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Biomedical subjects

W B Gefter

Publications and source records attributed to W B Gefter.

At least 109 records · Page 6Linked to original sources
PubMed1983

Ventilator-induced subpleural air cysts: clinical, radiographic, and pathologic significance.

Alveolar rupture from the high airway pressures used in the treatment of adult respiratory distress syndrome may cause interstitial dissection of gas peripherally and the formation of "subpleural air cysts." These thin-walled, rounded air collections are easily detectable radiographically, and their recognition can provide an important early sign of pulmonary barotrauma. This report summarizes the clinical, radiographic, and pathologic features of this lesion in 5 adult patients. We found that tension pneumothorax rapidly occurs after the appearance of these cysts if airway pressures are not reduced or chest tubes are not in place. Secondary infection of the cysts was also common and added significant morbidity to this already compromised group of patients.

Adult↗
PubMed1982

The role of mammography in evaluating patients with early carcinoma of the breast for tylectomy and radiation therapy.

The value of mammography in treatment planning for early breast cancer following excisional biopsy was studied in 38 patients. One-third of the post-biopsy mammograms yielded information useful for therapy or follow-up, specifically the presence or absence of gross residual tumor [11] and detection of occult lesions in the opposite breast or axillary nodes [3]. They also proved valuable as base-line studies, since scars seen on post-therapy mammograms may simulate new or recurrent tumor [3]. Approximately half [21] of the post-biopsy studies were nondiagnostic because of dense parenchyma [14] or biopsy-related distortion [7]. Four were considered falsely positive for residual tumor. These results indicate that mammography can contribute significantly to the management of patients undergoing tylectomy and primary radiotherapy for breast cancer.

Adult↗
PubMed1982

Bronchopleural fistula complicating invasive pulmonary aspergillosis.

Pleural involvement has been notably absent in reviews of invasive pulmonary aspergillosis. This report describes the development of a bronchopleural fistula complicating invasive aspergillosis in a patient receiving chemotherapy for leukemia. The fungal hydropneumothorax occurred despite early diagnosis of the pulmonary infection and prompt treatment with amphotericin B. Closed pleural drainage and continued antifungal medication resulted in ultimate cure of the infection. The presumed pathophysiologic aspects of this event are discussed and the literature on pleural aspergillosis is reviewed.

Adult↗
PubMed1982

Pleural thickening: its significance and relationship to asbestos dust exposure.

The admission chest radiographs of 824 were screened for the presence of bilateral pleural thickening. Those patients with pleural thickening were scored according to the ILO classification of radiographs of the pneumoconioses. The prevalence of bilateral pleural thickening was high (6.2%) in these patients, of whom 67% had an environmental or occupational history suggestive of asbestos exposure. The predictive value of bilateral pleural thickening alone as an indicator of previous asbestos exposure was 67%. If one excludes known medical or surgical etiologies of pleural thickening then the predictive value increased to 81%. The radiographic detection of bilateral pleural thickening has a strong association with prior asbestos exposure.

Adult↗
PubMed1982

Lobar bronchioloalveolar cell carcinoma.

Bronchioloalveolar cell carcinoma has a variety of radiographic appearances. Usually it is a localized, well circumscribed nodule in the lung periphery. Nodules of various sizes that appear to coalesce in one or both lungs characterize a diffuse pattern of this disease. Occasionally, chronic lobar consolidation simulating a bacterial pneumonia may be seen. The clinical and radiographic course of eight patients whose bronchioloalveolar cell carcinoma appeared initially as lobar consolidation was analyzed. Four tumors rapidly progressed to involved the opposite lung. Attempts should be made by radiographic and other means to establish inoperability, since surgery is rarely useful in this type of lung cancer.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1981

CT differentiation of solitary from diffuse bronchioloalveolar carcinoma.

The therapy and prognosis of bronchioloalveolar carcinoma vary greatly with the solitary versus the diffuse form of the disease. Solitary disease demonstrates a high resectability rate with good long term prognosis. This contrasts with the rapidly fatal course associated with the diffuse form. To date, categorization of patients into either the solitary or the diffuse form has been based solely on conventional radiography. Multiple authors have reported cases of disease not demonstrated radiographically but discovered at surgery or autopsy. With the superiority of chest computed tomography (CT) for demonstrating parenchymal abnormalities, we propose that preoperative CT may be crucial in the workup of patients with presumed solitary bronchioloalveolar cell carcinoma. Early identification of diffuse disease or confirmation of the presence of solitary disease by CT may allow the institution of proper therapy and better evaluation of patient prognosis.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1981

Candidiasis in the obstructed esophagus.

Four cases of esophageal candidiasis complicating functional or mechanical obstruction are described. The causes of the obstruction included achalasia, scleroderma, and postoperative fundoplication. None of the commonly recognized conditions predisposing to esophageal candidiasis was present. The findings on barium study ranged from plaque-like filling defects to extensive nodularity and roughening of the mucosal surface, which must be distinguished from ingested debris. It is suggested that esophageal stasis of any cause can lead to candidiasis.

Adult↗
PubMed1981

The hypereosinophilic syndrome.

The hypereosinophilic syndrome is a spectrum of clinical disorders characterized by leukocytosis and marked eosinophilia without definable cause. Clinical symptoms and radiographic findings are most often due to congestive heart failure, although parenchymal lung infiltrates from the eosinophilia itself may be seen. Four documented cases with chest radiographs are presented.

Adult↗
PubMed1981

"Semi-invasive" pulmonary aspergillosis: a new look at the spectrum of aspergillus infections of the lung.

A chronic cavitary form of pulmonary aspergillosis may occur with mild immunosuppression or underlying lung disease. In this "semi-invasive" type, the fungus is intermediate between a simple saprophyte and an invasive pathogen. Aspergillus may produce extensive lung destruction despite the lack of vascular invasion. The absence of a previous cavity distinguishes such cases from secondary noninvasive mycetomas. Radiographic features include a chronic infiltrate, progressive cavitation, and subsequent mycetoma formation. Biopsy may be helpful; however, marked squamous metaplasia can produce false-positive Class V cytological findings even though malignancy is excluded. This variety of aspergillosis supports the concept that the traditional allergic, saprophytic, and invasive forms may represent a spectrum of disease dependent on host immune status and lung architecture.

Aged↗
PubMed1981

Progressive systemic sclerosis subgroups: variable pulmonary features.

Evidence has accumulated which enables subdivision of progressive systemic sclerosis (scleroderma) into three categories: (1) classic progressive systemic sclerosis (PSS); (2) the CRST/CREST syndrome; or (3) overlap syndromes. Previous reports of the chest film manifestations of PSS have used only the broad category of scleroderma without subdivision. This study analyzed the chest film manifestations of 73 PSS patients which have been subgrouped. Radiographic abnormalities, either interstitial lung disease or pleural effusion, were present as follows: PSS, 18% (8/44); CRST/CREST, 0% (0/9); and PSS-overlap, 75% (15/20). Interstitial lung diseases in the PSS-overlap group was usually basilar and of mild severity on the initial chest film obtained. While the classic PSS group had a very much lower incidence of lung disease, it was usually more diffuse and severe.

Adult↗
PubMed1979

Ultrasonic differentiation of types of ascitic fluid.

A review of 65 cases of proven ascites was done to assess the accuracy of ultrasound in distinguishing transudates from exudates. In 10 patients with malignant ascites, ultrasound suggested this in six by showing matted bowel loops, loculation, or hepatic metastasis. In each of the five patients with peritonitis, infected ascites was suggested by observing septations or debris within the fluid. A sonographic diagnosis of exudate was not made in any of the 50 confirmed transudates. The echographic characteristics which may suggest infected or malignant ascites are discussed.

Ascites↗