[Clinical trial of metrizamide in femoral arteriography].
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Biomedical subjects
Publications and source records attributed to A Movin.
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In 45 patients with ureteral calculi 2 to 8 mm in diameter, attempts were made to remove the stones transurethrally, using a Dormia extractor and television fluoroscopic monitoring. The procedure was successful in 34 patients. The success rate was 74% when the stones were 5 mm or less and 68% with the larger stones. In 10 patients when instrumental extraction failed, this was followed immediately by open surgery, for removal of stone. The reasons for failure of the transurethral procedure are presented. Great care in performance and preparedness for open surgery are always required, especially when the stone is large. Television facilities should be good and include image intensifier. There were no serious complications of instrumental or surgical removal of calculi.
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A roentgenographic study was carried out on 104 Silastic Finger Joint Implants, Swanson design. Sixty-two of the implants were examined in the anterio-posterior-projection (AP) from 4 months to 5 1/2 years postoperatively, a total of 116 examinations. Forty-two implants were examined in the AP-projection and in the lateral projection by tomography in maximum active extension and flexion from 9 days to 42 months postoperatively, a total of 110 examinations. Stem fractures were found in 11/104 implants: two of these preceded by a laceration of the implant surface visualized by tomography. Fragmentation of the midsection was found in 14/104 implants. Cortical erosion was seen radially in the phalanx and the metacarpal bone in some joints showing ulnar deviation, predominantly MCP joints II and III. On the tomograms a cortical erosion dorsally in the metacarpal bone could be demonstrated. Particularly around the distal stem was found an intramedullary bone lamella, varying in distance from the stem as well as in density and regularity. Bone resorption was found at the site where the midsection bore on the metacarpal bone and the proximal phalanx, resulting in a migration of the implant in a proximal and/or distal direction. The migration of the implant was evaluated on the tomograms with maximum active extension and classified into 4 Grades. Concomitant with the migration in the proximal direction a bony spur developed volarly at the resected end of the metacarpal bone, also seen in the AP-projection. The degree of maximum joint flexion was measured on the tomograms by drawing a line along the dorsal contour of each bone. In some cases flexion was found to decrease as a consequence of implant migration in the distal direction or the development of a bony spur. In several cases the range of flexion was maintained by gliding of the stems, particularly the distal one.
Roentgenographic examination of the metacarpophalangeal joints of the index, long, ring and the little fingers is carried out routinely in antero-posterior (AP) and oblique lateral projections, while pictures in the straight lateral projection of each joint are hard to evaluate because of overprojection of the other metacarpal bones and proximal phalanges. A technique was devised to examine each joint separately in the straingt lateral projection by means of tomography. This is presented together with the technique for examination of the joint in the AP-projection. The tomograms in the lateral projection were found to be more valuable when carried out in active maximal extension as well as flexion. The great advantage of this method, particularly in examinations for scientific evaluation, has been demonstrated in repeated postoperative studies of 98 metacarpophalangeal joints.
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