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W R Janowitz

Publications and source records attributed to W R Janowitz.

26 records · Page 2Linked to original sources
PubMed1979

Pulmonary aspiration as a consequence of gastroesophageal reflux: a diagnostic approach.

A radioisotope scintiscanning technique that can document pulmonary aspiration of gastric contents in patients with gastroesophageal reflux is described. Six patients with suspected nocturnal aspiration from reflux were studied. Three of the six had positive lung scans 8 hr after intragastric placement of 10 mCi of technetium 99m sulfur colloid. Overnight intraesophageal pH monitoring revealed prolonged episodes of GE reflux in those with positive scans. These preliminary observations suggest that this scintigraphic technique may be an effective method for documenting pulmonary symptoms as a consequence of gastroesophageal reflux.

Adult↗
PubMed1978

Grey scale ultrasonography: evaluating the jaundiced patient.

Over a period of one year, 75 patients with jaundice were evaluated by grey scale ultrasonography. Intravenous cholangiography was attempted in 26 instances (bilirubin value greater than 4.3 mg/100 ml) and was diagnostic in only four. Ultrasound, on the other hand, was diagnostic for surgical jaundice in 62 of the 75 cases (82%). In 52 of the 62 patients a cause for the extrahepatic obstruction was demonstrated: 40 had cholelithiasis and choledocholithiasis, and 12 had tumors (11 pancreatic tumors, one lymphoma). In the remaining ten instances, obstruction was sonographically demonstrated but the cause was not. Of these, four patients were subsequently proven to have distal common duct stones, five had carcinoma of the pancreas and one had cholangiocarcinoma. This evidence indicates that ultrasound should be the noninvasive procedure of choice in the clinical assessment of obstructive jaundice.

Adolescent↗
PubMed1978

Gray scale ultrasonography and rose bengal scintigraphy in the evaluation of the patient with jaundice.

In our experience, the ultrasonic examination should be the procedure of choice in the initial investigation of the patient with jaundice. It is independent from liver function and a noninvasive test which can be performed rapidly; in addition, the cause of extrahepatic obstruction can often be determined preoperatively. In our study, in many patients, the rose bengal scintigram has been indeterminate and has not been helpful in predicting whether obstructive or nonobstructive jaundice exists. Rose bengal scintigraphy appears to be of most help only in those patients in whom an adequate sonographic examination cannot be performed. Newer imaging agents currently being developed may prove to be more satisfactory in the future.

Adenocarcinoma↗
PubMed1977

Noninvasive detection and quantification of left-to-right shunts in children using oxygen-15 labeled carbon dioxide.

A method for the detection and quantification of left-to-right intracardiac shunts is described which utilizes a single breath inhalation of oxygen-15 labeled carbon dioxide (C15O2). The inhaled gas rapidly crosses the alveolar membrane and the oxygen-15 label is exchanged through the carbonate cycle to form oxygen-15 labeled water within the pulmonary capillary blood. Pulmonary indicator clearance curves are measured by external scintillation probes. A simplified method of shunt flow quantification was developed from indicator dilution principles and used for the analysis of the clearance curves. Inhalation studies were performed with 62 children on the day prior to cardiac catheterization. The presence or absence of left-to-right shunt was confirmed by contrast angiography in all cases. Twenty-six children were found to have no shunts by C15O2 inhalation, oximetry or angiography. Of the 36 with shunts, 34 were detected by C15O2. Two of these were designated as equivocal because they were considered to be less than the threshold of definitive detection by C15O2 (having Qp/Qs less than 1.2); 32 were positive and there were two false negatives with small ventricular septal defects. There were no false positives by C15O2. The correlation coefficient between C15O2 and oximetry values of shunt flow for those patients with proven shunts was 0.82.

Adolescent↗
PubMed1976

A noninvasive technique for the study of cardiac hemodynamics utilizing C15-O2 inhalation.

A new technique for the study of cardiac hemodynamics is described which utilizes single-breath inhalation of C15O2 (T 1/2 = 124 sec.) and the recording of activity vs. time curves with scintillation counters placed externally over the left ventricle and right lung. The results from 10 normal volunteers and 28 patients with acquired or congenital heart disease have been compared to the findings at cardiac catheterization. The technique is safe, rapid, and nontraumatic, and yielded no false positives or negatives in this series.

Aortic Valve↗
PubMed1976

Left heart imaging following inhalation of 15O-cabon dioxide: concise communication.

Accelerator-produced C15O2 (t 1/2 = 124 sec) is a uniquely useful radiopharmaceutical because it can be introduced rapidly and selectively into the left side of the heart by the simple noninvasive process of inhalation and breath-holding. A standard scintillation camera system was used to obtain images of the left heart by this technique. The procedure involves minimal radiation dose to the patient and may be repeated within a few minutes if necessary.

Adult↗