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Biomedical subjects

George Joseph

Publications and source records attributed to George Joseph.

7 recordsLinked to original sources

Fish bone as a foreign body.

Fish bones are one of the most common foreign bodies in the upper aero-digestive tract. The use of plain X-ray in identifying fish bones has questionable value. We believe that the knowledge of the type of the fish ingested improves the diagnostic value of the neck X-rays. This study was designed to evaluate the relative radio-densities of the bones of commonly eaten fish in the UK. Twenty-three species of fish were studied and their bones were grouped into three depending upon their ratio-densities. This information is expected to be useful in identifying fish bones while reading plain radiography.

Animals↗

Severe intravascular hemolysis after transcatheter closure of a large patent ductus arteriosus using the Amplatzer duct occluder: successful resolution by intradevice coil deployment.

A 21-year-old female developed severe unremitting intravascular hemolysis following closure of a large patent ductus arteriosus using an Amplatzer duct occluder. Percutaneous deployment of fibered platinum coils within the nitinol wire cage of the Amplatzer duct occluder abolished the residual shunt through the device and resulted in cessation of intravascular hemolysis and reversal of its adverse sequelae.

Adult↗

Transjugular approach to balloon mitral valvuloplasty helps overcome impediments caused by anatomical alterations.

Ten patients who had anatomic alterations that cause impediments to successful completion of conventional transfemoral balloon mitral valvuloplasty (BMV) underwent transjugular BMV. They included six patients in whom conventional BMV could not be completed due to cardiac anatomic distortion; two patients with dextrocardia (one with visceroatrial situs solitus and the other with situs inversus); two patients with venous abnormalities (one with azygous continuation of the inferior vena cava and the other with bilateral iliac/femoral vein occlusion). Transjugular BMV was successful in all 10 patients (mean mitral valve area increasing from 0.68 +/- 0.17 to 1.92 +/- 0.40 cm(2); range, 1.56-2.76 cm(2)); it was quick (mean total fluoroscopy time, 10.5 +/- 2.7 min; range, 7.3-15.2 min); and it was safe (no major or minor complications except one patient who developed severe mitral regurgitation that only required medical therapy). The jugular approach to BMV overcomes many of the technical problems caused by anatomic changes that are encountered in transfemoral BMV and complements the latter approach.

Adolescent↗

Colour duplex ultrasound-guided sclerotherapy: a new approach to the management of patients with peripheral vascular malformations.

INTRODUCTION: Colour duplex ultrasound (CDU)-guided sclerotherapy is a valuable modality for treating peripheral vascular malformations (PVMs). PATIENTS AND METHODS: Between April 1996 and October 1998, 75 patients (age 5-65 years) with PVMs were subjected to CDU. Sclerotherapy was subsequently performed on 40 patients, without sedation, using 3% sodium tetradecyl sulfate, with mean follow-up of 4 years. RESULTS: CDU of the 33 high-flow lesions (HFLs) revealed direct arteriovenous (AV) communicating channels with very high forward diastolic flow in seven lesions (arteriovenous fistulas, AVFs), but not in the other 25 lesions (non-AVF). One was a mixed lesion picked up by CDU. Sixteen HFLs were subjected to sclerotherapy; 13 (81.25%) regressed. CDU of the 42 low-flow lesions (LFLs) helped categorize them into Type 1, where no supplying arteries could be seen (12 lesions), and Type 2, where supplying arteries were seen (30 lesions). Type 2 lesions could be further subcategorized based on the spectral trace of their supplying arteries: Type 2a, high-resistance flow (25 lesions); and Type 2b, low-resistance flow with a small forward diastolic flow (5 lesions). Twenty-four LFLs were subjected to sclerotherapy; 20 (83.3%) regressed. CONCLUSION: CDU findings correlated well with the clinical appearances of PVMs, and helped to further subcategorize these lesions based on flow. Significant differences in the Doppler flowmetry parameters of the supplying arteries seen in the HFLs and LFLs have enabled us to suggest values for differentiating between them. CDU was also found to be valuable in the follow-up of these lesions.

Abnormalities, Multiple↗

Multivessel cutting balloon angioplasty in a patient with type III nonspecific aortoarteritis.

A 23-year-old female patient with type III nonspecific aortoarteritis (Takayasu's arteritis) presented with multiple obstructive lesions and severe congestive heart failure. Large, cutting balloons 5-8 mm in diameter were used to dilate lesions in the abdominal aorta, both renal arteries, right common carotid artery, proximal left subclavian artery, and ostium of the left vertebral artery. Wide luminal expansion without residual stenosis, substantial dissection or need for adjunctive stenting was achieved at all six angioplasty sites. The use of cutting balloons appears suitable for treating obstructive lesions in aortoarteritis.

Adult↗