Biomedical subjects
Publications and source records attributed to J H Ruijs.
59 relatives with a family history of hereditary chemodectoma have been successfully screened by means of radionuclide scintiangiography. The findings showed a close correlation with selective roentgenangiography. 3 asymptomatic patients with chemodectoma were revealed by these methods without causing discomfort to the group involved.
Measurement of the spatial distribution of the clearance rate of xenon-133 from the kidney after its injection into the renal artery for estimating intrarenal blood flow can easily be combined with selective X-ray angiography as a routine method. Using a gamma camera as detection equipment anand applying a special computer analysis technique, 'functional images' can be obtained, by which the spatial distribution of the blood flow in the kidney is quantitatively mapped. Experiments with a rather heterogenous group of 12 patients suggest that in at least one type of renal pathology the xenon-133 flow study is more indicative for clinical evaluation than the X-ray angiography
The benefits of the direct-puncture carotid angiography with the proximal-compression technique are not fully evaluated if not compared with a more simple diagnostic procedure, i.e. the femoral-catheter technique. In order to discuss this, a case history of a patient who underwent simultaneously both types of examination is presented.
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A normal lung perfusion isotope scan can exclude pulmonary emboli. However, the demonstration of lung emboli presents problems, as an abnormal lung perfusion scan can have various causes. Some of these can be excluded if the perfusion scan is assessed in combination with a chest X-ray and a ventilation scan. In this study, 21 patients with an abnormal perfusion scan were also examined using digital subtraction angiography (DSA) of the lungs. With the help of DSA it was possible to differentiate between the various causes of a lung perfusion defect on the isotope scan by having a sufficiently reliable pulmonary angiogram. From experience it appears that the quality of the pulmonary angiogram confined to the first three divisions obtained with DSA, is comparable with that from a conventional pulmonary angiogram. A perfusion isotope scan is the initial screening modality for suspected lung emboli, if this shows an abnormality, DSA seems to be indicated as the next step.
Real-time ultrasonography (US) was used as a single non-invasive method in the management of 174 patients (56 inpatients and 118 outpatients) with suspected deep-vein thrombosis (DVT). Therapeutic decisions were based on the results of ultrasonography alone. If the US examination was abnormal anticoagulant treatment was started. If the initial US examination was normal, no treatment was given and the patient underwent repeated testing and physical examination after 1 day, 7 days and 3 months. In the outpatient group, 1.3% of the ultrasonographic negative patients developed thromboembolic complications (95% confidence limits, 0.03-7.21%). None of the initial ultrasonographic negative patients developed proximal DVT after 1 day and 7 days. In the inpatient group, 10% of the ultrasonographic negative patients developed thromboembolic complications (95% confidence limits, 1.2-31.7%). In 18% of the ultrasonographic negative patients an alternative, unexpected diagnosis was obtained by ultrasound. The most frequent alternative diagnosis was a popliteal cyst. The results indicate that US alone appears to be a safe diagnostic method in the management of outpatients with suspected DVT. In the inpatient group further research is required for definite recommendations regarding a safe ultrasound follow-up schedule.
After a preparatory phase in which a software link was realized, on-line communications between a diagnostic reporting console and a computed tomography (CT) apparatus were set-up. Two specific groups of CT investigations were selected to be diagnosed in a 'digital' as well as a 'conventional' manner. The 'digital' diagnosis implies medical as well as organizational aspects. The latter will be illustrated by an organization study based on activity diagrams performed to set-up a prototype digital archive (PDA). The PDA was developed to determine the information to be stored in a digital archive and the requirements that users have in accessing image data and corresponding attributes. First experiences with respect to the organizational aspects of this clinical picture archiving and communication systems (PACS) project, in which on-line communications are used in daily routine, will be presented.
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