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Biomedical subjects

A Lunderquist

Publications and source records attributed to A Lunderquist.

154 records · Page 9Linked to original sources
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Microvasculature architecture of small liver metastases in man. A correlation between microfil vascular preparations and histologic sections.

The hepatic artery and the portal vein of 12 human cadaver livers with metastases of various sizes and origins were injected with Microfil. The microvascular appearances of the metastases were studied in order to receive an explanation to findings at angiography and contrast enhanced computed tomography. Histologic examinations were also performed of Microfil-injected specimens.

Adult↗
PubMedDate not supplied

Computed tomographic angiography of the liver via the coeliac axis.

Sixty computed tomographic angiographic (CTA) examinations of the liver were performed with contrast injection into the coeliac axis. Data from both an arterial and a portal venous phase were recorded. In 41 patients it was possible to compare the results of CTA with palpation of the liver during laparotomy. The results from CTA and laparotomy were the same in 35 patients (85%). In one patient CTA disclosed verified liver lesions not diagnosed at laparotomy. There were 2 false negative and 3 false positive CTA examinations. In the remaining 19 patients, a clinical follow-up period of at least 6 months was used to evaluate the results of CTA. In the 7 patients in whom CTA showed benign lesions or a normal liver parenchyma, the clinical follow-up revealed no evidence of tumour growth in the liver.

Follow-Up Studies↗
PubMedDate not supplied

Effect of intravenously injected iodinated lipid emulsion on the liver. An experimental study correlating computed tomography findings with in vivo microscopy and electron microscopy findings.

Iodinated lipid emulsions have been shown to have great potential as site specific contrast media for the liver and spleen. Because of unacceptable adverse reactions none of these emulsions has been adopted for clinical use. In an attempt to find an explanation for these adverse reactions we tested three iodinated lipid emulsions, EOE-13, AG 60.99 and AG 66.18. The following models were used: Computed tomography (CT) of the rabbit liver, in vivo microscopy and electron microscopy of the rat liver. The emulsions contained particles of different sizes and were used in varying doses. We found that the larger the emulsion particles, the more likely they were to be taken up by the Kupffer cells and thereby the higher the opacification of the liver achieved at CT. We also observed changes in the microcirculation of the liver when the emulsions were given in doses required to secure satisfactory opacification of the liver at CT. The main changes were 1) a marked increase in the size of the Kupffer cells, and 2) damage to the sinusoidal endothelium, both contributing to sinusoidal congestion. These changes strongly suggest activation of the macrophages and this in turn probably results in the release of toxic mediators. We suspect that the adverse reactions observed in patients when using iodinated lipid emulsions are due to these toxic mediators.

Animals↗
PubMedDate not supplied

Experimental investigation of a new iodinated lipid emulsion for computed tomography of the liver.

Iodinated lipid emulsions are highly efficient macrophage imaging agents. Nevertheless, none of them has been accepted for clinical use because of adverse reactions. We have tested a new iodinated lipid emulsion, Intraiodol. The size and surface properties of the particles of this emulsion are similar to those of Intralipid which in turn closely resemble the naturally occurring chylomicrons. Using computed tomography (CT) of the rabbit liver as well as vital microscopy and electron microscopy of the rat liver we found that Intraiodol has low efficiency as a liver-specific contrast medium because its particles are predominantly taken up by the hepatocytes and to a less extent by the Kupffer cells, as is Intralipid. The low efficiency of Intraiodol could be fully compensated by an increase in dosage without any significant effect on sinusoidal blood flow. This in turn suggests that the likelihood of release of toxic mediators (and thereby related adverse reactions from activated macrophages) is reduced. We believe that this new way of delivering iodinated lipid particles to the liver represents an important advance in the search for a non-toxic lipid emulsion for CT of the liver.

Animals↗
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In vivo microscopy of the liver after injection of Lipiodol into the hepatic artery and portal vein in the rat.

The route, distribution and clearance of intraarterially administered Lipiodol in the liver has been the subject of much speculation. The hepatic microcirculation was therefore studied by in vivo microscopy after injection of Lipiodol into the hepatic artery and the portal vein in rats. After intraarterial injection, Lipiodol rapidly entered the portal branches through arterio-portal communications. Lipiodol also passed through the sinusoids from the portal into the hepatic veins and then into the systemic circulation. Sinusoidal congestion occurred when the oil droplets filled the liver microcirculation and resolved as the oil was cleared. It is of clinical significance to note the passage of the oil into the systemic circulation after arterial injection.

Animals↗
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Clinical trials with a new iodinated lipid emulsion for computed tomography of the liver.

A new iodinated lipid emulsion, Intraiodol, for which animal studies have indicated better tolerance than for other iodinated lipid emulsions, was tested in 15 patients with malignant lesions, and in one patient with focal nodular hyperplasia. Repeated CT scans of the liver and spleen and blood tests were performed for 24 hours after intravenous injection of Intraiodol. The uptake of Intraiodol in the liver (peak mean 28.6 HU) was higher than in the spleen (peak mean 21.8 HU). The uptake of Intraiodol in malignant lesions was minimal (peak mean 2.8 HU). The detection rate of hepatic lesions was equal to or better than that achieved by US, CT, and/or CT angiography. However, liver uptake of Intraiodol was low in 2 patients with severe fatty infiltration. Intraiodol produced vascular enhancement up to one hour after injection since it was eliminated slowly from the circulation. The observed adverse reactions consisted of temporary metallic taste in 5 of the patients, fever and exacerbation of back pain in one patient, and transient thrombocytopenia in one patient. Alkaline phosphatase increased (17%, p less than 0.01) only at two hours, and erythrocyte count (6%, p less than 0.05) at 24 hours after injection. Our initial results indicate diagnostic advantages of Intraiodol without serious adverse reactions. Further clinical studies are required to confirm these findings.

Aged↗
PubMedDate not supplied

Site and number of liver tumors recorded at angiography and computed tomography compared with the findings at laparotomy and of resected liver specimens.

Angiography and computed tomography (CT) were performed in 96 patients before laparotomy for an intended liver resection. Of these, 73 patients underwent liver resection, from a local excision to a trisegmentectomy. The accuracy of angiography in tumor localization was 77 per cent when the results were compared with the findings at laparotomy and from resected specimens. With CT the accuracy was 85 per cent. In 47 patients an analysis of the number of tumor nodules was possible. There were 76 nodules, and 42 (55%) were correctly identified by angiography and 58% (76%) by CT. Thirty-four tumor nodules were not seen at angiography, with the majority of these situated in the left liver lobe. At CT, 18 nodules were not observed, about equal numbers in right and left lobes. Five lesions thought to be present at angiography (9 at CT), could not be verified upon inspecting the resected specimens. Neither angiography nor CT seems to be reliable enough for an accurate prediction of resectability of liver tumors prior to laparotomy.

Adult↗