Biomedical subjects
Publications and source records attributed to J Andresen.
In a case of Takayasu's aortitis, digital subtraction angiography (DSA) revealed the detailed anatomy of patent intracerebral vessels through intraspinal and cervical collaterals with the only blood supply arising from the left vertebral artery. DSA gives not only anatomical, but also dynamic information, which means the direction of the blood stream is revealed.
By means of an intraarterial digital subtraction angiography a fistula due to a trauma could be visualised between the right vertebral artery and the jugular vein. The investigation was performed one year after the car accident. Visualisation with exact localisation of the beginning of the fistula at the arterial site should make it possible to perform an embolisation without affecting the vertebral artery. The clinical condition will be decisive.
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Bone loss was evaluated in 118 patients with rheumatoid arthritis by measurement of the total width and marrow cavity of the second metacarpal bone. Both in men and women a significant increase in width of the medullary cavity could be demonstrated, probably due to bone loss at the endosteal surface. Although a certain increase in the total width of the second metacarpal bone took place in men but not in women, combined cortical thickness and metacarpal bone mass decreased significantly. There was no significant difference in the values in patients on gold treatment and in patients without systemic treatment, while patients treated with steroids demonstrated a significantly greater loss of endosteal bone compared to the other two groups. Some correlation was found between the severity of joint involvement and the measured loss of cortical bone. In summary, the study shows that bone loss takes place in patients with rheumatoid arthritis, being most pronounced in steroid-treated patients, in postmenopausal women, and in patients with more severe joint involvement.
Ten children with disorders of keratinization (ichthyosis, 4, pityriasis rubra pilaris, 2, psoriasis, 2, and palmoplantar keratoderma, 2) were treated with etretinate for 0.5 to 9.6 years. The children ranged from 1.5 to 15.7 years of age. The total dose of etretinate ranged from 700 to 52,596 mg and the maintenance dose, from 0.21 to 0.86 mg/kg/day. Radiographic skeletal surveys were performed at various stages during treatment or following treatment. Bone abnormalities were found in eight children. Six children had periosteal thickening, two periosteal bone resorption, two osteoporosis, three disc narrowing, and one slender long bones. Compared with age- and sex-matched normal controls, the children had decreased cortical bone thickness of the second left metacarpal bone. The children's physical growth and laboratory investigations were normal. We recommend that children on long-term etretinate therapy be investigated regularly for bone changes.
In a case-control study of 209 workers from a local railway maintenance and repair workshop, pleuropulmonary lesions were studied on chest radiographs. All workers were known to have been exposed to asbestos fibers of all kinds for a long period of time, but the exposure was light. A "dose index" of every worker was calculated based upon the type of working process and cumulated time spent in the working process. We found a certain dose-effect relationship between asbestos exposure and pleural thickening.
Quantitative radiological measurements on the second left metacarpal bone were carried out in 23 patients with primary hyperparathyroidism, 22 corticosteroid-treated patients with polymyalgia rheumatica and 40 renal transplant recipients treated with prednisone and azathioprine. Women with primary hyperparathyroidism and corticosteroid-treated women showed significantly decreased mean values of metacarpal bone compared to normal controls, probably due to a higher bone resorption than formation at the endosteal surface. Bone loss was more pronounced in corticosteroid-treated women than in women with primary hyperparathyroidism, partly due to age difference. In renal transplant recipients, bone loss took place during the initial period after renal transplantation, probably due to increased endosteal bone resorption. During this period a periosteal new bone formation took place in female renal transplant recipients. The quantitative radiological measurements make it possible to determine whether bone loss is due to a higher ratio of bone resorption than of bone formation at the periosteal and/or endosteal surface.
The results of 68 abdominal angiographies were evaluated retrospectively with regard to localization of severe gastrointestinal and urological bleeding. Endoscopy prior to angiography was either impossible or showed poor results. Results of survey angiography were not encouraging. Selective angiography was very confident in localizing a bleeding. The possibilities of embolization or vasopressin treatment through the angiographic catheter are mentioned.
Twenty-seven healthy normal subjects, 30 non-dialyzed patients with chronic renal failure, 25 hemodialyzed patients on chronic hemodialysis, and 54 renal transplant recipients were evaluated simultaneously with regard to a correlation between the bone mineral content of the forearm and the total cortical thickness and area of the second left metacarpal bone. A significant correlation was found between bone mineral content of the forearm and the cortical bone mass of the metacarpal bone in normal subjects and in the patient groups.
The action of a synthetic 'atrial natriuretic factor' (sANF) on induced tone in isolated rat renal resistance vessels (lumen diameter about 200 microns) was examined and compared with the effects of sANF on resistance vessels of similar size taken from the cerebral, mesenteric and femoral vasculature. Synthetic ANF caused a relaxation of the renal vessels when these were submaximally activated with noradrenaline or serotonin, but had no effect on the responses of the other vessels to these agonists. In contrast to previous reports concerning rabbit aortic vessels, methylene blue (which is thought to cause inhibition of guanyl cyclase) did not reduce the dilator response to sANF in the renal vessels. The results demonstrate that sANF has a specific relaxing effect on renal resistance vessels, and are consistent with its effect being mediated through specific receptors. The mechanism of this relaxant effect remains unknown.
34 girls aged 3-12 years (mean age 7 years) with vesicoureteric reflux and 'distal urethral stenosis' were treated operatively by Otis' urethrotomy. They were investigated clinically and radiologically with regard to urinary tract infection, renal growth and scarring. At the end of the observation period, urinary tract infection was still present in 21%, vesico-ureteric reflux in 26%, decreased renal length in 15% and renal scarring in 23%. Compared to antibiotic therapy, Otis' urethrotomy gives no better results in curing infections or reflux or preventing renal scars.
Metacarpal bone mass, bone mineral content in the forearm and bone mineral concentration were measured in 54 renal transplant recipients with a well functioning renal transplant a mean of 67 months after transplantation. Significantly decreased values of metacarpal bone mass, bone mineral content and bone mineral concentration were found. A highly significant correlation between metacarpal bone mass and bone mineral concentration was found in renal transplant recipients, probably indicating that changes in the amount of cortical bone and bone mineral occur simultaneously after renal transplantation.
An unusual case of pneumopericardium is described. It is due to a fistulous communication between the small bowel and pericardium. 4 years previously a gastro-jejunostomy was performed, and now a peptic ulcer in the jejunum had developed with abscess formation, thus giving rise to a fistulous communication between intestine and pericardium. The cause, symptoms and diagnostic procedures are described.
Metacarpal bone mass (D2-d2)/D2 measured on radiographs, and bone mineral content (BMC) measured by photon absorptiometry, were studied in the forearms of 30 nondialyzed and 25 hemodialyzed patients with chronic failure and in a group of normal subjects. Metacarpal bone mass was reduced in nondialyzed women with chronic renal failure and the amount of bone mineral reduced both in males and females with chronic renal failure, whereas these measurements were normal in dialyzed patients with chronic renal failure. Bone mineral content in the forearm and metacarpal bone mass decreased with age, both in women with chronic renal failure and in normal women, the decrease being more pronounced in women with chronic renal failure than in normal women. No age-related decrease was seen in males. Bone mineral content corrected for the size of bone (BMC') decreased with age both in males and in females. Highly significant correlations were found between metacarpal bone mass and BMC' in nondialyzed and dialyzed patients with chronic renal failure, whereas no significant correlation could be demonstrated in normal subjects. The study indicates that changes in metacarpal bone mass and in BMC to some degree occur simultaneously in patients with chronic renal failure; an accelerated loss of bone mass and of bone mineral with age may be seen in women with chronic renal failure compared to normal women.
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The material includes 15 suprarenal and five other retroperitoneal neuroblastomas. All patients were examined by intravenous pyelography which was evaluated with regard to calcification; renal configuration; compression and displacement of the renal pelvis; and renal concentration. It was possible to distinguish between suprarenal and other retroperitoneal neuroblastomas. In five patients the final diagnosis was obtained by selective angiography. Adventitious tumour circulation was not always due to invasion. A brief survey is given of the clinical findings at the time of examination, metastases being present in 75%. Three patients underwent radical surgery, while six were treated conservatively and in 11 patients surgery was either impossible or incomplete. Survival is possible without total removal o the tumour. The survival rate over a five-year period was 30%.
The frequency of subperiosteal erosions and soft tissue calcifications was found to be about 36 and 33 per cent, respectively, in a series of 241 patients with chronic renal failure. In patients on chronic hemodialysis and in renal transplant recipients, subperiosteal juxta-articular erosions combined with soft tissue calcifications were observed in the same localization in 53 joints, most commonly in small joints of the hands. The calcifications appeared before the erosions, suggesting that the calcifications induced the erosions.
In measurements of the metacarpal bone mass the values in normal Danish adults did not differ between the right and left hand, but were significantly higher in women compared with men in subjects 20-59 years of age; beyond that age the bone mass decrease in women compared with men. The metacarpal bone mass decreased significantly during the period of dialysis in patients on chronic hemodialysis and decreased significantly after renal transplantation. Recipients who developed necrosis of bone or spontaneous fractures after transplantation had significantly reduced metacarpal bone mass at the time of transplantation as compared with normal controls whereas recipients without bone lesions after renal transplantation had normal values at the time of transplantation.