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Biomedical subjects

A Lunderquist

Publications and source records attributed to A Lunderquist.

At least 109 records · Page 6Linked to original sources

Localization of glucagonomas by catheterization of the pancreatic veins and with glucagon assay.

In two patients with the glucagonoma syndrome, percutaneous transhepatic puncture of the portal vein and catheterization of the pancreatic veins were performed simultaneously with catheterization of the inferior vena cava and abdominal aorta. Blood samples obtained from the vena cava, aorta and portal branches were assayed for glucagon. In both patients, clearcut arteriovenous glucagon differences allowed preoperative localization of the tumors. A comparison with other localization techniques, such as scintiscan, ultrasound, arteriography and pancreatic phlebography, showed the present method to be superior. Postoperatively, the same investigations were performed revealing arterial and venous glucagon levels comparable to the levels measured in a reference group of three patients without glucagonomas. The triple catheterization technique is advocated for all patients with clinical and laboratory findings that suggest pancreatic endocrine tumors.

Adult↗

Selective catheterization of the pancreatic vein for radioimmunoassay in glucagon-secreting carcinoma of the pancreas.

A glucagon-secreting tumor was seen in the tail of the pancreas in a 69-year-old man. The diagnosis was made by radioimmunoassay of the peripheral blood and the tumor was localized by pancreatic angiography and selective catheterization of the pancreatic veins followed by hormone assay. This technique may be a valuable adjunct in the study of endocrine tumors of the pancreas.

Aged↗

Hepatic angiography in ulcerative colitis and Crohn's disease.

Liver angiography was performed in 13 patients with Crohn's disease and three with ulcerative colitis. Of these patients, 13 underwent liver biopsy, and findings were correlated with results of angiography and biochemical tests. Twelve liver biopsies were abnormal, primarily showing fatty infiltration and reactive hepatitis. Thirteen angiographies were abnormal, with widened and tortuous liver arteries being the most common finding. Liver function tests were within normal limits for all but three of the 16 patients, thus correlating poorly with findings of the other tests. These data show that angiography is useful in detecting hepatic abnormality, but evaluation with liver biopsy is necessary to determine the nature of the lesion.

Adolescent↗

Percutaneous biopsy of carcinoma of the pancreas guided by angiography.

Histologic verification of the angiographic diagnosis of carcinoma of the pancreas may be achieved by percutaneous, transperitoneal fine-needle aspiration biopsy. The method was used in conjunction with the angiographic procedure in 29 patients with tumors of varying size down to 3 centimeters in diameter. Positive diagnosis was obtained in 22. Complications were not encountered. Since the method is simple and harmless it is recommended whenever histologic verification is desired.

Angiography↗

Selective catheterization of the portal vein and its tributaries. Preliminary report.

The portal vein and its tributaries were selectively catheterized in 90 patients. Only one complication required surgery. This technique not only provides information about the status of the portal circulation and liver parenchyma but can also be used in the treatment of bleeding esophageal varices by selective embolization of autologous clots or inert material.

Catheterization↗

Superior mesenteric angiography and blood flow following intra-arterial injection of prostaglandin F2alpha.

The effect of intra-arterially administered prostaglandin F2alpha(PGF2alpha) on venous demonstration in angiography of the superior mesenteric artery was compared to that of bradykinin in 10 patients, and the flow increase in this vessel following PGF2alpha was measured by a dye dilution technique in another 8 patients. The angiographic demonstration of veins was similarly improved by the 2 drugs, the effect of 60 mug. of PGF2alpha being roughly equivalent to that of 10 mug. of bradykinin. The loss of arterial detail was less marked after PGF2alpha which, however, had a longer duration of action. The flow studies indicated that 80 mug. of PGF2alpha increased the superior mesenteric blood flow 103 +/- 16 per cent. There was no influecne on blood pressure or pulse rate. The patients experienced a sensation of warmth in the abdomen for a few seconds following the injection of drugs, but no other side effect was noted. It is concluded that PGF2alpha causes a rapid increase of the superior mesenteric blood flow in man making it suitable for pharmacoangiography of this vascular bed.

Adult↗

Superior mesenteric blood flow in man studied with a dye-dilution technique.

The superior mesenteric blood flow in the post-absorptive state was studied with a dye-dilution technique using indocyanine green in 37 patients with apparently normal small bowel function. All the patients except 2 had been, or were to be, treated because of malignant disease, mostly rectal carcinoma. The investigations were performed in connection with portography. The dye was injected into the superior mesenteric artery as a single injection during continuous sampling of blood from the superior mesenteric vein, catheterized through the reopened umbilical vein. The blood flow was calculated from the dye-dilution curves obtained with a modified Stewart-Hamilton formula. As recirculating dye appeared in the later part of the dye-dilution curves, the appearance of the recirculating dye was timed in 4 patients. The hepatic extraction of the amount of dye usually injected, 1.25 mg, was 60%. The superior mesenteric blood flow averaged 706 ml/min (397 ml/min/m-2 body surface) or 12% of the cardiac output. The appearance time, mean transit time, vascular resistance and vascular volume were also determined.

Adolescent↗

Superior mesenteric blood flow in man following injection of bradykinin and vasopressin into the superior mesenteric artery.

The superior mesenteric blood flow was studied with a dye-dilution technique after catheterization of the superior mesenteric artery and vein. The investigation was performed in connection with portography in 22 patients with apparently normal small bowel function. Intra-arterial injection of 5, 10 or 20 mug bradykinin was followed within one minute by an increase, on the average, of 114, 176 and 223% respectively, in the superior mesenteric blood flow. The blood flow was dose-dependent in this range. The estimated vascular resistance decreased by 52, 61 and 67%, respectively. The portal venous pressure was increased slightly after intra-arterial injection, but the pressure was unchanged after intra-portal injection. Intra-arterial injection of bradykinin causes a highly improved venous phase at superior mesenteric angiography. This may be due not only to the increased flow but to some extent also to increased capillary permeability produced by bradykinin. Intra-arterial injection of 0.125 and 0.250 IU of vasopressin decreased the superior mesenteric blood flow by 53 and 54%, respectively, within 3 minutes of the injection. The dye-dilution method used was not applicable to blood flow below a level of about 200 ml/min. Continuous infusion of 0.05 IU/min decreased the superior mesenteric blood flow by, on an average, 58%. The portal venous pressure was decreased by 25% after the intra-arterial injection, but no change in pressure was recorded after intra-portal administration. The clinical use of intra-arterial infusion of vasopressin during gastrointenstinal bleeding is discussed.

Adolescent↗

Superior mesenteric blood flow during experimentally induced dumping in man.

The superior mesenteric circulation was studied with a dye-dilution technique after catheterization of the superior mesenteric artery and vein during provoked dumping in 5 patients. Dumping was provoked by intrajejunal instillation of 150 ml 50% glucose. A marked increase of, on the average, 157% was recorded in the superior mesenteric blood flow within a few minutes of the installation of glucose. The maximal increase in the flow was, on the average, 223% and occurred about 40 minutes after provocation. The instillation of glucose was promptly followed by a reduction in vascular resistance of the superior mesenteric vessels by 63% which decreased further to a mean maximal reduction of 76% below the resting level. The increase in the ratio between the superior mesenteric blood flow and cardiac output from 12 to 27% following instillation of glucose further underlines the pronounced vasodilatation of the small intestine. Superior mesenteric angiography at different intervals after provocation of dumping showed that the increased superior mesenteric blood flow is due to a local increase in the flow.

Aged↗

Superior mesenteric blood flow during digestion in man.

The superior mesenteric blood flow was studied with a dye-dilution technique after catheterization of the superior mesenteric artery and vein during the digestive phase after intake of a mixed meal (700 kcal). The material consisted of 5 patients. Within 5 minutes of the end of the meal the superior mesenteric blood flow, on the average, was increased by 60%. The largest increase was 113% and was noted one hour after the meal. The vascular resistance of the superior mesenteric vessles had by then fallen to a mean value of 55% below the prefeed value. The portal venous pressure was only slightly increased. The cardiac output was increased in 2 but slightly decreased in the remaining 3 patients. The pulse rate, blood pressure and haemoglobin concentration were largely unchanged. The ratio of the superior mesenteric blood flow to the cardiac output increased from 12 to 22% during the digestive period. The findings suggest the occurrence of a redistribution of blood after a meal with an increase in the superior mesenteric blood flow.

Aged↗

Angiographic spectrum in Crohn's disease of the small intestine and colon.

Barium and angiographic examinations of the small intestine and colon were performed in 34 patients with histopathologically verified Crohn's disease. The spectrum of angiographic findings varied from hypervascularity with no morphologic changes of the vasa recta to complete obstruction of the vasa recta resulting in hypovascularity of the diseased intestine. A distinctive angiographic pattern was present in the distal part of the small intestine in those patients with advanced narrowing of the intestinal lumen as demonstrated on barium examination.

Adolescent↗

Phlebography of the pancreatic veins.

Transumbilical and percutaneous transhepatic catheterization is performed of pancreatic veins. The normal phlebographic anatomy is reported together with the findings in patients with carcinoma of the pancreas. Selective catheterization of pancreatic veins with hormone essay for tumor localization is performed in two patients with islet cell tumor of the pancreas. The authors suggest this to be a valuable method in the diagnosis of endocrine tumors of the pancreas.

Adenocarcinoma↗

Portal and pancreatic vein catheterization with radioimmunologic determination of insulin.

Percutaneous transhepatic catheterization of the portal vein along with the catheterization of the aorta and the vena cava was performed in six patients, one of whom had hypoglycemic attacks due to Whipple's triad. Blood samples from different branches in the different vessel systems were withdrawn for radioimmunologic determination of insulin. By this method, preoperative localization of the insulin producing pancreatic islet cell tumor was su-cessfully performed. Multiple tumors as well as liver metastases were preoperatively excluded. Recatheterization and blood sampling for radioimmunologic determination of insulin was performed postoperatively to verify the radicality of the operation. Insulin concentrations from the hypoglycemic patients were compared with those of the patients without insulinoma and found to be significantly higher. The procedure is proposed as a useful method for localizing all types of gastrointestinal hormone producing primary or secondary tumors in which a method for hormone determination is available. The postoperative investigation is useful as a check of the operation performed and as a follow-up examination for the early diagnosis of recurrence.

Adenoma, Islet Cell↗