Biomedical subjects

E J Woolsey

Publications and source records attributed to E J Woolsey.

5 recordsLinked to original sources

PubMed1991

Stones and infection in renal caliceal diverticula: treatment with percutaneous procedures.

Percutaneous treatment of symptomatic caliceal diverticula has expanded the application of uroradiologic intervention. To assess the safety and efficacy of these procedures, we have reviewed our experience with percutaneous management of 12 symptomatic caliceal diverticula, 10 with stones and two infected. Nine stone-bearing diverticula were punctured directly with subsequent tract dilatation, nephroscopic stone extraction, and cavity obliteration (six with fulguration and drainage and three with drainage alone). One case was approached indirectly by puncturing a distant calix, dilating the diverticular neck, and flushing the stones into the collecting system for extraction. This cavity was not treated. Two infected diverticula were punctured directly for drainage and obliteration (one by fulguration and one by tetracycline sclerosis). Complete stone extractions were accomplished in all 10 cases. In eight with clinical follow-up ranging from 4 months to 6 years, one stone has recurred and seven patients are asymptomatic. Follow-up urograms were available in eight of 10 patients in whom cavity obliteration was attempted; in six (75%) of eight, nonvisualization of the diverticulum indicated successful obliteration. Only one major complication (urinoma requiring drainage) occurred. We conclude that percutaneous procedures are safe and effective in treating infected or stone-bearing caliceal diverticula. Direct diverticular puncture for access and diverticular fulguration for cavity obliteration is our preferred technique.

Adult↗

PubMed1987

Pancreas transplantation with pancreatico-duodeno-cystostomy for exocrine drainage: cystographic findings.

Pancreatic transplantation is becoming accepted therapy for a select subset of patients with type 1 insulin-dependent diabetes. At many centers, whole-organ transplants with pancreatico-duodeno-cystostomy for drainage of exocrine secretions is the preferred surgical procedure. We obtained 21 cystograms in nine patients who underwent this procedure who were suspected of having anastomotic leaks and possible abscess. Positive findings included extrinsic bladder compression (nine patients), filling of the transplanted duodenal segment (three patients), edematous bladder wall (four patients), intraperitoneal (two patients) and extraperitoneal (four patients) leaks, and fistulae (two patients). Intraperitoneal extravasation resulted in abscess formation and cutaneous fistulae, and these transplants were subsequently removed. We conclude that cystography is a useful technique in evaluating the site and extent of anastomotic leaks and fistulae.

Diabetes Mellitus, Type 1↗

PubMed1986

Adrenal tissue characterization using MR imaging.

Using a superconducting magnet operating at 0.35 T, the authors investigated the adrenal tissue characterization potential of magnetic resonance (MR) in 28 patients with 33 adrenal masses. There were 13 adrenal adenomas (12 non-hyperfunctioning, one aldosteronoma), nine adrenal metastases, four pheochromocytomas, two neuroblastomas, two adrenal lymphomas, two myelolipomas, and one adrenal cortical carcinoma. Spin-echo pulse sequences were obtained at TR 0.5, 2.0 sec and TE 28, 56 msec. Both qualitative (visual assessment) and quantitative (absolute signal intensity, intensity ratios, T1, T2) data were used for tissue characterization. The results suggest that non-hyperfunctioning adrenal adenomas can be distinguished from non-adenomas using both qualitative and quantitative data: 16/19 non-adenomas were visually hyperintense compared with liver at TR 2.0 sec, TE 56 msec, while none of the non-hyperfunctioning adenomas was relatively hyperintense at any pulse sequence used. Of the quantitative data, the intensity ratios of adrenal lesion/liver at TR 0.5 sec, TE 56 msec were most useful in diagnosis: all adenomas had ratios less than 0.83, while 19/20 non-adenomas had ratios exceeding this value. It is concluded that MR has considerable promise in adrenal tissue characterization.

Adenoma↗

PubMed1985

Comparison of two effervescent agents for double-contrast upper gastrointestinal tract radiography.

We prospectively evaluated the efficacy in 100 patients of two effervescent contrast agents commonly used in routine double-contrast upper gastrointestinal (GI) tract examinations: Baros and E-Z-Gas II granules. The study was double blinded. Two radiologists, who were not aware of which effervescent agent was being used, objectively evaluated the radiographic studies. Patient ease in swallowing and acceptance of the effervescent granules was 94% for Baros and 68% for E-Z-Gas II granules. The objective evaluation of the radiographs showed adequate gastric distension (Baros, 94%; E-Z-Gas II, 90%) and adequate to excellent mucosal coating for both agents (Baros, 92%, E-Z-Gas II, 94%). Areae gastricae were better seen with Baros (64% vs. 30%), and air bubbles were less of a problem with Baros. We conclude that Baros effervescent granules have certain distinct advantages over E-Z-Gas II granules regarding patient tolerance and acceptance, better visualization of the areae gastricae, and less degradation of the quality of the radiographs by air bubbles. The differences in mucosal coatings for the two agents was insignificant.

Adult↗

PubMed1985

Psoas abscess in inflammatory bowel disease.

The inflammatory bowel disease (IBD) is sometimes complicated by the development of a psoas abscess. We recently encountered three patients of IBD with psoas abscess. Two patients had Crohn's ileocolitis and one with ulcerative colitis. During 1979-1984, 23 patients with psoas abscess due to a variety of underlying disease processes were seen at our institution. At the same time period, 483 cases of Crohn's disease and 283 cases of ulcerative colitis were encountered. Therefore, of 766 patients with IBD only three were complicated by psoas abscess (incidence ratio = 0.6%). Thus, psoas abscess was a very rare complication of IBD in patients seen at our institution. In our series of 23 psoas abscess patients, IBD was not a major causative factor. Additionally, to our knowledge, psoas abscess complicating ulcerative colitis has not been reported previously.

Abscess↗