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Biomedical subjects

J Rösch

Publications and source records attributed to J Rösch.

At least 109 records · Page 6Linked to original sources

Limitations of angiographic differential diagnosis in major hepatic processes.

In 11 instances (6%) of 183 consecutive hepatic angiograms done for subsequently proven pathologic hepatic processes, either the diagnosis was incorrect (4 patients) or a satisfactory differential diagnosis was not established (7 patients), despite obvious angiographic abnormalities. Incorrect diagnoses were made in patients with suppurative hapatocarcinoma and liver cyst, macronodular regenerative cirrhosis, and multiple intrahepatic abscesses. Satisfactory differential diagnoses could not be established in patients with enlarged intrahepatic ducts, acute viral hepatitis, recurrent cirrhosis and acute liver necrosis. On analysis, means for minimizing diagnostic failure include the use of enhancement techniques such as infusion angiography and pharmacoangiography and an unbiased, detailed analysis of the angiographic findings. Changes secondary to the pathologic process and the coexistence of multiple processes, however, can occasionally prevent an accurate diagnosis.

Adult↗

Hand angiography and Raynaud's syndrome.

Forty-eight patients with Raynaud's syndrome and seven volunteers without it were studied by magnification hand angiography which included studies of the effects of cold exposure before and after the selective intraarterial administration of reserpine. Most of the patients with Raynaud's syndrome, in addition to organic obstructive disease, exhibited both basal vasoconstriction and exaggerated, persisting cryogenic vasospasm of the hand arteries. Studies done two days after reserpine administration revealed decreases in both basal and cryogenic vasospasm in most patients and the degree of angiographic improvement correlated well with subsequently determined clinical responses to long-term vasodilator drug therapy. Hand angiography with examinations after cold exposure and its combination with the postreserpine pharmacodynamic studies is a useful technique in Raynaud's syndrome, both diagnostically and in predicting the outcome of longterm vasodilator therapy.

Adolescent↗

Rapid onset of hand ischemia of unknown etiology: clinical evaluation and follow-up of ten patients.

Ten patients presenting with a history of the acute onset of hand ischemia have undergone detailed clinical, immunologic, and arteriographic evaluation. The disease is characterized by the acute onset of hand ischemia proceeding to fingertip ulceration, in the absence of recognized systemic disease. None of the patients had any evidence of large artery obstruction. Arteriography showed diffuse obstruction of the palmar and digital arteries. No evidence was found in any patient of any systemic disease process associated with small artery obstruction. These patients are suspected of having a previously unreported variant of hypersensitivity angiitis. Patients are left with permanent obstruction of the palmar and digital arteries. Follow-up suggests the disease in non-recurrent and is characterized by progessive clinical improvement associated with the development of collateral circulation. Conservative management of the condition is recommended.

Adolescent↗

The importance of temperature in angiography of the hand.

Angiograms of the hand of a normal volunteer taken at skin temperatures ranging from 22 to 33 degrees C revealed that visualization of the arteries was highly dependent on the temperature. Lower temperatures produced vasospasm beginning in the smaller vessels and proportionally involving medium-sized and major arteries. Moderate warming led to optimum filling and is recommended prior to angiography of the hand. Prior injection of contrast material caused no perceptible change in the filling or appearance of the arteries.

Angiography↗

Cryodynamic hand angiography in the diagnosis and management of Raynaud's syndrome.

Cryodynamic hand angiography (CHA) with angiograms done before, just after, and during rewarming following hand immersion in ice water was performed in 39 patients with Raynaud's syndrome and eight volunteers without it. The normal response to cold stimulus was angiographically evident as mild, transient digital arterial constriction. Most of the patients with Raynaud's syndrome, in addition to organic obstructive disease, exhibited basal vasoconstriction and exaggerated persisting cryogenic vasospasm of the hand arteries. Similar angiographic studies done in 32 cases two days after the selective intra-arterial administration of reserpine revealed no differences in normal subjects but substantially decreased vasospasm in patients with Raynaud's syndrome. CHA with postreserpine studies was found to be diagnostically useful in Raynaud's syndrome, revealing the degree of organic arterial disease and functional vasospasm. In addition, correlation of postreserpine studies with observed clinical responses to long-term vasodilator drug therapy indicated that CHA has a good chance to predict the probable outcome of such therapy in Raynaud's syndrome.

Adult↗

Angiography in the diagnosis of retroperitoneal and mediastinal chemodectomas. Report of two cases.

Two cases of angiographically demonstrated chemodectomas of uncommon locations and behavior are reported: one located retroperitoneally and one with multi-centric sites including both carotid bodies and the upper mediastinum, with late distant bone metastases. Based on this experience and that reported by others, the angiographic appearance of chemodectomas is described and the value of angiography in the diagnosis and therapy of chemodectomas is discussed.

Aged↗

Angiography in the diagnosis of liver disease in children.

75 angiographic examinations were done in 64 children aged 1 day to 16 years; 41 with various liver diseases and 23 with normal lives. The angiographic diagnosis was accurate in 95% of 44 patients where proof was established by surgery and/or biopsy. Properly used hepatic angiography is a reasonably safe procedure of great value in diagnosing and planning the surgical management of liver masses. It is also a useful tool in the diagnosis of diffuse hepatic processes of neoplastic, inflammatory or degenerative origin.

Adolescent↗

Angiography in the diagnosis of renal scleroderma.

Three patients with different stages of renal scleroderma are presented, and the angiographic diagnosis of this disease is dicussed. No one pattern is specific, but the combination of findings is considered diagnostic of this disease. Pharmacoangiography is proposed for differential of renal scleroderma, and selective renal artery infusion of vasodilators is suggested as a potential means of therapy.

Adult↗

Left main coronary artery spasm. A potential cause for angiographic misdiagnosis of severe coronary artery disease.

Two patients had catheter-induced spasm of the left main coronary artery during diagnostic coronary arteriography. One patient had no coronary artery disease, and the other had minimal disease of the right coronary artery. Spasm was relieved by nitrates; however, in one patient several doses were needed over 35 minutes. Catheter-induced spasm must be considered in the diagnosis of left main coronary artery disease, particularly on a patient with isolated left main coronary artery disease.

Angiography↗

Infusion hepatic angiography in diagnosis of liver metastases.

Infusion hepatic angiography was used, together with conventional angiography, for diagnosis in 68 patients with liver metastases. The combination of both techniques led to a diagnostic accuracy of 97%. Metastases were missed in only two patients, both of whom had underlying liver or biliary disease. In a comparison of the two techniques, the infusion study was found diagnostically essential in five patients (7%) and afforded improved diagnosis in 49 others (72%). In 10 patients (15%), it gave equivalent information; and in four patients (6%) less information than the conventional technique. Infusion hepatic angiography is a useful complementary technique in antatomic liver diagnosis, especially in its ability to improve upon the diagnostic accuracy of the capillary phase of hepatic angiography.

Adult↗

Intra-arterial sympathetic blockade in the treatment of clinical frostbite.

Regional medical sympathectomy achieved by the intra-arterial injection of reserpine appeared to be of benefit in the treatment of five patients with acute or chronic frostbite injuries. Clinical improvement was associated with a significant increase in arteriographically determined regional perfusion.

Adult↗

Arteriovenous fistula complicating renal transplantation.

A case of arteriovenous fistula of the major transplant vessels contributing to posttransplant hypertension hypertension and severe microangiopathic hemolytic anemia is reported. Improvement in blood pressure and correction of anemia followed ligation of the fistula. This case reinforces the need for diagnostic evaluation of all patients with sustained post-transplant hypertension.

Adult↗

Diagnostic effectiveness of infusion hepatic angiography. A comparison with the conventional technique.

The diagnostic effectiveness of infusion hepatic angiography was evaluated in 72 patients with various liver diseases, who also had conventional hepatic angiography. In a comparison of the two techniques, the infusion study was found diagnostically essential in 4 patients (6%), and afforded improved diagnosis in 52 others (72%). In 13 patients (18%), it gave equivalent information; and in 3 patients (4%), less information than the conventional technique. Infusion hepatic angiography is a useful complementary technique in anatomical liver diagnosis, especially in its ability to improve upon the diagnostic accuracy of the capillary phase of hepatic angiography.

Adult↗