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  • 1
    Electronic Resource
    Electronic Resource
    Solitary ulcers in reflux esophagitis: radiographic findings (1997)
    Springer
    Abdominal imaging 22 (1997), S. 5 -7 
    Details
    ISSN: 1432-0509
    Keywords: Key words: Reflux esophagitis—Gastroesophageal reflux disease—Esophageal ulcers. [xm [fs99]
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Background: Some patients with reflux esophagitis have solitary ulcers in the distal esophagus. This study was undertaken to characterize further the radiographic features of these ulcers and to determine whether or not they have a predisposition to develop on the posterior esophageal wall. Methods: Radiologic files and teaching files at our university hospital and affiliated Veterans Administration hospital revealed 29 patients with solitary reflux-induced ulcers. The radiographs were reviewed retrospectively to determine the size and location of the ulcers as well as the presence or absence of other findings. Results: Twenty ulcers (69%) were located on the posterior wall, five (17%) on the left or right lateral wall, and four (14%) on the anterior wall. All but two ulcers were located 1–4 cm from the gastroesophageal junction. All of the ulcers were less than 10 mm in width and 5 mm in depth. Other associated findings included hiatal hernias in 11 patients (38%), mucosal nodularity or granularity in 12 (41%), one or more tiny satellite ulcers in three (10%), esophageal intramural pseudodiverticula in three (10%), an inflammatory esophagogastric polyp in one (3%), and scarring or stricture formation in 12 (41%). Conclusion: Our findings suggest that solitary reflux-induced ulcers tend to occur on the posterior wall of the distal esophagus near the gastroesophageal junction, producing characteristic radiographic findings. We postulate that affected individuals sleep primarily in the supine position, so that refluxed acid pools on the dependent or posterior esophageal wall, causing maximal injury in this location.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002619900128
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  • 2
    Electronic Resource
    Electronic Resource
    Total proctocolectomy and ileoanal pouch: the role of contrast studies for evaluating postoperative leaks (1998)
    Springer
    Abdominal imaging 23 (1998), S. 375-379 
    Details
    ISSN: 1432-0509
    Keywords: Key words: Proctocolectomy—Ileoanal pouch.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Background: To assess the role of contrast enemas for the evaluation of leaks in symptomatic and asymptomatic patients after the first stage of restorative proctocolectomy. Methods: We reviewed the findings of 59 contrast enemas in 40 patients who underwent total proctocolectomy with creation of an ileoanal pouch and a proximal diverting ileostomy. Thirty-seven patients initially underwent routine contrast studies of the ileoanal pouch, and three underwent contrast studies because of suspected fistulas or obstruction. Medical records were also reviewed to determine the clinical presentation and course of these patients. Results: Of 37 patients who underwent routine postoperative contrast enemas, 33 (89%) had normal studies, three (8%) had clinically silent leaks (including two blind-ending tracks from the ileoanal anastomosis and one from the pouch), and one (3%) had pouchitis. In all three patients with unsuspected leaks, ileostomy closure was delayed. In two other patients with abdominal pain and fever, contrast enemas revealed leaks from the ileoanal pouch and distal ileum, respectively. The remaining patient had a contrast enema because of abdominal pain and distention; this patient had a distal ileal obstruction due to adhesions. Conclusions: Routine postoperative contrast studies revealed clinically silent leaks from the ileal J pouch or ileoanal anastomosis in three of 37 patients (8%) after the first stage of restorative proctocolectomy. Our findings suggest that routine contrast enema can detect clinically silent leaks after this surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002619900364
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  • 3
    Electronic Resource
    Electronic Resource
    Barrett's esophagus and esophageal adenocarcinoma: the scope of the problem (1995)
    Springer
    Abdominal imaging 20 (1995), S. 291-298 
    Details
    ISSN: 1432-0509
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusion Barrett's esophagus is probably a more common condition than previously recognized. Although the classic radiologic findings of Barrett's esophagus are present in only a small percentage of patients, this condition should be suspected whenever reflux esophagitis or peptic strictures are demonstrated on double-contrast esophagography. Recent literature also suggests that Barrett's carcinomas comprise up to 50% of all esophageal cancers. Because of the increased risk of developing adenocarcinoma in Barrett's esophagus, endoscopic surveillance has been advocated to detect dysplastic or carcinomatous changes at the earliest possible stage. When barium studies are performed on patients with known Barrett's esophagus, the radiographs should be carefully evaluated for signs of early adenocarcinoma, so these patients can be referred for appropriate management prior to the development of advanced, unresectable tumors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00203356
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  • 4
    Electronic Resource
    Electronic Resource
    Barium enema and colonoscopy: appropriateness of utilization in a Medicaid population (1997)
    Springer
    Abdominal imaging 22 (1997), S. 41 -44 
    Details
    ISSN: 1432-0509
    Keywords: Key words: Barium enema—Colonoscopy—Practice patterns. [xm [fs99]
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Background: To assess the appropriateness of utilization patterns for the barium enema and colonoscopy in a Medicaid population. Methods: From 1987 to 1991, a Medicaid managed-care database in Philadelphia revealed claims for a total of 2357 outpatient barium enemas and 896 outpatient colonoscopic examinations. The database was reviewed to determine the primary diagnostic (ICD-9-CM) codes assigned to patients who underwent these procedures. These codes were used as a proxy for indications. Each of the diagnostic codes for barium enema and colonoscopy was then classified either as appropriate, inappropriate, equivocal, or miscoded based on current guidelines in the medical literature. Results: A total of 1962 claims (83%) for barium enema were classified as appropriate, 126 (5%) as inappropriate, 84 (4%) as equivocal, and 185 (8%) as miscoded, whereas 645 claims (72%) for colonoscopy were classified as appropriate, 176 (20%) as inappropriate, 65 (7%) as equivocal, and 10 (1%) as miscoded. Thus, significantly more colonoscopic examinations were rated as inappropriate (p 〈 0.001). Conclusion: Our study suggests that more stringent criteria need to be used by physicians in ordering diagnostic examinations of the colon, particularly colonoscopy. Further investigation of the appropriateness of these procedures and the development and dissemination of guidelines seems warranted.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002619900135
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  • 5
    Electronic Resource
    Electronic Resource
    Metastatic thyroid carcinoma presenting as an expansile intraluminal esophageal mass (1995)
    Springer
    Abdominal imaging 20 (1995), S. 20-22 
    Details
    ISSN: 1432-0509
    Keywords: Esophagus neoplasms ; Esophagus metastasis from thyroid carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a patient with metastatic thyroid carcinoma invading the esophagus in whom barium and MR examinations revealed an expansile intraluminal mass indistinguishable from that of a primary esophageal malignancy. Metastatic thyroid carcinoma should therefore be included in the differential diagnosis of an expansile esophageal mass. As in our patient, MR imaging may be useful for showing that the mass originates in the thyroid gland.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00199636
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  • 6
    Electronic Resource
    Electronic Resource
    Splenic implant in the jejunum: Radiographic and pathologic findings (1995)
    Springer
    Abdominal imaging 20 (1995), S. 518-520 
    Details
    ISSN: 1432-0509
    Keywords: Splenosis ; Jejunum, neoplasms ; Post-splenectomy complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a patient in whom barium studies and computed tomography revealed an intramural mass in the jejunum that consisted pathologically of ectopic splenic tissue. Because the patient had a prior splenectomy, the lesion probably represented splenosis rather than an accessory spleen. When intramural lesions are detected on barium studies in patients who have had prior abdominal trauma or splenectomy,99mTc-tagged, heated-red blood cell scintigraphy may be performed to confirm the diagnosis, thereby eliminating the need for surgery in these patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01256702
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  • 7
    Electronic Resource
    Electronic Resource
    Drug-induced disorders of the esophagus (1999)
    Springer
    Abdominal imaging 24 (1999), S. 3-8 
    Details
    ISSN: 1432-0509
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002619900431
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  • 8
    Electronic Resource
    Electronic Resource
    Drug-induced disorders of the stomach and duodenum (1999)
    Springer
    Abdominal imaging 24 (1999), S. 9-16 
    Details
    ISSN: 1432-0509
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002619900432
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  • 9
    Electronic Resource
    Electronic Resource
    Preliminary X-ray crystallographic analysis of human salivary cystatin (1996)
    Copenhagen : International Union of Crystallography (IUCr)
    Acta crystallographica 52 (1996), S. 869-870 
    Details
    ISSN: 1399-0047
    Source: Crystallography Journals Online : IUCR Backfile Archive 1948-2001
    Topics: Chemistry and Pharmacology , Geosciences , Physics
    Notes: Human salivary cystatin, a thiol proteinase inhibitor, has been implicated in potential antimicrobial and antiviral functions of saliva. A variant of human salivary cystatin SN expressed and purified in an Escherichia coli expression system lacking residues 12–16 near the N-terminus (Δ12–16) has been crystallized by the vapor-diffusion technique. The crystals are of the hexagonal space group P622 and have cell constants of a = 85.41, b = 85.41, c = 131.6 Å, α = β = 90, γ = 120°, and contain two molecules of molecular weight 13 500 per asymmetric unit. The crystals diffract up to a resolution of 2.2 Å and are suitable for X-ray diffraction analysis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1107/S090744499600323X
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  • 10
    Electronic Resource
    Electronic Resource
    Structure of Human Salivary α-Amylase at 1.6 Å Resolution: Implications for its Role in the Oral Cavity (1996)
    Copenhagen : International Union of Crystallography (IUCr)
    Acta crystallographica 52 (1996), S. 435-446 
    Details
    ISSN: 1399-0047
    Source: Crystallography Journals Online : IUCR Backfile Archive 1948-2001
    Topics: Chemistry and Pharmacology , Geosciences , Physics
    Notes: Salivary α-amylase, a major component of human saliva, plays a role in the initial digestion of starch and may be involved in the colonization of bacteria involved in early dental plaque formation. The three-dimensional atomic structure of salivary amylase has been determined to understand the structure-function relationships of this enzyme. This structure was refined to an R value of 18.4% with 496 amino-acid residues, one calcium ion, one chloride ion and 170 water molecules. Salivary amylase folds into a multidomain structure consisting of three domains, A, B and C. Domain A has a (β/α)8− barrel structure, domain B has no definite topology and domain C has a Greek-key barrel structure. The Ca2+ ion is bound to Asnl00, Arg158, Asp167, His201 and three water molecules. The Cl− ion is bound to Arg195, Asn298 and Arg337 and one water molecule. The highly mobile glycine-rich loop 304–310 may act as a gateway for substrate binding and be involved in a `trap-release' mechanism in the hydrolysis of substrates. Strategic placement of calcium and chloride ions, as well as histidine and tryptophan residues may play a role in differentiating between the glycone and aglycone ends of the polysaccharide substrates. Salivary amylase also possesses a suitable site for binding to enamel surfaces and provides potential sites for the binding of bacterial adhesins.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1107/S0907444995014119
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