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Biomedical subjects

J E Meyer

Publications and source records attributed to J E Meyer.

At least 19 recordsLinked to original sources
PubMed1992

Image-guided aspiration of solitary occult breast 'cysts'.

During the 30-month period from March 1, 1988, through August 31, 1990, image-guided aspirations of 183 solitary occult breast masses, which were considered possible cysts, were performed. Indications for aspiration included (1) mass on mammography, either invisible on ultrasonography or with features atypical of a cyst, in 111 patients; (2) enlarging solitary mass on mammography with ultrasonic features suggesting a cyst in 45 patients; and (3) mammographic mass with features typical of a cyst in 27 patients, with confirmation requested by the referring physician. Of the group, 151 (83%) lesions were fluid-filled and 32 (17%) were solid. All aspirates had normal cytologic features. Of the 32 aspirates found to be solid, 19 were subsequently removed after wire localization and 13 were unchanged on mammography for a minimum of 6 months after aspiration. This is a simple and safe procedure, confirming the innocuous nature of an occult solitary breast cyst, and obviates the need for surgical biopsy.

Adult↗
PubMed1992

[The new euthanasia-discussion from the psychiatric viewpoint].

The practice to kill terminally ill patients on their own demand has resulted in the Netherlands in a decriminalisation of active euthanasia which thus has fundamentally changed the way to deal with dying patients. Sooner or later this development will extend to other European countries as well as to the USA. Involuntary euthanasia of severely handicapped newborn children or of demented persons is propagated by the practical ethics of P. Singer and other representatives of utilitarianistic philosophy. According to the standpoint of utilitarianism a human being should only have the right to live as long as he or she is a person, i. e. has rationality and self-consciousness. The next step toward the elimination of elderly people can easily be predicted. For economical reasons these persons may be withheld from life-saving medical treatment or may be supposed to commit suicide. A moral pressure is created to make a decision for suicide as soon as severe invalidity occurs. The consideration of such ideas shows that in today's debate on euthanasia the issue is no longer the right of a few severely and terminally ill human beings to their "own death". Instead, the right to live of a large group of handicapped and "socially useless" or "unproductive" persons is at stake. This is the danger of today's discussion of euthanasia.

Persons with Disabilities↗
PubMed1992

Enlarging occult fibroadenomas.

From July 1, 1989, through June 30, 1991, 1,218 preoperative wire-localization breast biopsies were performed at one institution. In this group, 254 (21%) of the abnormalities were fibroadenomas, 26 of which had enlarged or developed in the interval between routine or short-interval follow-up mammography. This interval growth was noted in 21 premenopausal women and in five who were postmenopausal and receiving oral estrogen supplementation.

Adenofibroma↗
PubMed1992

Improved radiology film library operations.

An interdisciplinary task force at the authors' institution developed a design for a new film library that placed heavy emphasis on service to its customers. The task force established locations and staffing for "satellite" inpatient film libraries organized by clinical specialties. Inpatient films were not permitted to be taken from the radiology department but were available for 24-hour viewing. Film locations were recorded in the radiology information system. Reorganization led to important improvements in film library operations and in the clinical staff's opinion of film library service. Objective measures of performance, such as the fraction of requested films available for conferences, showed significant improvement (P less than .001). Closer working relationships developed between film librarians, radiologists, and their clinical colleagues. Film library personnel were recruited more easily and stayed on the job longer. Several hundred thousand film-tracking transactions per year were recorded. The authors conclude that decentralization of certain film library activities improved many critical aspects of performance.

Libraries↗
PubMed1991

Lobular carcinoma in situ: mammographic-pathologic correlation of results of needle-directed biopsy.

The mammographic and histologic findings were reviewed in 41 consecutive cases of isolated lobular carcinoma in situ (LCIS) unassociated with any malignant diagnosis. Thirty-one needle-directed breast biopsies were performed to evaluate clustered microcalcifications. In 24 of the 31 cases, the calcifications were found in areas of benign breast disease, with LCIS representing a separate process. In the few cases in which microcalcifications were seen in association with LCIS, a greater number of similar calcifications were present in adjacent benign disease. Soft-tissue abnormalities necessitating the performance of a biopsy represented benign foci, except in one patient with LCIS in and adjacent to a fibroadenoma. The authors conclude that LCIS has no characteristic mammographic features. LCIS is detected as an incidental finding at breast biopsy, with the mammographic abnormality predominantly reflecting a benign process.

Adult↗
PubMed1990

Biopsy of occult breast lesions. Analysis of 1261 abnormalities.

From January 1, 1987, to December 31, 1988, roentgenographically guided biopsies of 1261 occult breast abnormalities were performed. There were 626 (49.6%) masses and 635 (50.4%) lesions with calcification as the dominant feature. Of the total, 237 (18.8%) were found to be malignant, including 85 cases of ductal carcinoma in situ. Biopsies performed for a mass yielded a 20.8% (130/626) incidence of cancer; and for calcification, 16.9% (107/635). The biopsy results were supported by the interpretations of four radiologists (J.E.M., P.C.S., and M.R.S.) who were practicing at Brigham and Women's Hospital in 22.2% of the total (280), whereas the remaining 981 lesions were discovered on mammograms that were performed and interpreted elsewhere and were referred to our hospital for surgical consultation. The biopsy results of the mammograms from other facilities yielded a positive predictive value of 16.7% (164/981) vs 26.1% (73/280) for the Brigham and Women's Hospital group. This statistically significant difference lends support to the value of a second opinion in patients with biopsy recommendations for occult breast lesions, especially when findings are inconclusive.

Boston↗
PubMed1990

Mammographic changes associated with postmenopausal hormone replacement therapy: a longitudinal study.

A retrospective study of radiologic findings from 50 postmenopausal women who underwent hormone replacement therapy was performed to determine the frequency and distribution of changes in the screen-film mammographic appearance of breast tissue between pretreatment and posttreatment mammography. Twelve (24%) of the women developed increased parenchymal density during a median follow-up of 18 months (range, 6-39 months). Mammographic changes included diffuse increase in density in seven (14%) of the women; increased multifocal, asymmetric densities in two (4%); and cyst formation in three (6%). A greater percentage of women who received estrogen-progesterone replacement (26%, 10 of 38) demonstrated changes than those who received estrogen alone (17%, two of 12), but the difference was not statistically significant. The authors conclude that benign increases in mammographic density associated with postmenopausal hormone replacement therapy are not uncommon, and they suggest that the serial changes observed in some women may diminish the sensitivity of mammography for the earlier detection of breast cancer.

Adult↗
PubMed1979

Fibrosarcoma of breast metastatic to stomach.

A case of fibrosarcoma of the breast metastatic to the stomach and small bowel is reported. Upper gastrointestinal bleeding secondary to a "bull's eye" or "target" gastric ulcer was successfully treated by surgical resection.

Breast Neoplasms↗
PubMed1979

Giant ureteral calculi.

Giant ureteral calculi are defined as weighing at least 50 g or measuring more than 5 cm in greatest diameter. Two patients with this rare entity are described.

Female↗
PubMed1978

Fat necrosis of the breast.

Fat necrosis of the breast is an uncommon entity but may mimic malignancy on both mammographic and clinical examination. Seven patients had recent excisional breast biopsy specimens that showed fat necrosis. The mammographic appearance is a reflection of the reparative phase of the lesion, with a cystic appearance representing early or incomplete healing. Progression to connective tissue invasion appears as an irregular, dense, spiculated mass. Clinically, these tumors may be firm, fixed, and produce overlying skin or nipple retraction. No matter how strong the clinical suspicion that a breast lesion represents fat necrosis, an excisional biopsy is necessary for confirmation in all cases.

Adult↗
PubMed1978

Pretreatment radiographic evaluation of patients with malignant melanoma.

During a four year period, 53 patients with malignant melanoma underwent extensive pretreatment radiographic evaluation for detection of occult extranodal metastatic disease. This included chest x-ray with tomography, upper G.I. series with small bowel follow through, barium enama, intravenous pyelogram, and radio-nuclide scans of the brain, liver and bone. All occult metastatic disease in asymptomatic patients was discovered on routine chest x-ray examination. There were three false positive examinations, which necessitated further diagnostic tests but there was no change in the final treatment decision. There was no alteration in the management of the remainder of the patients on the basis of the pretreatment radiographic evaluation.

False Positive Reactions↗
PubMed1978

Radiographic evaluation of metastatic melanoma.

Malignant melanoma can potentially involve any organ system in the body once it metastasizes beyond the regional lymph nodes. A survey of the radiographic and associated clinical manifestations of metastatic melanoma is presented. The findings from 74 autopsies of patients who died of metastatic melanoma are included.

Adult↗
PubMed1978

Thoracic effects of therapeutic irradiation for breast carcinoma.

Therapeutic irradiation produces alterations in normal tissue which, when visible on diagnostic x-ray examinations, may be confused with recurrent tumor or other unrelated conditions. Therapeutic irradiation of breast carcinoma may produce gross effects in the lungs, bone, breast, heart and great vessels, esophagus, liver, and spinal cord. The radiographic appearance of such changes is presented and contrasted with changes secondary to the malignancy itself or benign inflammatory processes. Recognition is imperative for proper management.

Aged↗