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Biomedical subjects

W P Maier

Publications and source records attributed to W P Maier.

At least 19 recordsLinked to original sources
PubMed1995

Limitations of craniocaudal thallium-201 and technetium-99m-sestamibi mammoscintigraphy.

UNLABELLED: Previous studies with 201Tl and 99mTc-sestamibi (MIBI) have used large field of view (LFOV) cameras not optimized for breast imaging. The purpose of this study was to compare these agents and to determine if a small field of view (SFOV) camera designed to minimize the camera-to-breast distance could improve tumor detection. METHODS: A 28-cm (SFOV) camera was fitted with slant-hole and diverging collimators to perform craniocaudal scintigraphy for direct comparison with mammography. Of the 46 patients studied, 20 had 201Tl imaging alone and 26 had combined 201Tl and MIBI imaging. LFOV (40 cm) breast and axillary images also were obtained. Visual and quantitative analyses of tumor uptake were performed. RESULTS: The SFOV camera with nonparallel collimation showed variable 201Tl and MIBI normal breast activity. This was partly due to significant scatter from cardiac and abdominal activity. Overall, 201Tl had a sensitivity of 53%, which was 67% for tumors > or = 1.5 cm and 20% for tumors < or = 1.5 cm. MIBI sensitivity was 90% (9/10) for lesions > or = 1.5 cm. Specificity was 93% for 201Tl and 83% for MIBI. There was no significant difference in 201Tl (1.76 +/- 0.55) and MIBI (1.82 +/- 0.95) tumor uptake ratios (p = 0.75). CONCLUSION: Technetium-99m-MIBI was more sensitive than 201Tl for imaging lesions > or = 1.5 cm. Craniocaudal positioning minimized the camera-to-breast distance but did not increase 201Tl detection of tumors < 1.5 cm and increased background breast activity due to scatter.

Adult↗
PubMed1994

Nonlactational breast infection.

Experiences with the treatment and results of treatment of 96 patients with acute or chronic periareolar abscesses are presented. A mammillary sinus or fistula was demonstrable in virtually every instance. The key to preventing recurrence is demonstrating and either removing or unroofing the sinus tract.

Abscess↗
PubMed1990

Intravenous immunoglobulin therapy in systemic lupus erythematosus-associated thrombocytopenia.

Seven patients with thrombocytopenia and systemic lupus erythematosus were treated with intravenous (IV) doses of human immunoglobulin to assess clinical response and to examine the mechanism of action of IV immunoglobulin in these patients. Five of 7 patients had a greater than 50% increase in their platelet counts. Four of these patients had a sustained benefit of at least 6 months duration. The initial effectiveness of IV immunoglobulin therapy was not dependent on the reduction of levels of circulating platelet-binding IgG or circulating immune complexes.

Antigen-Antibody Complex↗
PubMed1987

Complete heart block as the initial manifestation of systemic lupus erythematosus.

Complete heart block is a rare complication of systemic lupus erythematosus, as well as other rheumatic diseases. We describe a patient with systemic lupus erythematosus who presented with complete heart block as the initial manifestation of the disease. Anti-Sjögren's syndrome antibodies as well as antiribonucleoprotein antibodies were present in the patient's serum.

Adult↗
PubMed1987

Esophagogastric anastomosis.

Sixty-one consecutive patients underwent an end to side esophagogastric anastomosis combined with plication of the stomach around the distal part of the esophagus. No instance of free leakage occurred. Heartburn and regurgitation have been uncommon in this series of patients.

Esophagus↗
PubMed1984

Preoperative nuclear scans in patients with melanoma.

One hundred forty-one liver scans, 137 brain scans, and 112 bone scans were performed in 192 patients with clinical Stage 1 melanoma. One liver scan was interpreted as abnormal; liver biopsy of that patient showed no metastasis. There were 11 suggestive liver scans; three of the patients with suggestive liver scans had negative liver biopsies. The remaining eight patients were followed from 4 to 6 years and none of those patients developed clinical evidence of hepatic metastases. All of the brain scans were normal. Five patients had suggestive bone scans and none of those patients had manifested symptoms of osseous metastases with a follow-up of 2 to 4.5 years. This study demonstrates that the use of preoperative liver, brain and bone scan in the evaluation of patients with clinical Stage 1 melanoma is virtually unproductive.

Adolescent↗
PubMed1984

Long-term follow-up of patients with Grave's disease treated by subtotal thyroidectomy.

This long-term follow-up study of 83 patients with Grave's disease who were treated by subtotal thyroidectomy reemphasizes the fact that postoperative hypothyroidism occurs primarily in the first postoperative year (27 percent of the study patients). In addition, there was no evidence of progressive increase in the incidence of hypothyroidism in subsequent years. Patients treated with radioactive iodine have a reported incidence of hypothyroidism of 70 percent 10 years postoperatively [4]. The 6 percent incidence of recurrent hyperthyroidism is much less than a reported incidence of 90 percent in patients treated with long-term antithyroid drugs [7]. Subtotal thyroidectomy continues to be an excellent method of treatment for patients with Grave's disease and compared favorably with both radioactive iodine and long-term antithyroid drugs.

Adolescent↗
PubMed1982

Periareolar abscess in the nonlactating breast.

Periareolar abscesses in nonlactating women are usually accompanied by a sinus tract that communicates with the nipple. This abnormal tract represents the source of the initial invasive infection and, if left unattended, may be the nidus for recurrence. The medical records of 32 patients with periareolar abscess treated at Temple University Hospital from January 1970 through January 1980 were reviewed. Follow-up data were obtained recently for 21 patients, including 1 patient with bilateral disease. Several patients also had an inverted nipple. Nineteen patients denied recurrence after our initial treatment and two required a secondary procedure for cure. Only one patient was dissatisfied with the postoperative appearance of the surgical site. None required partial or simple mastectomy for cure, as reported elsewhere. Excision of the sinus tract and, when present, correction of the inverted nipple as herein described are necessary to prevent reinfection. Simple abscess excision or incision and drainage is usually inadequate therapy.

Abscess↗
PubMed1980

Gastroesophageal scintigraphy to assess the severity of gastroesophageal reflux disease.

Thirty-six (36) patients with symptomatic gastroesophageal reflux were studied. Symptoms of heartburn, regurgitation and dysphagia were scored as to their severity and compared to quantitative tests of gastroesophageal reflux. Patients were studied with the acid reflux test, fiberoptic endoscopy, esophageal mucosal biopsy with a pinch forceps, esophageal manometry and radioisotopic gastroesophageal scintigraphy. Symptoms were scored according to an arbitrary grading system as mild, moderate, or severe. There were significant correlations between symptoms scores and both the degree of endoscopic esophagitis and the gastroesophageal reflux indices as measured by the radioisotopic scintiscan, but not with the degree of histologic esophagitis or lower esophageal sphincter pressure. Review of the findings suggests the following profile for patients who might require antireflux surgery: severe symptoms, presence of endoscopic esophagitis; resting lower esophageal sphincter pressure below 10 mmHg; and gastroesophageal reflux index above 10%.

Adult↗
PubMed1980

The role of cytology in the diagnosis of carcinoma of the stomach.

Cytology is an invaluable adjunct in the diagnosis of carcinoma of the stomach. It should be included in the initial diagnostic studies of every patient suspected of having a malignant lesion of the stomach. The yield and accuracy rates of brush cytology are superior to those of endoscopic biopsy. Early or superficial carcinoma can be detected by cytology. Common use of cytology should improve the resectability and the survival rates of the patients.

Adenocarcinoma↗
PubMed1978

Antireflux surgery for symptomatic gastroesophageal reflux: mechanism of action.

To determine the effects of Nissen fundoplication upon the symptoms of reflux and the diagnostic tests employed to evaluate reflux and to examine the relationship between gastroesophageal reflux and lower esophageal sphincter pressure before and after fundoplication, 10 patients with symptomatic reflux were studied before and after operation. Clinical evaluation, barium esophagography, endoscopy with mucosal biopsy, esophageal manometry, acid-perfusion and acid-reflux testing, and gastroesophageal scintiscaning were performed on each patient before and after surgery. Following fundoplication, marked symptomatic, radiographic, endoscopic, and histologic improvement was observed. Serial acid-reflux tests at increasing gastroesophageal pressure gradients returned to normal after surgery. Lower-esophageal-sphincter (LES) pressure increased from 8.2 +/- 1.3 to 12.0 +/- 1.5 mm Hg (P less than 0.01). In addition, surgery resulted in a significant decrease in the gastroesophageal reflux index from 17.4 +/- 2.4 to 2.7 +/- 1.1% (P less than 0.001). Surprisingly, the pre- and postoperative resting LES pressures did not correlate significantly with corresponding gastroesophageal reflux indices for individual patients. We conclude that increased LES pressure alone does not explain adequately the functional and clinical improvement which follows fundoplication.

Adult↗