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Perforator imaging

Ryan S Dolan, Daryl Goldman, Mark El-Deiry, Nima Kokabi, Zachary L Bercu, Janice Newsome, Jonathan G Martin
RATIONALE AND OBJECTIVES: Requests for gastrostomy tube placement in patients on aspirin (ASA) 325 mg are common, particularly in patients following reconstructive surgery for head and neck cancer, but periprocedural guidelines and recommendations regarding management of high dose aspirin are inconsistent. The purpose of this study was to assess the bleeding risk of percutaneous gastrostomy tube placement in patients on ASA 325 mg. MATERIALS AND METHODS: This retrospective study of 213 patients who underwent image-guided "push" percutaneous gastrostomy tube placement compared rates of significant bleeding and other secondary outcomes (including all-cause mortality within 30 days, procedure-related mortality, bowel perforation, abdominal abscess, peritonitis, aspiration pneumonia, intraprocedural airway complications, and tube dislodgement) between patients maintained on ASA 325 mg and patients not on antiplatelet or anticoagulation therapy...
March 14, 2019: Academic Radiology
Fatemeh Abdolali, Reza Aghaeizadeh Zoroofi, Yoshito Otake, Yoshinobu Sato
PURPOSE: The objective of medical content-based image retrieval (CBIR) is to assist clinicians in decision making by retrieving the most similar cases to a given query image from a large database. Herein, a new method for content-based image retrieval of cone beam CT (CBCT) scans is presented. METHODS: The introduced framework consists of two main phases: training database construction and querying. The goal of the training phase is database construction, which consists of three main steps...
March 14, 2019: International Journal of Computer Assisted Radiology and Surgery
Andreas Schörghofer, Martin Drerup, Thomas Kunit, Lukas Lusuardi, Josef Holzinger, Josef Karner, Michael Groher, Christoph Zoubek, Rosemarie Forstner, Felix Sedlmayer, Frank Wolf
BACKGROUND: Rectal spacers are used to limit dose to the anterior rectal wall in high dose external beam radiation therapy of the prostate and have been shown to reduce radiation induced toxicity. Here we report the complication rate and toxicity of the implantation procedure in a large cohort of patients who have either received a gel- or balloon-type spacer. METHODS: In total, 403 patients received rectal spacing, 264 with balloon, 139 with gel. Allocation was non-randomized...
March 15, 2019: Radiation Oncology
Sahil Koppikar, David Yu, Mark Ropeleski, David Robertson
Connective tissue diseases can be associated with rare gastrointestinal complications such as pneumatosis intestinalis and pneumoperitoneum. In this article, we report a unique case of recurrent pneumatosis intestinalis and spontaneous pneumoperitoneum without evidence of peritonitis in a patient with long-standing mixed connective tissue disease. Computed tomography scan of the abdomen and pelvis revealed pneumatosis of the jejunum and intra-abdominal free air, without evidence of perforation. The patient was managed non-operatively...
December 2018: Archives of Rheumatology
Hemin Oathman Sheriff, Kawa Abdullah Mahmood, Nzar Hamawandi, Aram Jamal Mirza, Jawad Hawas, Esther Granell Moreno, Juan Antonio Clavero, Christopher L Hankins, Jaume Masia
No abstract text is available yet for this article.
September 2018: Journal of Reconstructive Microsurgery
Sarthak Soin, Sumathi Vijaya Rangan, Faisal Shaukat Ali, Chukwudumebi Okafor
Necrotising fasciitis (NF) resulting from sigmoid perforation is rare, but none the less remains life threatening. Early surgical intervention and empiric broad-spectrum antibiotic remains the standard of care. A 65-year-old man with history of stage 4 rectal cancer presented with bilateral hip pain. An X-ray of the hip and pelvis to rule out fracture revealed abnormal gas pattern overlying the right hip. CT imaging revealed distal sigmoid perforation with air extending from the pelvis to posterior aspect of the right hip and thigh...
March 14, 2019: BMJ Case Reports
Andrew Mitchell, Alexandre Dugas
BACKGROUND: Malakoplakia is a chronic inflammatory disease characterized by tissue infiltrates of large granular macrophages containing distinctive intracytoplasmic inclusions termed Michaelis-Gutmann (MG) bodies. The genitourinary system is the most commonly involved site, followed by the gastrointestinal tract. Malakoplakia may occur as a complication of primary or secondary immunosuppression and, therefore, renal transplant recipients are at risk. The graft itself or extra-renal sites may be involved...
March 13, 2019: Diagnostic Pathology
Deniz Durmush, Arthur J Kaffes
PURPOSE OF REVIEW: Strictures of the small bowel are an underdiagnosed entity with significant morbidity because of obstruction and risk of perforation and penetrating disease. RECENT FINDINGS: Recent advances in imaging, enteroscopy, and therapeutic advances particularly in Crohn's disease have enabled gastroenterologists to target and individualize management of small bowel strictures, preventing untimely surgery and complications. SUMMARY: All patients with obstructive symptoms, suspected small bowel disease, and negative panendoscopy should be evaluated for small intestinal strictures with cross-sectional imaging and considered for capsule endoscopy...
March 6, 2019: Current Opinion in Gastroenterology
Mehebub Sahana, Haoyuan Hong, Haroon Sajjad, Junzhi Liu, A-Xing Zhu
This study aimed to model deforestation susceptibility in forest ecosystem of Rudraprayag district, India. For this purpose, site-specific physical (slope angle, slope aspect, altitude, annual average rainfall, soil texture, soil depth), and anthropogenic (population distribution, distance from road, distance from settlement, proximity to agricultural land) deforestation conditioning factors were chosen. Landsat TM and OLI images for 1990 and 2015 were utilized to evaluate the changes in forest cover. The frequency ratio model was used for deforestation susceptibility mapping...
June 15, 2018: Science of the Total Environment
Waseem A Mirza, Mujtaba Z Naveed, Kumail Khandwala
Introduction Making an accurate diagnosis of acute appendicitis (AA) is vital to prevent the morbid complications associated with untreated AA. This is challenging in up to 30% of pediatric patients which is a significantly high number. Ultrasound (US) has been generally used as the initial mode of imaging in pediatric patients due to the lack of ionizing radiation. Given its variable accuracy, adjuvants such as secondary signs can be used to aid the radiologist in making an accurate diagnosis. Materials and methods Patients between the ages of two and sixteen years with acute abdominal pain suspicious for AA, who underwent right lower quadrant US between 2003 and 2016, were retrospectively identified...
December 27, 2018: Curēus
Saori Yajima, Hiroshi Asano, Hiroyuki Fukano, Yasuhiro Ohara, Nozomi Shinozuka, Chih-Ping Li, Taketo Yamada
BACKGROUND: Polyarteritis nodosa is a disease that presents with necrotizing vasculitis in small and medium-sized arteries. It may occur in various organs, but approximately half of cases have gastrointestinal involvement. Prognosis is not favorable once organ dysfunction begins as evidenced by gastrointestinal symptoms; thus, treatment with steroids should be promptly initiated. We report the case of a patient who presented with necrosis of the small intestine, which was pathologically diagnosed as polyarteritis nodosa and treated successfully with steroids...
March 9, 2019: Journal of Medical Case Reports
Yu-Lun Tsai, Pei-Chieh Yu, Hsin-Hua Nien, Shih-Yu Sung, Yi-Hsuan Kuan, Ching-Jung Wu
Cervical cancer patients may sometimes experience different types of uterine perforation by a tandem during brachytherapy. The purpose of this study was to address possibly different management strategies regarding different tandem positions from a dosimetry aspect by evaluating radiation doses delivered to organs-at-risk (OAR) in order to help medical professionals handle different types of uterine perforation. Images and dosimetry data in cervical cancer brachytherapy with uterine perforation were reviewed...
March 4, 2019: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Jacob C Hoffmann, James Kellam, Manickam Kumaravel, Kurt Clark, Milton L Chip Routt, Joshua L Gary
OBJECTIVES: To determine the frequency where a posterior and cranial screw in a femoral neck that appeared contained on fluoroscopy violates the cortex. METHODS: Ten specimens including the hemipelves with the proximal femur were obtained from unidentified embalmed specimens that were to be cremated after an institutional review board waiver was granted. Under fluoroscopy, the posterior and cranial screw of the inverted triangle configuration for the femoral neck was placed using standard technique with a cannulated 6...
February 26, 2019: Journal of Orthopaedic Trauma
Yoav Baruch, Michal Canetti, Yair Blecher, Yariv Yogev, Dan Grisaru, Nadav Michaan
OBJECTIVE: Clinically suspected appendicitis is the most common nonobstetric surgical problem encountered in pregnancy. The diagnosis of appendicitis is hampered by equivocal symptoms during pregnancy. Ultrasonography (US) remains, as a rule, the imaging test of choice for the diagnosis of clinically suspected appendicitis during pregnancy and other imaging tools such as computed tomography (CT) or MRI are usually avoided. We evaluated the accuracy of US in the diagnosis of appendicitis during pregnancy...
March 7, 2019: Journal of Maternal-fetal & Neonatal Medicine
Kosuke Nomura, Daisuke Kikuchi, Mitsuru Kaise, Toshiro Iizuka, Yorinari Ochiai, Yugo Suzuki, Yumiko Fukuma, Masami Tanaka, Yosuke Okamoto, Satoshi Yamashita, Akira Matsui, Toshifumi Mitani, Shu Hoteya
BACKGROUND AND OBJECTIVES: Conventional endoscopy provides two-dimensional (2D) information without depth information. This study compared three-dimensional (3D) endoscopy and 2D endoscopy using an endoscopic submucosal dissection (ESD) training model to evaluate the utility of 3D endoscopy. METHODS: Porcine stomach specimens (7 × 7 cm) were prepared from commercially available resected porcine stomachs and a 10-mm hypothetical lesion was marked at the center of each specimen...
March 6, 2019: Surgical Endoscopy
Mahesh Gajendran, Priyadarshini Loganathan, Guillermo Jimenez, Anthony P Catinella, Nathaniel Ng, Chandraprakash Umapathy, Nathalie Ziade, Jana G Hashash
Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disorder of the colon that causes continuous mucosal inflammation extending from the rectum to the more proximal colon, with variable extents. UC is characterized by a relapsing and remitting course. UC was first described by Samuel Wilks in 1859 and it is more common than Crohn's disease worldwide. The overall incidence and prevalence of UC is reported to be 1.2-20.3 and 7.6-245 cases per 100,000 persons/year respectively. UC has a bimodal age distribution with an incidence peak in the 2nd or 3rd decades and followed by second peak between 50 and 80 years of age...
March 2, 2019: Disease-a-month: DM
Hidetoshi Matsukawa, Hiroyasu Kamiyama, Takanori Miyazaki, Yu Kinoshita, Nakao Ota, Kosumo Noda, Takaharu Shonai, Osamu Takahashi, Sadahisa Tokuda, Rokuya Tanikawa
OBJECTIVEPerforator territory infarction (PTI) is still a major problem needing to be solved to achieve good outcomes in aneurysm surgery. However, details and risk factors of PTI diagnosed on postoperative MRI remain unknown. The authors aimed to investigate the details of PTI on postoperative diffusion-weighted imaging (DWI) in patients with surgically treated unruptured intracranial saccular aneurysms (UISAs).METHODSThe data of 848 patients with 1047 UISAs were retrospectively evaluated. PTI was diagnosed on DWI, which was performed the day after aneurysm surgery...
March 1, 2019: Journal of Neurosurgery
Meryem Etoz, Firdevs Asantogrol, Rıdvan Akyol
OBJECTIVE: This study was performed to retrospectively analyse the imaging features of 13 patients with central giant cell granulomas (CGCGs) examined at a single institution. METHODS: The orthopantomography and cone beam computed tomography images of 13 patients histopathologically diagnosed with CGCGs were retrospectively analysed. Patients aged > 30 years underwent measurement of their calcium and parathyroid hormone levels. No cases of hyperparathyroidism were identified in the study group...
March 1, 2019: Oral Radiology
Tomonori Aoki, Shuntaro Yoshida, Hiroyuki Abe, Satoshi Ono, Ayako Nakada, Yumiko Ota, Akiko Narita, Takeshi Yoshikawa, Hiroto Kinoshita, Yosuke Tsuji, Atsuo Yamada, Mitsuhiro Fujishiro, Yoshihiro Hirata, Masashi Fukayama, Kazuhiko Koike
BACKGROUND: Factors associated with efficacy and safety of cold snare polypectomy (CSP) are not well established. The aim is to elucidate the predictors of R0 resection and immediate bleeding of CSP. METHODS: We retrospectively reviewed a database of patients who underwent CSP for subcentimetric polyps at the University of Tokyo Hospital in Japan. Using the data regarding the characteristics of patients and polyps, such as location, size, and macroscopic appearance; use of narrow band imaging with magnification (NBI-M); and endoscopists' experience, we revealed the predictive factors associated with R0 resection and immediate post-CSP bleeding by univariate and multivariate analyses...
2019: PloS One
Anita T Mohan, Lin Zhu, Mohamed Morsy, Yoo Joon Sur, Gregory J Michalak, Nirusha Lachman, Samir Mardini, Michel Saint-Cyr
BACKGROUND: The superficial femoral artery and medial thigh region has been an underused donor site for perforator flaps. This study evaluated perforasomes of the superficial femoral artery and its principal branches to review the clinical applications for locoregional reconstruction. METHODS: Twenty-six fresh cadaveric lower extremities were dissected. Perforator size and anatomical course from the superficial femoral artery, descending genicular artery, and saphenous artery branch were documented...
March 2019: Plastic and Reconstructive Surgery
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