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Biomedical subjects

F J Roth

Publications and source records attributed to F J Roth.

At least 55 records · Page 3Linked to original sources

[Rotation angioplasty--initial clinical results of peripheral vascular occlusions].

After experimental investigations in postmortem human arteries, 19 patients with chronic peripheral artery occlusions were treated with a new technique between December 1986 and October 1987. In 17 patients the superficial femoral artery, and in two patients the popliteal artery, was completely occluded. The length of occlusions were between 5 and 25 cm (mean 10.9 cm); the duration (estimated according to patient's history) was 5-48 months (mean 17.2 months). In five patients, durations of up to 30 months had been documented by angiography. A flexible, blunt, motor-driven rotating catheter was introduced over an 8 or 9 F sheet and rotational angioplasty was performed at low speed, up to 200 rpm. In 11/14 patients in whom this new technique was used as the first attempt, the occlusions could be successfully reopened. In two patients after failure of the conventional technique the rotating catheter could not bypass the preexisting dissections in the same intervention. In 2/3 further patients after failure of the conventional technique the occlusions could be successfully reopened in a second intervention after several weeks. In none of our 19 patients did a perforation occur. It is concluded that by using the new technique, chronic peripheral artery occlusions can be reopened with a high success rate and without the danger of vessel wall perforation. The method can also be applied in patients in whom conventional techniques have failed.

Adult↗

[Venous diseases of the lower extremities--methods and results of phlebography of the lower extremity--the superficial and deep systems].

The vena saphena magna is the most important arterial vascular substitute in today's vascular surgery. That is why modern varicose vein surgery is performed very carefully and cautiously with an aim to preserve the vessels as much as possible. This can be done only if the radiologist visualises both the healthy and the diseased superficial and deep venous systems as completely and a easily appreciable as possible when diagnosing varicosis. It is not enough to merely produce contrast images of the deep venous system when attempting to clarify varicosis via phlebography. The conditions obtaining at the points where the great saphenous vein and the small saphenous vein open into the femoral and popliteal veins, respectively, must be clearly visible. The maximum possible number of insufficient venae perforantes must be shown and the side branches of the great saphenous vein that have undergone varicose changes, must be visualised. It goes without saying that the deep venous system must be shown in a manner that it can be safely assessed. An extended thrombosis of the deep veins of the leg and pelvis does not present any diagnostic pitfalls when assessing the phlebogram. On the other hand, a beginning deep leg thrombosis is easily overlooked. Phlebographically it is quite difficult to clarify a relapsing thrombosis. This requires detailed knowledge of the patterns of signs in deep leg vein thrombosis.

Humans↗

Treatment of neurofibromatosis associated renal artery stenosis with hypertension by percutaneous transluminal angioplasty.

A 12 year old girl with severe arterial hypertension was found to have neurofibromatosis associated bilateral stenoses of the main renal arteries and elevated plasma renin activity in the right main renal vein. Antihypertensive treatment was unable to normalize blood pressure. PTA of the right renal artery from a left axillary approach resulted in normalization of blood pressure and peripheral plasma renin activity. PTA seems to be an effective and safe method for treatment even of complicated forms of renal artery stenosis.

Angioplasty, Balloon↗

Results of percutaneous transluminal angioplasty.

Percutaneous transluminal angioplasty (Dotter technique) was used in 2,942 cases of iliofemoral atheromatous disease. Results varied with the characteristics of the obstructing lesion (length and location) and the clinical stage of ischemia (claudication, rest pain, gangrene). Based on the foregoing, angioplasty is done either as the preferred primary treatment or for the relief of clinically advanced disease in patients unsuitable for high risk surgery. Success is favored by the use of aggregation inhibitors and single-use Teflon or balloon catheters; complications are few.

Aged↗

[Cinedensitometric flow measurements before and after angioplasty in the femoropopliteal region].

In 31 patients with obstructions of the superficial femoral artery in occlusive vascular disease the flow in the popliteal artery was cinedensitometrically measured before and after angioplasty with the balloon catheter. Under resting conditions the flow was improved to the 2.63 fold value by recanalization of the 18 occlusions. By dilatation of the 13 stenoses the flow nearly could be doubled (f = 1.82). The idea is that a high flow is able to counteract to a reocclusion immediately after angioplasty. Therefore a vasodilatator should be applied in order to diminish the peripheral resistance and increase the flow in the treated region.

Absorptiometry, Photon↗

[Computer-assisted tomography, B-scan sonography and cerebral angiography in obliterations of the carotid artery (author's transl)].

The real-time-B-scan is a new and essential method for diagnosing carotid stenoses. Whereas computer-assisted tomography shows only a minor sensitivity for detection of obliterations of cervical arteries, B-scan sonography has high sensitivity and specificity. B-scans should be increasingly performed both after uncertain clinical and computer tomographic findings prior to angiography of extracranial cerebral vessels. A more stringent indication for angiography and thus avoidance of investigational and irradiation risk can be achieved. Wide use of B-scan sonography may, through early recognition of carotid obliterations, lead to prevention of cerebral insults as patients can undergo vascular surgery at an early stage.

Arterial Occlusive Diseases↗

Hemodilution (HD) in patients with ischemic skin ulcers.

In 25 patients with arterial occlusive disease in the clinical stage IV according to Fontaine a hemodilution down to an average hematocrit value of 0.31 +/- 0.02 was performed. Eighteen patients had peripheral ulcers of the lower limbs and 3 patients had ulcers of the upper ones. Four patients had tissular lesions both at the level of the feet and toes and hand and fingers. The average age of the patients was 43. Hemodilution was achieved by repeated withdrawals of approx. 500 ml blood, followed by reinfusion of the autologous plasma associated with infusion of substitutive solutions of low-molecular weight dextran to avoid hypovolemia. In all patients with peripheral ulcers of the upper limbs, with no exception, a good to a very good clinical effect was obtained ranging from extended to complete healing. The healing tendency of lesions in the feet and toe region was on the whole less marked and depended basically on the total number of vascular impediments found in one patient. The rheological and hemodynamic mechanism of the therapeutic effect of hemodilution, the preliminary criteria for indicating this therapy and its observed complications are discussed.

Adult↗

[A comparison of radiation exposure of angiographers using an above-table or below-table image intensifier (author's transl)].

Phantom measurements in the vicinity of an angiographic installation with the image intensifier below the table and subsequently with the intensifier above the table have shown that the former arrangement produces three times as much radiation to the head, gonads and leg during screening than when the intensifier is above the table. This has been confirmed in clinical practice during angioplastic procedures in other units. There is also a factor of 2.6 in favour of the above table intensifier applied to the lens of the eye of the investigator Radiation to the hand of the investigator is at least half with the above table arrangement.

Angiography↗

Immunological cross-reactivity between a glycoprotein isolated from Trichophyton mentagrophytes and human isoantigen A.

A glycoprotein isolated from the cell wall of Trichophyton mentagrophytes was assessed for its cross-reaction with human blood group isoantigens. Rabbit antiglycoprotein antibodies agglutinated human erythrocytes of blood groups A1 and A2, and precipitated Blood Group Substance A in agarose gels. Erythrocytes of blood group B were only slightly agglutinated, and O(Rho+) and O(Rho-) erythrocytes were not. Additionally, the glycoprotein was shown to specifically inhibit isoagglutination of erythrocytes of group A. Partial identity between the glycoprotein and a crude extract of the fungus was demonstrated by immunodiffusion. Analyses revealed the glycoprotein to be composed of approximately 17% protein and 80% carbohydrate. The glycoprotein was found by indirect immunofluorescence to be located in the mycelial cell wall. The possibility that cross-reacting antigens may lead to a chronic, spreading infection is discussed.

ABO Blood-Group System↗

[Fibronolytic treatment with activator: clinical results, angiographic findings and laboratory results (author's transl)].

Two-day treatment with activator (equimolar streptokinase-human plasminogen complex) was given to 26 patients. Indications were chronic arterial occlusion and stenosis of the lower-limb arteries (25 patients), and thrombosis of the subclavian veins. The onset of claudication had on average been 7.5 months previously, average walking distance 288 metres. Five occlusions of iliac arteries and three of femoral arteries were removed. In addition, stenosis of the aorta (one case), the iliac artery (ten cases) and femoral artery (one case) was partly removed. Occlusion of the axillary vein was also removed. Average duration of the successfully treated occlusions was 4.3 months. Those stenoses that responded to activator had the well-known morphological criteria for fibrinolysis. The walking distance of the patients increased from an average of 288 to 401 metres. Activator treatment was well tolerated. No serious, especially cerebral, complications occurred. The most striking laboratory finding was of circulating plasmin during the entire duration of the infusion.

Adult↗