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Biomedical subjects

R B Dyer

Publications and source records attributed to R B Dyer.

At least 91 records · Page 5Linked to original sources
PubMed1988

Diabetes and hypertension in South African Indians. A community study.

A community survey was done to assess the prevalence of diabetes and hypertension in Indians living in Durban. Each subject, selected by systematic cluster sampling, had blood pressure measured and a glucose tolerance test. Diagnoses of diabetes mellitus and of hypertension were based on World Health Organization criteria. Of the 1,064 subjects studied 9% had diabetes and 14.2% hypertension; diabetes mellitus was more common in women (10.5%) than men (7%), whereas the prevalence of hypertension was similar in both sexes (women 13.5%, men 14.7%). Hypertension was found in 45.8% of the diabetic subjects, 31.4% of those with impaired glucose tolerance and 9.9% of those with normal glucose tolerance. Although hypertension was more common in women (63.3%) than men (37.9%) in the diabetic group, there was no significant difference in the sex distribution in the subjects with impaired glucose tolerance and those with normal glucose tolerance. Of the subjects with hypertension, 29.1% had diabetes; there was no significant difference in the sex distribution. The mean age-adjusted body mass indices were significantly higher in the hypertensive subjects with all degrees of glucose tolerance than in normotensive subjects. There was a trend towards elevation of both systolic and diastolic blood pressure with increasing degrees of glucose intolerance and increasing age.

Adolescent↗
PubMed1988

Testicular germ cell tumors in HLA-genotype non-twin brothers.

The diagnosis of metastatic testicular carcinoma in a thirty-three-year-old man and his nineteen-year-old brother is reported. Histologically, the tumor of the older brother consisted predominantly of embryonal carcinoma with minor components of seminoma and adult teratoma; the tumor of the younger brother consisted entirely of embryonal carcinoma. Since previous reports suggest the possibility that the HLA genotype may be a factor in the etiology of testicular cancer, we typed the parents and four children of this family. The two affected brothers shared a paternal HLA-A3, Cw-,B7,DR2 haplotype that had not been transmitted to the two other living siblings. Analysis of the distribution of HLA haplotypes of the affected non-twin brothers of this family and those of three other non-twin pairs of brothers that have been reported showed that the affected pairs in each family shared one HLA haplotype. The differences between the expected and the observed distribution of HLA haplotypes in the four sibling pairs is not statistically significant, perhaps because of the small number of patients typed. Two of the four pairs shared a common haplotype. Additional family studies are required to establish a genetic origin of testicular tumors and to determine whether or not a "testicular carcinoma disease" gene is linked to the HLA complex. A large number of multicase families will be required for linkage analysis.

Adult↗
PubMed1988

End stage renal disease associated with acquired cystic disease and neoplasia.

Acquired renal cystic disease is a recently recognized disease entity that primarily afflicts patients on chronic hemodialysis. The incidence of acquired renal cystic disease in patients with end stage renal disease ranges from 30 to 95 per cent. The major complications of acquired renal cystic disease appear to be neoplasia and hemorrhage. Neoplasia has been demonstrated in up to 45 per cent of all end stage kidneys with acquired cystic disease. Our surgical experience with 7 cases of end stage renal disease is reported. Acquired renal cystic disease was noted in 4 of the 7 cases (57 per cent) and renal neoplasia was evident in all 7. Worldwide experience to date in combined pathology and radiology series of patients undergoing hemodialysis demonstrates that acquired cystic disease, "tumor" (usually adenoma or oncocytoma) and renal carcinoma occur at respective rates of 47.1, 4.8 and 1.5 per cent. Since the pathologist will detect more tumors and cysts than the radiologist, these figures probably are an underestimate of the true incidence. Long-term surveillance of patients harboring end stage kidneys is recommended beginning with a baseline ultrasound.

Adenoma↗
PubMed1988

Radiologic contribution to the management of patients undergoing extracorporeal shock wave lithotripsy.

Since its first clinical application in 1980, the use of extracorporeal shock wave lithotripsy (ESWL) has dramatically changed the treatment of urinary tract stone disease. More than 80% of patients with urolithiasis will undergo ESWL as a first line therapy. Detection of stones, appropriateness of ESWL treatment, successful stone therapy, termination of the ESWL procedure, and evaluation of treatment complications are all dependent on radiologic input. The application of adjuvant interventional radiologic percutaneous techniques will extend the use of ESWL to an additional 15% of patients and reduce the need for surgical intervention. Additionally, percutaneous techniques can be used to improve success rates in problematic cases and to treat complications related to the ESWL procedure. This article discusses the pre- and postprocedural radiologic evaluation of patients undergoing ESWL. Adjuvant interventional radiologic techniques useful in the management of these patients are also discussed.

Humans↗
PubMed1987

Cardiac beriberi. A report of 4 cases.

Four cases of beriberi were diagnosed on clinical grounds and 3 were confirmed biochemically. The cases cover a spectrum of beriberi heart disease ranging from a hyperdynamic circulation to circulatory shock. They are Shoshin beriberi, beriberi with high output failure, beriberi with signs of a hyperdynamic circulation alone and beriberi with underlying cardiomyopathy.

Adult↗
PubMed1987

Juvenile pemphigus vulgaris. A case report.

A 13-year-old South African Indian boy who presented with oral mucosal lesions and skin blisters due to juvenile pemphigus vulgaris is described. Treatment with high-dose oral corticosteroids produced a prompt clinical response. Pemphigus vulgaris is rare in the young and this may lead to misdiagnosis and inappropriate therapy.

Adolescent↗
PubMed1986

Magnetic resonance imaging of the renal mass.

To compare the effectiveness of magnetic resonance imaging with that of excretory urography, retrograde pyelography, ultrasound, computerized tomography, angiography and venography 34 patients with renal masses, including 25 renal cell carcinomas, were examined on a 0.15 Tesla Picker 1100 magnetic resonance imager with multiple pulse sequences. Pathological proof was available for all cases except renal cysts, for which ultrasound or computerized tomographic findings were accepted. Differentiation of solid from cystic lesions was seen with magnetic resonance imaging, ultrasound and computerized tomography but not excretory urography. Tumor invasion of the renal vein and inferior vena cava was visualized in 7 patients by magnetic resonance imaging, ultrasound, computerized tomography and venography but not by excretory urography. Magnetic resonance T1 contrast scans best characterized renal masses, with good resolution of metastatic lymphadenopathy and renal cysts. Scans showing T2 contrast were best for identification of pseudocapsules in renal carcinoma, venous invasion by tumors and papillary adenocarcinoma. Advantages of magnetic resonance imaging include differentiation of solid masses from benign cystic lesions, and identification of major blood vessels and vascular invasion without administration of contrast medium. Disadvantages of magnetic resonance imaging are long imaging times and motion artifacts. Advances by the manufacturer in solving these problems will strengthen the role of magnetic resonance imaging in renal evaluation.

Angiography↗
PubMed1986

The abnormal nephrogram.

Recognition of qualitative abnormalities in the nephrogram may be as important as the recognition of structural abnormalities for the detection of renal disease.

Angiography↗
PubMed1986

Atypical carcinoid of the lung: radiographic features.

Atypical carcinoid of the lung is a neuroendocrine neoplasm with cellular and clinical features intermediate between those of typical carcinoid and small cell undifferentiated carcinoma of the lung. These neoplasms exhibit a wide range of histologic appearances and are misdiagnosed in up to 50% of cases. The clinical records and radiographs of 32 patients with this diagnosis from the University of Virginia Medical Center and Wake Forest University Medical Center were reviewed. Sixteen of these cases had been misdiagnosed pathologically. While the most frequent radiographic finding was a round or avoid lobulated peripheral mass, other appearances included thin-walled cavities, poorly defined nonsegmental infiltrates, and mediastinal masses. Fifty percent of the patients in this study have died from their tumor, with a mean survival of 15.5 months. This contrasts with both typical carcinoid and small cell undifferentiated carcinoma, in which patients develop fatal metastatic disease in 5% and nearly 100%, respectively. Proper categorization of typical carcinoid, atypical carcinoid, and small cell undifferentiated carcinoma is necessary to determine appropriate therapy, prognosis, and reporting of end results.

Adult↗
PubMed1985

The prevalence of diabetes mellitus in a large group of South African Indians.

The prevalences of diabetes mellitus and impaired glucose tolerance (IGT) among 866 Indians living in the Chatsworth area of Durban were determined. The study group was selected by cluster sampling and the participants underwent a modified glucose tolerance test (GTT) (determination of fasting and 2-hour plasma glucose levels after a 75 g glucose load). On the basis of the revised World Health Organization criteria the overall prevalence of diabetes mellitus was 11% and of IGT 5,8%. Of the 368 men, 7,6% were found to have diabetes mellitus and 7,1% IGT; the prevalence of diabetes mellitus was much greater among women (13,5%), while there was less IGT (4,8%). Subjects with diabetes mellitus were significantly older (mean 50,7 years) than those with a normal GTT (mean 30,9 years), but of similar age distribution compared with the IGT group (mean 46 years). Subjects with a normal GTT had a significantly lower mean body mass index (22,1 +/- 2,8) compared with diabetic subjects (26,1 +/- 5,2) or the IGT group (25,8 +/- 6,6). Obesity was commonly associated with both diabetes mellitus and IGT, particularly among women.

Adolescent↗
PubMed1983

Computed tomographic features of round atelectasis.

Computed tomography (CT) of the chest is often variable in the evaluation of pulmonary masses. Our case demonstrated characteristic findings on CT that aided in the diagnosis of round atelectasis.

Diagnosis, Differential↗
PubMedDate not supplied

Interureteric ridge edema: incidence and etiology.

BACKGROUND: Interureteric ridge edema may be seen at intravenous urography (IVU) and is related to acute lower ureteral obstruction, trauma, or calculi. The purpose of this study was to explore the relationship between interureteric ridge edema and acute distal ureteral obstruction caused by ureteral calculi. METHODS: A total of 338 patients who had IVU for various indications during a 6-month period were reviewed for the presence of interureteric ridge edema. RESULTS: Interureteric ridge edema was seen in 12 (4%) of 338 patients, all with acute lower ureteral obstruction from stones. Interureteric ridge edema was best demonstrated with the partially filled bladder film or post-void bladder film in all cases. CONCLUSION: Interureteric ridge edema is most commonly caused by stone-induced distal ureteral obstruction and is less commonly seen with recent passage of a stone or other etiologies. Interureteric ridge edema was present in 26% of patients with acute lower ureteral obstruction.

Adult↗
PubMedDate not supplied

Mass effect in the renal sinus: an anatomic classification.

Before the advent of modern imaging techniques, pathologic processes in the renal sinus were diagnostic enigmas. Many of the conditions create nonspecific deformities of the contrast-filled collecting system. In the past, the discovery of these abnormalities often led to unnecessary exploration. Modern imaging techniques usually allow a specific diagnosis to be made, but because a number of the pathologic conditions affecting the renal sinus have similar appearances on a single type of imaging study, complete delineation may require correlation of a number of diagnostic techniques. An understanding of the normal sinus anatomy allows classification of pathologic processes that occur in this region and ensures an orderly imaging investigation. The anatomic classification is based on the structure from which the mass arises. The source of the mass may be any structure within the renal sinus (intrinsic), the enveloping renal parenchymal (adjacent), or a source outside the kidney itself with subsequent sinus involvement (extrinsic). This classification will be used to review a number of pathologic processes that occur in the renal sinus and pertinent imaging features.

Diagnosis, Differential↗
PubMedDate not supplied

Radiologic findings in acute urinary tract obstruction.

Acute urinary tract obstruction, a common disease in daily practice, often requires performance of emergency intravenous urography (IVU). However, the spectrum of urographic abnormalities seen with acute obstruction has not been thoroughly addressed. The purpose of this study was to explore the IVU findings in patients with acute urinary tract obstruction. Records of 380 patients who underwent IVU in our hospital during a 6-mo period were reviewed for IVU evidence of acute urinary tract obstruction. Of the 380 patients, 53 (14%; 39 men, 14 women; average age = 43 yr) had acute urinary tract obstruction. All obstructions except one were located in the lower one-third of the ureter. The causes of acute urinary obstruction included ureteral stones in 34 (64%), ureteral edema or lucent stones in 16 (30%), neoplasms in 2 (4%), and inflammatory disease in 1 (2%). Abnormal radiologic findings were hydroureter in 46, nephropyelographic delay in 36, hydronephrosis in 35, interureteric ridge edema in 11, persistent dense nephrogram in 6, urine extravasation in 5, vicarious excretion in 1, striation in 1, and stricture in 1. Radiographic results were normal in one patient. The most common clinical indications of acute ureteral obstruction are flank pain and hematuria, and calculi are the major cause. In one-third of patients, radiopaque calculi are not detectable with IVU during acute urinary tract obstruction. A careful and thorough evaluation of the IVU should be performed in patients with clinical indications of acute urinary obstruction.

Acute Disease↗