Robert mindelzun - Academia.edu (original) (raw)

Papers by Robert mindelzun

Medical Radiology, 2000

ABSTRACT The peritoneal cavity is the largest lumen in the body. It is lined by a serosal layer w... more ABSTRACT The peritoneal cavity is the largest lumen in the body. It is lined by a serosal layer which reflects at multiple specific sites to constitute mesenteries and ligaments, extending to support and ensheath parenchymal organs and bowel. The scaffolds provided by the mesenteries and ligaments-conveying subserous connective tissue, nerves, blood vessels, and lymphatics-serve as pathways for the dissemination of disease between diverse sites. These same structures contribute to the formation of multiple recesses or compartments within the peritoneal cavity. Because of the dynamic circulation of intraperitoneal fluid related to physical and anatomic factors and local responses, these reflections and recesses serve as watershed areas and drainage basins for inflammatory, hemorrhagic, and malignant effusions. These modes of pathogenesis and the characteristic radiologic features have been firmly established and clearly documented (MEYERS 1994, 1970a,b, 1973a,b, 1975, 1976, 1981a,b; MEYERS and WHALEN 1971, 1973; MEYERS and MCSWEENEY 1972; MEYERS and EVANS 1973; MEYERS et al. 1973a,b, 1981, 1987; CHURCHILL and MEYERS 1986; OLIPHANT and BERNE 1982; OLIPHANT et al. 1986, 1988, 1993a,b, 1994, 1995, 1996).

Radiologic Clinics of North America

Radiolucencies in and around the liver may be caused by normal or abnormal accumulations of fat o... more Radiolucencies in and around the liver may be caused by normal or abnormal accumulations of fat or gas. Computed tomography, which measures the differential photon absorption of tissue more accurately than does abdominal radiography, readily demonstrates interfaces between the liver and air or fat. The correlation of these two modalities in detecting and identifying hepatic radiolucencies is explored.

Western Journal of Medicine

The American Journal of Gastroenterology

Cowden's disease is a rare autosomal dominant condition characterized by multiple hamartomas ... more Cowden's disease is a rare autosomal dominant condition characterized by multiple hamartomas of ectodermal, endodermal, and mesodermal origin affecting many organ systems. Gastrointestinal manifestation includes the formation of multiple polyps of various benign histopathological types throughout the alimentary tract. Recent literature suggests that the frequency of gastrointestinal involvement is approximately 70-85%. The diagnosis of Cowden's disease, however, relies mainly on subtle dermatologic findings, which may not be obvious to the gastroenterologist. We describe a patient with Cowden's disease and review the English literature on the topic of gastrointestinal polyposis and Cowden's disease. These studies suggest that gastrointestinal polyposis is commonly found in this disease, and that diffuse esophageal glycogenic acanthosis is a characteristic feature of Cowden's disease. We propose that the finding of extensive glycogenic acanthosis in the presence o...

LEARNING OBJECTIVES 1. To review the MDCT findings of small bowel obstruction2. To demonstrate ho... more LEARNING OBJECTIVES 1. To review the MDCT findings of small bowel obstruction2. To demonstrate how soft copy review of volumetric MDCT data sets in cinematic viewing mode can assist the radiologist in identifying the site and cause of small bowel obstruction ABSTRACT CT has become the modality of choice for evaluation of small bowel obstruction. Nevertheless, precise delineation of the site and cause of the obstruction remains challenging because of the tortuosity of bowel loops. MDCT data sets, which are inherently volumetric, can be reconstructed in a variety of planes. These multiplanar data sets, when viewed in a cine mode, may often have vivid "beaks" or "swirls" that the eye is naturally drawn to as the picture moves because they contrast with the familiar background configurations. We suggest that viewing small bowel obstructions as a cine loop may help the radiologist identify the site and nature of bowel caliber transitions that imply obstruction. Helpfu...

Radiology, 1997

Page 1. 43 Robert E. Mindelzun, MD #{149}R. Brooke Jeffrey, MD Devil&#x27;s Advocate ... ... more Page 1. 43 Robert E. Mindelzun, MD #{149}R. Brooke Jeffrey, MD Devil&#x27;s Advocate ... The introduction of unenhanced (no oral or intravenous administration of contrast material) helical computed tomography (CT), however, challenges this well-established algorithm. ...

Radiology, 1980

The computed tomographic (CT) findings in four diabetic patients with gram-negative pyelonephriti... more The computed tomographic (CT) findings in four diabetic patients with gram-negative pyelonephritis are described. Excretory urography with tomography was performed in three patients, with normal results. Linear areas of low denisty which were observed on the CT scans corroborate previous reports, and the authors suggest that CT may be more sensitive than conventional techniques in the detection of infectious renal parenchymal disease.

American journal of surgery, 1968

ABSTRACT

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1972

Recent developments in semiconductor detector technology have caused much interest in nuclear med... more Recent developments in semiconductor detector technology have caused much interest in nuclear medicine (7). However, the medical use of semi conductor detectors is, at the present time, restricted to certain research institutes. Flanigan et al (2) have compared the uptake of different simultaneously in jected radiopharmaccuticals into tumor-bearing dogs with a dual Nal(Tl) detector. However, their results could not provide sufficient precision because of the difficulty inherent in detecting many radiopharma ccuticals with a conventional Nal(Tl) detector. On the other hand, the Ge(Li) semiconductor detector has a high-resolution for gamma rays compared with a conventional Nal(Tl) detector. The use of the Ge(Li) detector made it possible to detect up takes of different simultaneously injected radiopharmaceuticals in the organ at the same time. Numerous recent reports have indicated that li7Gacitrate is readily taken up by malignant tissues (3-5). In addition there has been recent evidence that mlnchloride and 7r'Se-seIenite are also preferentially in corporated into tumors (6,7). The authors studied the uptake of these simultaneously injected radiopharmaceuticals by Ehrlich's tumor-bearing mice

The Journal of urology, 1972

Radiology, 1986

Hirschprung disease is usually diagnosed in infancy. Occasionally patients reach adulthood withou... more Hirschprung disease is usually diagnosed in infancy. Occasionally patients reach adulthood without diagnosis or treatment. Four cases of adult Hirschprung disease are described. The principal radiographic findings are a markedly dilated, feces-filled colon above the zone of transition; a narrowed rectum; a cone- or funnel-shaped zone of transition; and a mosaic colonic pattern caused by collapsed redundant mucosa after colonic cleansing. In an adult, identification on a barium enema examination of an abrupt, smooth transition zone in the rectum with proximal colonic dilatation, in conjunction with an appropriate clinical history, should suggest the diagnosis of adult Hirschprung disease.

Radiology, 1991

Six cases of splenic flexure volvulus were studied over a 14-year period. The patients were aged ... more Six cases of splenic flexure volvulus were studied over a 14-year period. The patients were aged 15-62 years. Five of the six patients were mentally retarded, lifelong residents of a long-term-care institution. Two patients had congenital absence of normal colonic attachments; the other four patients had elongated mesocolons, presumably from chronic constipation. All patients underwent abdominal radiography, followed by a barium enema study. In the appropriate clinical setting, radiographic diagnosis of a splenic flexure volvulus is suggested when the following are seen: (a) a markedly dilated, air-filled colon wtih an abrupt termination at the anatomic splenic flexure; (b) two widely separated air-fluid levels, one in the transverse colon and the other in the cecum; (c) an empty descending and sigmoid colon; and (d) a characteristic beak at the anatomic splenic flexure at a barium enema examination.

$Research paper thumbnail of Bladder injury and pelvic fractures$

Emergency Radiology, 1994

ABSTRACT This study had two goals. The first was evaluating the relationship of intraperitoneal a... more ABSTRACT This study had two goals. The first was evaluating the relationship of intraperitoneal and extraperitoneal bladder injury to pelvic fractures. To determine that 10 patients with bladder rupture and no pelvic fracture were compared with 24 patients having both bladder injury and pelvic fracture following blunt trauma. In patients with pelvic fractures, extraperitoneal bladder ruptures were more common (15 of 24) than intraperitoneal tears. An extraperitoneal rupture was unlikely in the absence of a pelvic fracture (1 of 16). It thus appears that the compressive force that deforms and fractures the pelvic bones and ligaments exerts a shearing force on the bladder base resulting in an extraperitoneal injury. Intraperitoneal bladder rupture was more common (7 of 10 patients) without pelvic fractures and most likely resulted from sudden compression of a distended bladder. The inebriated patient appears to be at increased risk for intraperitoneal rupture. The second goal was to determine if the vector mechanism causing pelvic injury determines the frequency and type of bladder laceration. Toward that goal 127 patients with pelvic fracture and no lower urinary tract injury were compared with 24 patients suffering a combined pelvic fracture and bladder rupture. Based on the radiographic pattern of pelvic fracture, we found no statistically significant difference in the frequency of bladder injury with lateral compression, anteroposterior compression, vertical shear, or complex pelvic fractures.

The American Journal of Surgery, 2000

Pancreatitis and jaundice secondary to ductal obstruction are common in intraductal papillary muc... more Pancreatitis and jaundice secondary to ductal obstruction are common in intraductal papillary mucinous tumors (IPMT) of the pancreas. However, the incidence and severity of the complications of obstruction are not well documented. The aim of the study was to investigate the clinical presentation and outcome of 10 patients with IPMT. All cases of IPMT diagnosed between 1994 and 1999 were reviewed. Four of the 10 patients developed severe acute illness with systemic complications resulting from ductal obstruction. Three suffered acute cholangitis with sepsis, and 1 developed necrotizing pancreatitis and ARDS. There was 1 postoperative death in a patient with adenocarcinoma. All other patients are alive and well with a median follow-up of 26 months (survival 90%). Pancreatic or common bile duct obstruction in IPMT may result in acute, life-threatening disease. Aggressive surgical therapy is warranted before development of complications of ductal obstruction or progression of tumor occurs.

Radiographics : a review publication of the Radiological Society of North America, Inc

The field of diagnostic and therapeutic radiology has always been characterized by constant innov... more The field of diagnostic and therapeutic radiology has always been characterized by constant innovation and creativity to evolve to its current form. There are numerous imaging techniques that were once prevalent but have become outdated and were replaced by the current examinations and modalities, which improve diagnostic accuracy and patient outcomes. Many of these outdated examinations were first described in the journal Radiology during its first 100 years of existence and were subsequently able to be disseminated across its vast readership to become the standard of care across the nation and the world. These earlier techniques, such as pneumoencephalography as it applies to neuroimaging and neurosurgery; kymography, a predecessor of cardiac imaging; contrast agents such as Thorotrast; and miscellaneous cultural tools, such as the shoe-fitting fluoroscope, left lasting impressions on the current practice of radiology and reflect a small subset of the imaging examinations of our p...

Radiology, 1970

The authors have investigated the incidence and type of bone lesions in 38 patients with Wilson&#... more The authors have investigated the incidence and type of bone lesions in 38 patients with Wilson's disease (hepatolenticular degeneration) and correlated the radiographic findings with dysfunction of the central nervous system, liver, and kidneys. The skeletal surveys were considered normal in 5 patients, while 18 demonstrated demineralization alone. Nine showed subarticular cysts; fragmentation of bone about the joints was seen in 6, primarily in the hands, wrists, feet, and ankles.

Seminars in Ultrasound, CT and MRI, 1999

CT performed without oral or intravenous contrast is the initial imaging study of choice in many ... more CT performed without oral or intravenous contrast is the initial imaging study of choice in many situations for the detection of hemorrhage anywhere in the abdomen and pelvis. The presence or absence of hemorrhage can be determined rapidly, and the amount and precise location of hemorrhage can also be evaluated. This article reviews the appearances and the common and unusual etiologies of abdominal and pelvic hemorrhage on unenhanced CT. The role of intravenous contrast-enhanced CT in patients with known or suspected abdominal and pelvic hemorrhage is also examined.