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Biomedical subjects

C A Muhletaler

Publications and source records attributed to C A Muhletaler.

At least 19 recordsLinked to original sources
PubMed1984

Advantages of nonionic contrast agents in adult urography.

Nonionic radiographic contrast agents have a reported advantage of decreased contrast osmolality. Before clinical significance can be attributed to this lower osmolality, an observed difference must be documented. In a randomized double-blind study with 55 patients, Iohexol, a new nonionic contrast agent, is compared with Renografin 60 for use in adult urography. Hemodynamic parameters, serum and urine chemistries, including osmolality, were recorded before and after contrast injection. Radiographic quality and adverse reactions were recorded. This study focused on the change in urine osmolality (delta Osm) from pre- and post-injection urine specimens. The group receiving nonionic contrast agents had an average delta Osm of 65 mOsm/L while those receiving the ionic agent had an average delta Osm of 120 mOsm/L. This significant difference in urine osmolality is discussed with respect to the observed advantage in radiographic quality and the lower incidence of adverse reactions noted in the group receiving nonionic contrast material.

Adolescent↗
PubMed1983

Palpable breast masses: evaluation by high frequency, hand-held real-time sonography and xeromammography. Work in progress.

The purpose of this study was to evaluate the diagnostic virtues and limitations of the combined use of high frequency, real-time ultrasound scanning (US) using hand-held transducers and xeromammography (XM) in the evaluation of palpable breast masses. Seventy-one patients, who ranged in age from 14 to 88 years and who had histologically proved masses, were examined by both imaging modalities. US demonstrated the highest degree of accuracy in establishing the presence of cysts (96%) and fibroadenomas (89%). XM afforded better overall depiction of the breast and correctly identified seven carcinomas, five of which were prospectively diagnosed by sonography. When all types of breast masses were considered, the combined use of XM and US was more accurate (89%) than when either XM (70%) or US (85%) was used alone. For this reason, a combined approach using both modalities in the examination of most patients with palpable breast masses is advocated. The advantages and limitations of both XM and US in the evaluation of palpable masses are discussed and illustrated.

Adenofibroma↗
PubMed1983

Renal transplant arterial stenosis: percutaneous transluminal angioplasty.

Seven hypertensive patients underwent percutaneous transluminal angioplasty for relief of arterial stenosis complicating renal allotransplantation. Five had end-to-side anastomosis of the donor renal artery to the recipient external iliac artery, and two had end-to-end anastomosis of the donor renal artery to the recipient internal iliac artery. Each patient had developed hypertension (blood pressure greater than 145/95 mm Hg), elevated peripheral venous plasma renin, and six demonstrated decrease in renal function as detected by an increase in serum creatinine at least 2 months after transplantation and without evidence of rejection. Angioplasty was technically successful without significant complications and blood pressure and biochemical abnormalities were improved or stabilized in all seven patients.

Adolescent↗
PubMed1983

Iohexol for excretory urography: a comparative study.

A new iodinated nonionic contrast agent (Iohexol) was compared to an ionic contrast agent (renografin 60) in a double-blind study. Fifty-five patients with normal renal function were studied for incidence of undesirable side-effects and quality of the resultant excretory urogram. No major adverse reactions occurred. Minor side-effects due to the contrast occurred more than two times as often with Renografin than when Iohexol was used. The quality of visualization of the collecting system on urography was considered excellent in 44% of the patients receiving Iohexol as compared to a 17% frequency when Renografin was used.

Adolescent↗
PubMed1982

Partial splenic embolization for hypersplenism in renal transplantation.

Immunosuppressive therapy is necessary in the treatment and prevention of rejection in renal transplant recipients. Unfortunately, these patients may become intolerant to this therapy when it is complicated by hypersplenism with leukopenia and/or thrombocytopenia. The therapy must then be either decreased or stopped, thus preventing adequate treatment or prevention or rejection. Splenectomy has been used to treat the hypersplenism to break this cycle. It requires operative intervention with general anesthesia and prolonged hospitalization, and has been associated with fulminant bacterial septicemia. For these reasons, partial splenic embolization was offered to our patients as an alternative to splenectomy in the treatment of their immunosuppressive therapy intolerance due to hypersplenism. Six patients with acute rejection episodes and one patient on dialysis awaiting transplantation underwent partial splenic embolization. It corrected the hypersplenism in each case without significant complications allowing control of the rejection episode with adequate immunosuppressive therapy in six patients. Strict aseptic technique, pain control, and antibiotic prophylaxis are advised to prevent the complications of splenic abscess, rupture, or septicemia when this technique is used.

Adolescent↗
PubMed1981

Pathogenesis of giant colonic diverticula.

The clinical, radiographic, and pathologic findings of 3 patients with giant colonic diverticula are presented. Although several theories have been proposed for the formation of these diverticula, they have not been fully documented. One of our cases illustrates the evolution of this disorder following typical colonic diverticulitis. The pathogenesis and differential diagnosis of this unusual entity are discussed.

Acute Disease↗
PubMed1981

Infarction after embolization of the ileocolic artery.

Treatment of colonic hemorrhage by therapeutic embolization of the involved artery may, rarely, result in bowel infarction. In one patient with angiodysplasia, bowel infarction resulted from a therapeutic embolization of the ileocolic artery, because of the arterial anatomy of the cecum, occlusion of the cecal branches can result in devascularization of the cecum and appendix, even if the colic and ileal branches are not occluded. Thus, the ileocolic artery may not be a good candidate for therapeutic embolization.

Cecum↗
PubMed1981

Conjugated sodium tyropanoate (Bilopaque) in the bowel: significance of its presence or absence after first-dose oral cholecystography.

Oral cholecystography following the ingestion of 4.5 g of sodium tyropanoate (Bilopaque) was performed in 1,053 patients. The radiographs of 89 patients in whom the gallbladder was either faintly visualized or nonvisualized were reviewed for the presence of conjugated contrast material in the bowel. All 89 of these patients underwent second-dose cholecystography. Oral cholecystography was found to be 100% accurate in the diagnosis of gallbladder disease when conjugated contrast media was found in the bowel in the presence of a faintly visualized or nonvisualized gallbladder. When this combination of findings is seen on the first-dose examination, a second-dose examination is unnecessary. When no conjugated contrast material is seen in the bowel after a first dose, a second dose is helpful only in those patients with normal biochemical liver function tests.

Adolescent↗
PubMed1981

Sonographic assessment of the bowel wall.

The thickness and regularity of the bowel wall can often be assessed by sonographic imaging. In 26 normal patients, the bowel wall averaged 3 mm in thickness when distended and 5 mm when nondistended. In contrast, in 12 patients with an abnormally thickened bowel wall, bowel wall thickness averaged 23 mm and the affected bowel segment exhibited decreased or absent peristalsis on real-time scanning. The data derived from this study may enable the sonographic distinction of abnormally thickened bowel wall from normal bowel segments in the collapsed and distended state.

Adenocarcinoma↗
PubMed1980

The pill bottle desiccant. A cause of partial gastrointestinal obstruction.

Two cases of partial upper gastrointestinal obstruction were found to be due to a pill bottle desiccant. In both patients, an organic stricture was present. The cylindrical nonsoluble container of the desiccant had a very characteristic radiological appearance. It is seen as a filling defect, with straight borders and square angles.

Accidents, Home↗
PubMed1980

Occurrence of oesophageal intramural pseudodiverticulosis in patients with pre-existing benign oesophageal stricture.

Five patients with benign oesophageal stricture are described who subsequently developed oesophageal intramural pseudodiverticulosis. Stricture was due to reflux oesophagitis in three patients and to lye ingestion in two. The minimum time between diagnosis of stricture and recognition of pseudodiverticulosis was two years. Most authors regard chronic inflammation as the initiating cause of pseudodiverticulosis. Although stricture is common, it generally occurs as part of the disease process and has not been regarded as a cause of the disorder. In our patients it is suggested that chronic inflammation due to stasis above a stricture, was the cause of pseudodiverticulosis. Out of the 36 cases of oesophageal intramural pseudodiverticulosis already reported, we could find only one patient in whom this sequence of events occurred.

Adolescent↗
PubMed1980

Acid corrosive esophagitis: radiographic findings.

Thirty-nine esophagograms of 24 patients after ingestion of muriatic acid (27% HCI) in suicide attempts were reviewed. All esophagograms were obtained in the acute, subacute, and chronic phases. In the acute and subacute phases, the radiographic findings consisted of mucosal edema, submucosal edema or hemorrhage, ulcerations, sloughing of the mucosa, atony, and dilatation. Strictures of the esophagus were present in the chronic phase. These radiographic findings were not different from those found in alkaline corrosive esophagitis. The severity of the corrosive esophagitis is considered related to the concentration, amount, viscosity, and duration of contact between the caustic agent and the esophageal mucosa.

Acute Disease↗
PubMed1980

Diagnosis of obstructive jaundice with nondilated bile ducts.

Obstructive jaundice with nondilated bile ducts was identified by percutaneous transhepatic cholangiography (PTC) in nine of 29 jaundiced patients in whom the etiology of the jaundice was not clearly established by clinical or laboratory means and no dilated ducts were seen at somography or computed tomography (CT). PTC was helpful in these none patients by: (1) differentiating obstructive from nonobstructive jaundice, (2) localizing the site and etiology of the obstructing lesion, and (3) determining operability.

Adenocarcinoma↗
PubMed1980

Traumatic aortic aneurysm: validity of esophageal tube displacement sign.

Displacement of the nasogastric tube to the right as a new sign in the diagnosis of an acute traumatic rupture of the thoracic aorta was reevaluated by statistical analysis in 28 patients (seven patients with a traumatic aortic aneurysm and 21 patients with normal aortas). This new sign was compared with the commonly used chest radiographic findings in 46 patients (eight patients with a traumatic aortic aneurysm and 38 with normal aortas). This study showed that when both the trachea and the nasogastric tube were shifted to the right, as seen on the chest radiograph, the patient had a 96% probability of having an acute rupture of the thoracic aorta.

Adolescent↗
PubMed1980

Pseudopathologic hip fracture: anatomic explanation.

Fracture of the hip may result in external rotation of the femoral diaphysis. When this occurs the proximal diaphysis may appear homogeneously dense, particularly in elderly woman. Computed tomography shows that the misleading appearance is due to variations in cortical thickness anteroposteriorly and mediolaterally. This finding is important as this appearance of the femur must be distinguished from a pathologic fracture.

Aged↗
PubMed1980

Gastroduodenal lesions of ingested acids: radiographic findings.

Abdominal radiographs and barium studies of the stomach and duodenum of 27 patients after ingestion of muriatic acid (27% HCl) in suicidal attempts were reviewed. Eleven patients were studied in the acute phase (1-10 days), nine in the subacute phase (11-20 days), and 15 in the chronic phase (21 days or more). Extensive gastric and duodenal mucosal and submucosal damage was radiographically demonstrated in all patients studied in the acute and subacute phase. Four patients had gastric perforation. The radiographic findings in the chronic phase were characterized by marked contraction of the lesser curvature, antral stenosis, irregular gastric contours, and deformed duodenal bulb. Esophageal mucosal and submucosal lesions were radiographically demonstrated in all these patients.

Acute Disease↗