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Biomedical subjects

W R Eyler

Publications and source records attributed to W R Eyler.

At least 19 recordsLinked to original sources
PubMed1989

Chest pain and dyspnea related to "crack" cocaine smoking: value of chest radiography.

The chest radiographs of 71 patients who had chest pain or shortness of breath following the smoking of highly potent "crack" cocaine were retrospectively evaluated. Nine patients had abnormal findings on radiographs as follows: atelectasis or localized parenchymal opacification in four, pneumomediastinum in two, pneumothorax in one, hemopneumothorax in one, and pulmonary edema in one. Radiographic detection of these abnormalities was important in the clinical management of these patients. This spectrum of findings is presented with a discussion of the pathophysiologic mechanisms responsible.

Adolescent↗
PubMed1986

Contrast media for angiography: effect on renal function.

A total of 125 patients with severe peripheral vascular disease were examined with translumbar aortography. The mean dose of contrast medium injected was 65 ml of Angio Conray (containing 31.2 g of iodine). Forty patients were pretreated with mannitol, and 32 received furosemide. Thirty-eight patients (30%) had diabetes and, presumably, diabetic nephropathy. Eleven of them had significant azotemia (creatinine values greater than or equal to 4 mg/dl). Administration of contrast material did not significantly reduce renal function in any patient group. We conclude that acute renal failure following the injection of contrast material is uncommon, is reversible, and almost always occurs when avoidable complicating factors are present.

Adolescent↗
PubMed1982

The value of radiographic and computed tomography in the staging of lung carcinoma.

A prospective double-blind study was undertaken to compare computed tomography (CT) and conventional radiographic tomography (RT) in the staging of lung carcinoma. Seventy-five patients had CT and RT of the mediastinum and hilum prior to operation. The presence or absence of metastasis to lymph nodes documented at the time of operation was the standard applied to the studies. CT correctly predicted the presence or absence of mediastinal lymphadenopathy in most cases (sensitivity 91%, specificity 94%), while RT was less helpful (sensitivity 61%, specificity 86%). Metastatic mediastinal lymph nodes in those patients with false negative CT and RT studies averaged only 0.8 cm in diameter, probably accounting for the negative radiographic findings. Both CT and RT had poor predictive values in detecting hilar lymphadenopathy (sensitivity 73% and 47%, specificity 87% and 72%, respectively). The predictive value of CT in the evaluation of mediastinal lymphadenopathy equaled that of mediastinoscopy or mediastinotomy. When CT of the mediastinum demonstrates no lymphadenopathy, invasive staging can be deferred for definitive thoracotomy. Since false positive values were seen with both CT and RT scans of the mediastinum (4% and 8%, respectively), invasive staging will still be necessary in those patients with positive studies.

Adult↗
PubMed1982

The renal sinus during allograft rejection: sonographic and histopathologic findings.

In fourteen renal allografts, the sonographic appearance of the renal sinus was correlated with the histopathologic findings. In each allograft specimen, the histologic changes in the renal sinus were compared with those in the renal cortex. Except for one case (hyperacute rejection), the histologic rejection changes were of similar severity within the cortex and renal sinus. When the renal sinus histologic changes of rejection were considered to be minimal (three patients), the sonographic appearance of the renal sinus was classified as normal. With moderate histologic changes in the renal sinus (five patients), the sonographic findings in four patients were considered moderate, with a change in spatial distribution resulting in a coarse and uneven distribution of renal sinus echoes. When the renal sinus histologic changes of rejection were interpreted as severe (six patients), the sonographic findings were similarly more advanced. Except for a very few intense echoes distributed in an irregular pattern, the area of the renal sinus blended with the adjacent parenchyma. The study demonstrated a good correlation between histology and sonography of the renal sinus during allograft rejection, and promises reliable prediction of the severity of the rejection process using a noninvasive, rapid, and relatively simple approach.

Adipose Tissue↗
PubMed1982

Renal parenchymal disease: sonographic-histologic correlation.

A retrospective study of 109 patients who underwent renal biopsy was designed to correlate the sonographic appearance of the kidney with the histologic changes and clinical and laboratory findings in various renal parenchymal diseases. The clinical, pathologic, and sonographic data were analyzed blindly and independently by a team from each corresponding discipline. There was no correlation between the specific sonographic appearance and the type of renal disease. There was a significant correlation between renal length and the prevalence of global sclerosis, focal tubular atrophy, and the number of hyaline casts per glomerulus. A significant positive correlation was also found between cortical echogenicity and the severity of global sclerosis, focal tubular atrophy, the number of hyaline casts per glomerulus, and focal leukocytic infiltration. While there was overall significant correlation between the degree of cortical echogenicity and blood urea nitrogen and creatinine concentrations in each group, a wide range of variance was present. It is not currently feasible to distinguish different types of renal medical disorders using diagnostic ultrasound.

Adolescent↗
PubMed1982

Disease in the femoral triangle: sonographic appearance.

Twenty-nine patients had sonographic evaluation of the femoral triangle because of pain or swelling. The entities diagnosed by sonography were abscesses (seven), cellulitis (three), hematoma (five), nodal enlargement (four), aneurysm of the femoral artery (three), and thrombophlebitis of the femoral vein (seven). Both abscesses and hematomas were poorly defined primarily anechoic masses. Soft-tissue swelling but no distinct masses were present in cellulitis, and all cases of adenopathy were well defined anechoic masses. Aneurysms were also primarily well defined, pulsatile, anechoic masses except mycotic aneurysm, which may present as a primarily solid mass. The sonographic features of thrombophlebitis which has received scant attention in the sonographic literature are stressed. Findings suggest a dilated anechoic vein is characteristic of this entity. Although the sonographic findings or clinical data of many of these entities may be nonspecific, when used in combination, the correct diagnosis can usually be obtained.

Abscess↗
PubMed1981

Acute post-transplantation renal failure: differential diagnosis by ultrasound.

Sonograms of 35 patients with cadaveric renal allografts were reviewed. The patients included five with successful renal transplantations, seven with acute tubular necrosis, 19 with acute rejection, one with complete occlusion of the renal artery, and three with stenosis of a renal artery. During the course of acute tubular necrosis, the renal anatomy remained sonographically unaltered. During the course of acute rejection, there was a spectrum of sonographic findings including increase in renal volume, decreased amplitude of the renal sinus echoes, enlarged medullary pyramids, indistinct corticomedullary boundary, increased echogenicity of the renal cortex, areas of decreased parenchymal echogenicity, sparse cortical echoes, and perirenal fluid collections as a result of hematoma or crescentic collection of fluid around the kidney. In both arterial occlusion and stenosis, no sonographic abnormalities of renal anatomy were seen and the only finding was lack of normal post-transplantation hypertrophy. Our study encourages the use of sonography in acute post-transplantation renal failure. If serial ultrasound studies are available and correlation with clinical and laboratory data and nuclear medicine studies are obtained, the correct diagnosis may be reached without the use of invasive procedures.

Acute Kidney Injury↗
PubMed1981

Sonographic findings in complicated peptic ulcer.

The sonographic findings in 7 patients with complicated peptic ulcer are reported. Of 4 patients with perforated ulcers, 2 had a subphrenic fluid collection, 1 had subhepatic extraluminal fluid, and 1 had an inflammatory mass in the gallbladder fossa. The ulcer penetrated into the liver in 1 and the pancreas in 2. The sinus tract between the duodenum and the liver could be seen. The patients with penetrating ulcer had a solid mass indistinguishable from other solid pancreatic masses.

Aged↗
PubMed1980

Sonographic features of ATN and of acute rejection in renal allografts.

The sonographic changes occurring during post transplant acute tubular necrosis and rejection are discussed. Seven patients with proven ATN are shown to maintain normal sonographic features and exhibit normal hypertrophy. In contrast during acute rejection the findings in 21 patients included in order of frequency the following 1) sudden increase in renal volume, 2) prominent medullary pyramids, 3) abnormal echogenicity, 4) decreased amplitude of the central sinus echoes, 5) increased cortical thickness, 6) crescent shaped fluid collections and 7) indistinct corticomedullary boundary.

Acute Kidney Injury↗
PubMed1979

The role of ultrasound in the diagnosis of kidney allograft rejection.

Seventeen nephrectomized dogs underwent kidney transplantation from unrelated donors. Routine immunosuppressive therapy was administered. Serial ultrasound studies and biopsies and complete pathological examinations were performed and compared. A number of sonographic changes were observed within the renal parenchyma during rejection, some of which were present before a significant rise in serum creatinine levels. The medulla became enlarged due to edema, followed by growth of the rest of the kidney and thickening of the cortex. The cortical echoes became more sparsely distributed and either increased or decreased in amplitude; distribution was generalized or localized. During rejection, the corticomedullary boundary became indistinct. Later, a decrease in the renal sinus echoes was also noted. In 2 cases, perirenal fluid collections occurred as the result of renal rupture.

Animals↗
PubMed1979

Evaluation of acute post-transplant renal failure by ultrasound.

Autotransplantation of the kidney was performed in seven adult mongrel dogs. A model of acute tubular necrosis (ATN) was developed by subjecting the kidney to warm ischemia (37 degrees C) for 40 to 60 minutes. Serial ultrasound examinations were performed every 12 hours until the animal died or was killed. Sonographic findings were correlated with laboratory and histological data. Throughout the course of ATN, the characteristic normal echo pattern of the kidney remained unchanged in six of seven dogs. In one animal there were changes in the renal cortex, while the medullary pyramids showed no alteration from the base-line study. This contrasts with extensive abnormalities found during rejection.

Animals↗
PubMed1979

Diagnostic accuracy in peripheral lung lesions. Factors predicting success with flexible fiberoptic bronchoscopy.

Ninety-seven consecutive peripheral lung lesions were evaluated by biplane fluoroscopically guided flexible fiberoptic bronchoscopy and analyzed to define features that predict diagnostic yield. The overall diagnostic accuracy was 56 percent (63 percent for malignant and 38 percent for benign lesions). The most important characteristic associated with a positive cyto- or histopathologic diagnosis was size of the lesion; the yield was 28 percent when the diameter was less than 2.0 cm compared to 64 percent if the diameter was greater than or equal to 2.0 cm (P = 0.0035). The diagnostic yield was similar for lesions located in the outer and middle third of the lung if the diameter was greater than 2.0 cm; inner one-third lesions were correctly diagnosed more frequently, related in part to the larger size of these lesions. There was no significant difference in diagnostic yield for the following: segmental location, greatest distance from carcina on either the posteroanterior or lateral radiograph, or radiographic characteristics of the lesion. We conclude that biplane fluoroscopically guided flexible fiberoptic bronchoscopy is a reasonable diagnostic procedure for peripheral lesions greater than or equal to 2.0 cm in diameter, but that alternative procedures should be used for lesions under 2.0 cm in diameter.

Adult↗
PubMed1977

Metastatic basal cell carcinoma: review, pathogenesis, and report of two cases.

In 93 reported cases of metastatic basal cell carcinoma (BCC), 76 had spread through lymphatics or blood vessels. Two more cases are presented, bringing the total to 78. Metastasis to regional lymph nodes was the most frequent, followed in frequency by lungs, bones, and other organs. The size of the primary tumor, its site, its resistance to x-ray therapy, and the effects of radiation appeared to contribute to the occurrence of metastasis. However, in an appreciable number of cases, tumor dissemination was related to incomplete excision followed by immediate wound closure, particularly by grafting. It is recommended that wound grafting be delayed for at least six months after excision or large or recurrent BCC in order to assure complete removal.

Basal Cell Carcinoma↗