been previously reported.

Colonic Diseases↗
PubMed1995

Breast abscess as a late complication of plombage.

The authors describe a patient who had undergone plombage as a treatment for tuberculosis approximately 40 years previously and who presented with a breast abscess secondary to migration of the plombage material. This complication of plombage, which has not previously been reported, was demonstrated by computed tomography.

Abscess↗
PubMed1994

CT of the chest and abdomen in patients on mechanical pulmonary ventilators: quality of images made at 0.6 vs 1.0 sec.

OBJECTIVE: Chest and abdominal CT scans using 1.0-sec scan times are often limited by motion in patients who are unable to hold their breath. With our scanner we can obtain images in 0.6 sec (partial scan) that use data from 225 degrees instead of the 360 degrees used for 1.0-sec scans. The purpose of this study was to assess whether the quality of images of the chest and abdomen in patients on mechanical pulmonary ventilators who could not breath-hold could be improved if images were taken using a scan time of 0.6 sec rather than 1.0 sec. MATERIALS AND METHODS: Thirty patients who were being treated with mechanical pulmonary ventilation with indications for chest or abdominal CT or both were scanned with a scan time of 1.0 sec. At the end of the examination, additional 0.6-sec images were taken at three or four levels. Images obtained with these two scan times were filmed at similar levels and windows, and anatomically matched levels were compared. The images were masked and independently evaluated by three radiologists for motion, noise, artifact, and overall image quality. Each parameter was rated using a scale of 1 to 4. Using Kendall's tau correlation, there was no significant difference between the radiologists in the grading of individual parameters or of overall image quality. Therefore, the average of the scores of the three radiologists was used. Statistical analysis was done using repeated measures multivariate analysis of variance. RESULTS: Images obtained in 0.6 sec had significantly less motion (p < .001) but more noise (p < .001) than those obtained in 1.0 sec. We found no statistically significant difference in artifacts between the two scan times. Overall image quality was judged to be significantly better on scans obtained in 0.6 sec than on scans obtained at 1.0 sec (p < .001), in spite of the greater noise on 0.6-sec images. The higher quality of 0.6-sec images was most noticeable for lung window settings. CONCLUSION: Our results indicate that scans taken in 0.6 sec (partial scans) provide better quality images than those obtained in 1.0 sec in patients being treated with mechanical pulmonary ventilation who cannot breath-hold. This technique may be useful not only in this population but in all patients who are unable to cooperate with breath-holding instructions.

Contrast Media↗
PubMed1990

Separate annular strictures of the rectosigmoid colon secondary to unsuspected prostate cancer.

Rectal involvement from prostate cancer occurs in 1.5-11% of cases. A rarer presentation is that of a separate metastasis to the high rectosigmoid colon causing an annular stricture. We present our experience with six such cases who presented with gastrointestinal symptoms. Two of the cases had undergone intestinal resections. All 6 patients had radiographic evidence of an annular stricture in the rectosigmoid area. Retrospective review revealed evidence of metastatic disease in all cases in the form of abnormalities in one or more of the following: intravenous urography, radionuclide bone scan, liver spleen scan, acid phosphatase, or alkaline phosphatase. The mean survival was 9.3 months. This rare presentation of prostate cancer may be difficult to distinguish from primary colorectal cancer and therefore needs to be ruled out to avoid intestinal resections.

Aged↗
PubMed1990

CT of thoracic aortic aneurysms.

Aneurysms of the thoracic aorta are most often the result of arteriosclerotic disease. Other causes include degeneration of the medial layer of the aortic wall, either idiopathically or due to genetic disorders such as Marfan syndrome; aortic dissection; trauma; syphilis and other bacterial infection; noninfective aortitis; and congenital anomaly. We review normal anatomy of the aorta and discuss our technique and interpretation of computed tomography (CT) in the evaluation of the thoracic aorta. We illustrate the CT appearance of different types of aortic aneurysms as well as discuss the use of CT for assessing complications of aneurysms, for postoperative follow-up, and in the differentiation of aortic aneurysm from a paraaortic mass.

Aorta, Thoracic↗
PubMed1990

Colonic stenoses: use of oral barium when retrograde flow is completely obstructed on barium enema studies.

Forty patients with complete obstruction to retrograde barium flow on barium enema examinations, without clinical or radiographic evidence of obstruction, were studied further with orally administered barium in the same session. All patients had undergone aborted double-contrast barium enema studies and had received antispasmodics intramuscularly before the examination. The authors describe the technique, as well as the clinical and radiologic findings, that allows the safe ingestion of oral barium in patients with stenotic lesions of the colon. In all patients, oral barium passed through the small bowel and the stenotic site in an average of 148 minutes, with no complications. In seven patients, there were synchronous lesions in the colon and small bowel, and the findings were determined better with oral barium studies in 19 patients. If a barium enema study is done and retrograde passage of barium is obstructed by a lesion in the left side of the colon, additional diagnostic information can be obtained by giving the patients oral barium. This practice is safe if precise criteria are applied.

Administration, Oral↗
PubMed1989

Computed tomography in traumatic defects of the diaphragm.

Two patients with traumatic diaphragmatic defects visible on computed tomography are presented. The diagnosis was delayed for several years in both patients. The diagnosis of these acquired diaphragmatic defects is often difficult. Computed tomography can lead to earlier diagnosis by demonstrating the defect in some patients when radiographic studies are not diagnostic.

Adult↗
PubMed1988

Computed tomography of posterior pararenal and properitoneal metastases.

Identification of the retroperitoneal fascial planes with modern computed tomographic scanners allows for precise localization of pathologic processes in the individual compartments of the retroperitoneum. Metastatic disease to the posterior pararenal space or properitoneal space in 6 patients is reported. Two patients had diffuse histiocytic lymphoma and 4 had metastatic melanoma.

Female↗
PubMed1987

Traumatic longitudinal disruption of the carpus.

Traumatic longitudinal disruption of the carpus is a rare injury that usually occurs through a weak point between the third and fourth metacarpals and the capitate and hamate. Three cases are reported; all injuries were work related and occurred with a broad crushing injury to the hand and wrist. Two patients were treated by fasciotomies, a carpal tunnel release, and excision of a fractured hook of the hamate. The third patient was treated with carpal tunnel release and percutaneous pinning of a wide diastasis. Despite the return of wrist motion, pinch and grip strength remained below normal range in all three patients at follow-up examinations.

Accidents, Occupational↗
PubMed1987

Osteomyelitis of the sacrum as the initial manifestation of Crohn's disease.

A 17-year-old boy had low back pain for four months prior to the development of sacral osteomyelitis, which led to the initial diagnosis of Crohn's disease. Musculoskeletal problems occur in about one-third of the patients with Crohn's disease. Only a few patients with osteomyelitis complicating Crohn's disease have been reported. This case is rare because he had had no gastrointestinal symptoms. This patient illustrates the point that musculoskeletal signs and symptoms, including osteomyelitis, may prove to be a manifestation of gastrointestinal tract disease.

Adolescent↗
PubMed1986

Coiled-spring sign of the cecum in acute appendicitis.

A concentric ring appearance of the cecal mucosa on a barium enema is a distinctive but nonspecific radiographic finding that has been termed the vortical, whirlwind, or coiled-spring sign. It can be caused by inversion of a postappendectomy stump and transient intussusception of the intact appendix in asymptomatic patients. The sign has also been reported with mucoceles, carcinoma, and endometriosis of the appendix, but there has been little mention of it in connection with acute appendicitis. The records of 18 patients with a coiled-spring sign and nonfilling of the appendix were reviewed. Acute appendicitis was proven in 14 of 18. In five of these 14, this sign was the only finding accompanying nonfilling of the appendix. On review of 53 cases of pathologically proven acute appendicitis studied by preoperative barium enema, 14 had a coiled-spring sign. The coiled-spring sign is nonspecific but can be produced by acute appendicitis, where it may be the only positive sign accompanying nonfilling of the appendix.

Adolescent↗