Biomedical subjects
Publications and source records attributed to C J Tegtmeyer.
Radiation is known to produce changes in the small vessels and interstitium of the kidneys resulting in hypertension. Two cases of renal artery stenosis and resultant hypertension secondary to abdominal irradiation are reported and the literature is reviewed.
A new complication of transvenous pacing is described. Twists developing in an endocardial lead indicate that the pulse generator pocket is too large. Pacemaker failure because of electrode dislodgement or lead fracture will ensue.
Two cases with mediastinal parathyroid adenomas are presented. Both patients had undergone previous unsuccessful neck explorations. Angiography correctly localized the parathyroid adenomas in each case, substantiating the value of parathyroid angiography in mediastinal tumors.
The roentgenogram is a valuable resource in the implantation and management of cardiac pacemakers. An understanding of the mechanisms of pacemakers and the principles of insertion is essential to the physician caring for patients with these devices. The roentgenogram can identify the type of pacemaker, the position of the electrode tip and the occurrence of lead fractures; it can also detect failing batteries.
The arteriographic findings are described and the embryology is discussed in a rare case of situs inversus of the abdominal viscera combined with reversed rotation of the bowel. The arteriogram correctly localized the precise site of hemorrhage in this perplexing case, and a complex surgical problem was simplified.
Dionosil and powdered tantalum laryngograms are compared in 18 patients with known laryngeal cancer. Dionosil more reliably defined the epiglottis, valleculae, and pyriform fossae. The glottic and subglottic regions were more clearly visualized with the use of tantalum. Both agents were equally effective in the evaluation of the supraglottis.
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Changes in balloon and catheter technology have led to the development of smaller, more flexible, and less traumatic balloon dilatation systems. The physical principles that govern balloon angioplasty and the current status of balloon materials and catheter designs will be reviewed. A compilation of various angioplasty catheters is also summarized.
Rapidly evolving angioplasty balloon techniques need continual evaluation for the type or frequency of balloon-related complications. We recently encountered a case where a new narrow shaft polyethylene terephthalate balloon completely separated from the catheter following circumferential rupture. The balloon was successfully retrieved using grasping forceps and a basket. Patterns of balloon rupture and subsequent management are discussed. Problems of this type were more frequent in the early days of balloon angioplasty, but have since become rare. Close surveillance of new low profile balloons is recommended to determine whether this represents an isolated occurrence or a return to the earlier experience.
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