Biomedical subjects
Publications and source records attributed to Z Rubinstein.
A case of congenital hepatic fibrosis (CHF), a relatively rare disease, was diagnosed preoperatively on the basis of clinical and radiological findings. The diagnosis was confirmed by computerized tomography and later proven by a liver biopsy performed during cholecystectomy. Increased awareness of this entity may reveal heretofore unidentified cases of CHF.
Sixteen women suffering from ovarian cancer were staged by clinical and pathological means and concomitantly scanned by computed tomographic means. Computed tomography (CT) was found accurate in nine patients. The staging of the disease was upgraded in three patients following the CT examination. CT examination in four patients was equivocal or failed to detect the true extent of the disease. It was not possible to accurately assess the true nature of the pelvic mass on CT following a partial debulking pelvic procedure, as the remnant pelvic bed tissue could be misinterpreted as recurrent cancer. Small peritoneal cancer seedings were not detected on CT. CT scanning despite certain limitations is a valuable noninvasive adjunct in the assessment of carcinoma of the ovary and its response to treatment.
Captopril was administered prior to renal vein renin sampling in an attempt to select patients amenable to surgical treatment for renin dependent hypertension. Renal venous blood for plasma renin activity was taken only after captopril stimulation. Sampling from the antecubital vein before and after this provocation showed a marked rise in renin, thereby confirming the efficacy of the test. Elimination of the initial selective renal vein sampling shortens the catheterization period without affecting the accuracy and dependability of the procedure.
The indications, technique and results of percutaneous drainage in 20 patients with abscesses and other fluid collections are presented. Special emphasis is placed on the complementary use of ultrasound and computed tomography and the relative indications for the use of each. Of the 20 patients, 5 had hepatic abscesses, 7 had subphrenic or subhepatic abscesses, 3 had pancreatic pseudocysts and the remaining 5 had loculated fluid collections in either the abdomen or chest.
We treated two patients with congenital cyanotic heart disease (CCDH) in whom associated hypertrophic osteoarthropathy (HOA) developed. Both were severely cyanotic and hypoxic for many years before HOA was fully manifested. Clinical and roentgenographic indications of bone and joint lesions disappeared completely shortly after corrective of palliative surgery. There appears to be an etiologic connection between HOA and CCHD.
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Two rare event occurred in one patient: luxation erecta, an unusual form of dislocation at the shoulder, and axillary artery injury, hitherto undescribed in this type of dislocation. The arterial injury consisted of rupture of the intima with secondary thrombosis and occlusion. Following resection of the contused artery and saphenous vein graft replacement normal circulation was restored.
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Experience with the use of ultrasound for investigating hydatid disease of the abdomen is reported. The presence of daughter cysts within the parent cyst gives a pathognomonic sonographic picture, whether the cyst is single or multiple. The presence of single cysts without daughter cysts is still a diagnostic problem, unless calcification is seen. Associated secondary infection changes the picture to one of a nonspecific abscess, and only the presence of additional cysts can give a clue about the etiology.
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A case of severe duodenal hemorrhage in a septic renal allograft recipient is presented in which successful occlusion of the gastroduodenal artery by Gelfoam emboli also resulted in severe hepatic infarction and gallbladder necrosis. These complications were caused by reflux of emboli from the gastroduodenal artery into the distal branches of the hepatic artery.
The value of computed tomography (CT) in the diagnosis and management of retroperitoneal masses is discussed. Neoplastic, inflammatory, and hemorrhagic conditions are shown. In addition to facilitating the detection of these mass lesions, CT is especially valuable in allowing accurate biopsies and aspiration to be performed and in the follow-up of the patient.