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Biomedical subjects

E Salomonowitz

Publications and source records attributed to E Salomonowitz.

At least 55 records · Page 3Linked to original sources

[Mirizzi syndrome: a sonographic diagnosis?].

The ultrasound appearances of 11 patients with operatively confirmed Mirizzi syndrome have been analysed. The trio 'dilated intrahepatic bile ducts, concretions in the neighbourhood of the dilated common hepatic duct with a normal distal duct' permit the diagnosis of the Mirizzi syndrome with considerable certainty. In five patients these features were found by sonography and no other diagnostic procedure was necessary. In six patients, ERC was carried out in order to evaluate the distal common bile duct. In one case PTC was carried out, since the liver hilum could not be seen on sonography.

Bile Ducts, Intrahepatic↗

Pancreas imaging by computed tomography after endoscopic retrograde pancreatography.

A method using CT after endoscopic retrograde pancreatography (CT-ERP) is described for pancreatic imaging. When using an ERP technique in the canine model comparable to that used in humans, small amounts of contrast material in peripheral pancreatic radicles resulted in enhancement of the pancreas on CT scans. Nine patients were also studied by CT-ERP. In normal patients (n = 5) there was opacification of the entire pancreas on CT-ERP images. The main pancreatic duct was seen on delayed images. In cases of chronic pancreatitis (n = 2), pancreatic opacification was patchy and heterogeneous. There was no contrast-material enhancement in areas of pancreatic carcinomas (n = 2). CT-ERP showed the true extent of carcinoma better than ERP alone.

Adult↗

Rotational kymography. Technique for automated analysis of cine left ventriculograms.

A new device provides an automatic photographic record of left ventricular contraction and expansion. A radially slotted disk is interposed between the moving cine left ventriculogram and a disk of photographic film. By rotating either the slotted disk or the film, a kymographic record of regional wall motion is obtained. Unlike more complex computer programs, the speed as well as the magnitude of contraction can be determined.

Automation↗

Percutaneous arterial grafting.

A new technique for percutaneous arterial grafting was developed using a unique metal alloy (nitinol) with a heat dependent memory. Ten tightly wound nitinol coils (5-15 mm in diameter and 2-5 cm in length) were straightened in ice water and passed via catheter into the iliac artery or abdominal aorta of nine animals. Long term patency (15 weeks) was demonstrated in all but one graft. In one animal, an experimentally created abdominal aortic aneurysm was successfully treated by interposition of a nitinol graft. This new technique may be a valuable adjunct to conventional treatment of both obstructive and aneurysmal arterial disease in man.

Alloys↗

Percutaneous transluminal angioplasty of the aorta. Light and electron microscopic observations in normal and atherosclerotic rabbits.

Histological changes which developed after percutaneous transluminal angioplasty in normal and atherosclerotic rabbit aortas were correlated with balloon size and inflation time. In normal rabbits, progressive changes were observed in the intima and media with increasing balloon size and inflation time. The atherosclerotic aortas exhibited unpredictable fragility, with limited correlation between histological changes, balloon size, and inflation time, attributable mainly to the distribution and thickness of plaques. In atherosclerotic vessels, the mechanism of angioplasty consisted of plaque dehiscence and fracture, followed by overstretching of the plaque-free wall segments. No plaque compression was observed.

Angioplasty, Balloon↗

Balloon dilatation of benign biliary strictures.

Percutaneous transhepatic balloon dilatation of benign postoperative biliary strictures was performed in 6 patients. The procedure was curative in 1 patient. These findings indicate the need for repeated long-term, high-pressure dilatation of these strictures, using an inflation device and pressure gauge. Large catheters should be left in place as stents. Early non-surgical management may improve the salvage rate of this surgical complication.

Adult↗

Carbon dioxide as a lighter-than-urine contrast medium for percutaneous nephrostomy.

Carbon dioxide was used either alone or in combination with standard triiodinated contrast media in 32 patients who underwent percutaneous nephrostomy. Carbon dioxide was used to opacify the posterior calyces, which are the uppermost structures in the kidney of the prone or prone-oblique patient. Carbon dioxide is usually injected in small amounts (20-40 cm3), although clinical and laboratory data indicate that it can be used as the only medium in large amounts with complete safety. There were no complications.

Adult↗

A new vena caval filter for percutaneous placement and retrieval: experimental study.

A new vena caval filter that can be inserted percutaneously through an angiographic catheter is described. The filter is secured by controlled penetration of the caval wall and is designed for percutaneous retrieval. The filter was easily and safely placed and removed in 11 mongrel dogs, and in an in vitro study, the filter was shown to be highly effective and less dependent than the Greenfield filter on positioning. The authors believe that the filter will be suitable for prophylactic placement in patients at high risk for pulmonary thromboembolic disease.

Animals↗

Failing arteriovenous dialysis fistulas: evaluation and treatment.

A total of 31 patients with 45 episodes of failing arteriovenous dialysis fistulas was studied. Fistula failure was usually due to venous and/or anastomotic stenosis, often in conjunction with thrombosis. Abnormalities were treated by percutaneous dilation and occasionally streptokinase infusion. Most complications and failures occurred either in patients with recently created fistulas or in those with multiple or long segment stenosis associated with thrombosis. Patients with a single nonobstructing stenosis were very successfully treated with percutaneous techniques, which are the treatment of choice for this condition.

Adult↗

Nephrotoxicity of contrast media assessed by occlusion arteriography.

The authors describe an experimental model for the study of nephrotoxicity induced by contrast media, based on a standardized injection combined with occlusion of the renal artery so as to expose the kidney to a high concentration of contrast medium for ten minutes. Iopamidol, ioxaglate, and both isosmolar and hyperosmolar saline were well tolerated, but diatrizoate caused marked radiological and pathological changes. This model may be helpful in studies of the mechanisms underlying contrast medium nephrotoxicity and evaluating differences in toxicity between contrast agents.

Animals↗

Transluminal angioplasty evaluated by electron microscopy.

To gain more understanding about the changes that follow balloon angioplasty, an electron and light microscopic study was carried out in normal canine arteries. Thirty-five arterial segments were dilated with balloon catheters. Early changes consisted of denudation of the intima with widespread necrosis of myocytes and dehiscence of collagen fibers. After three days, myocytes had disappeared leaving empty spaces and edematous ground substance. After two weeks, reendothelization occurred and there was evidence of intimal hyperplasia persisting up to two months. Repair of the dilated arterial segments occurred by proliferation of myocytes, formation of intima, and proliferation of collagen. In two to three months, repair of the intima and media was completed. After six months, dilated segments were characterized by persistent intimal hyperplasia and increased collagen content in the media.

Angioplasty, Balloon↗

Long-term patency of the ductus arteriosus after balloon dilatation: an experimental study.

Balloon dilatation of the ductus arteriosus was carried out in vivo in eight piglets that were 12 to 16 days old. The ductus was functionally closed in all animals before dilatation. Long-term patency for periods of up to 6 months after the procedure was demonstrated in six animals by angiography, Doppler ultrasound examination, and at autopsy. The presence of hemodynamically significant shunts was indicated by clinical development of heart failure, pulmonary infections, and left ventricular hypertrophy. These results confirm the value of this laboratory preparation to create left-to-right shunts at the ductus level.

Angioplasty, Balloon↗

Role of ischemia in contrast-induced renal damage: an experimental study.

Total and regional cortical blood flow was measured in dogs by the radioactive microsphere technique after renal damage of varying severity had been induced by combining selective injection of diatrizoate, iopamidol, or normal saline with a 10 min occlusion of the renal artery. There was extensive tubular and glomerular damage in the kidneys exposed to diatrizoate, but not in the kidneys exposed to saline. Iopamidol caused intermediate changes. Average cortical blood flow was reduced from baseline levels in all groups 5 min after perfusion was restored. After 1 hr the flow had returned to the baseline level. Analysis of variance did not show a statistically significant difference among the groups. A tendency for redistribution of flow from outer to inner cortical layers was seen, but this was present in all groups. The flow changes detected in this study cannot explain the varying severity of renal damage.

Animals↗

Effect of prostaglandin inhibition on the renal vascular response to ionic and non-ionic contrast media in the dog.

In an attempt to study the role of prostaglandins in the renal vascular response to contrast media in mongrel dogs, renal arterial injections of 6 ml of either the non-ionic contrast medium Iopamidol or the ionic medium diatrizoate meglumine/Na+ were performed, before and after intravenous injection of a buffered solution of acetylsalicylic acid (10 mg/kg) (ASA). Renal blood flow was recorded using non-occluding electromagnetic flow probes. The resting renal blood flow was significantly reduced after ASA. The usual biphasic response to contrast injection was observed both before and after ASA, and using either contrast medium. Analysis of the results failed to show any difference in degree of vasodilation or vasoconstriction after ASA. We conclude that prostaglandins may affect the resting level of renal blood flow but are not mediators of the instantaneous changes in response to contrast injection.

Animals↗

CT of abdominal lymphoma after renal transplantation.

Six patients aged 33-68 years developed posttransplant lymphoma of the abdomen an average of 105 months after successful renal transplantation. On computed tomography (CT), five lymphomas presented as bulky masses in intra- (four) or retroperitoneal (one) location. Infiltrative growth into transplanted kidney (three), colon (two), and retroperitoneum (one) resulted in poorly defined margins on CT. Central areas of lower attenuation presumably reflected tumor necrosis. Metastatic deposits in liver (two) and renal transplant (one) were of a focal nature. Prompt radiologic recognition of this serious late complication of renal transplantation is crucial.

Abdominal Neoplasms↗