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Biomedical subjects

M C Beachley

Publications and source records attributed to M C Beachley.

At least 19 recordsLinked to original sources
PubMed1988

Percutaneous transluminal angioplasty following endarterectomy.

Prior to the introduction of percutaneous transluminal angioplasty (PTA), bypass grafting or endarterectomy was the treatment of choice for aortoiliofemoral atherosclerotic occlusive disease. Currently, PTA is a well-established procedure for the treatment of aortoiliofemoral atherosclerotic occlusive disease. PTA is as effective as, and safer than, surgery in these cases. Percutaneous transluminal angioplasty and endarterectomy cause similar trauma to the arterial wall, i.e., intimal denudation, plaque disruption and splitting, and medial disruption, splitting, and overstretching. Both PTA and endarterectomy heal in a similar manner, i.e., neointima formation and scarring. Both PTA and endarterectomy can be repeated. Therefore, PTA can be performed after endarterectomy or vice versa. Several patients with recurrent occlusive disease after endarterectomy have been safely treated with PTA. Our results obtained with PTA in patients who had a prior endarterectomy are comparable to the results obtained in patients who did not have a prior endarterectomy. No complications have been encountered. A previous endarterectomy does not preclude a subsequent PTA, or vice versa, in patients with recurrent occlusive disease.

Angioplasty, Balloon↗
PubMed1987

Splanchnic artery aneurysms and pseudoaneurysms: transcatheter embolization.

Over the past 7 years, eight patients with splanchnic artery aneurysms and pseudoaneurysms were studied and treated. Transcatheter embolization resulted in occlusion of the lesions in all eight patients. Potentially risky and difficult surgery was avoided completely in four patients. Three patients had elective surgery at a later date when their condition was more stable. The remaining patient had definitive surgery after embolization. Transcatheter embolization should be the initial treatment of choice in splanchnic artery aneurysms and pseudoaneurysms.

Aneurysm↗
PubMed1986

Selective low-dose streptokinase infusion in the treatment of acute transplant renal vein thrombosis.

A renal transplant recipient developed acute renal transplant vein thrombosis following surgery for a total hip replacement. As an alternative to standard surgical therapy, the patient was treated with selective intravenous low-dose infusion of streptokinase at doses of 5,000-20,000 units/h. The infusion was continued for 120 h with constant monitoring of PT, PTT, and fibrinogen levels. Therapy resulted in excellent preservation of renal function without complications. Low-dose selective infusion of streptokinase should be considered a potential alternative therapy for acute transplant renal vein thrombosis.

Acute Disease↗
PubMed1984

Computed tomography versus angiography in the diagnosis of large right adrenal carcinomas.

Adrenal carcinomas are rare. We present four surgically and pathologically proved large right adrenal carcinomas studied by computed tomography, angiography, and other imaging modalities. Computed tomography demonstrated large nonhomogeneous right upper quadrant masses in all four cases, but the adrenal origin of the mass could not be ascertained by computed tomography in three patients due to the transverse display of the anatomy. Ultrasonography provided important additional information in these cases. Arteriography was diagnostic in each case by demonstrating minimal to marked tumor vascularity supplied by adrenal arteries. We also present, for differential diagnostic purposes, a proved benign adrenal hemorrhagic cyst with computed tomography and angiography findings indistinguishable from those of adrenal carcinomas. Computed tomography does not eliminate the need for angiography in patients with large right upper quadrant masses suspected of being an adrenal carcinoma.

Adrenal Gland Diseases↗
PubMed1984

Low-dose fibrinolytic therapy in hand ischemia.

Intra-arterial, low-dose streptokinase therapy was administered to five patients with acute hand ischemia (2 to 48 hours' duration) and one patient with chronic hand ischemia (3 months' duration). In the five patients with acute ischemia excellent restoration of patency of occluded hand arteries was obtained, with complete recovery of hand function and avoidance of tissue loss despite the severity of these cases. In the remaining patient with an iatrogenic chronic occlusion, ischemia could not be relieved and bypass surgery was performed with satisfactory results noted at the 3-month follow-up examination. No complications were encountered during or after any of these procedures. The catastrophic consequences of hand ischemia, i.e., loss of limbs or digits, were avoided.

Adult↗
PubMed1984

Percutaneous transluminal angioplasty following endarterectomy.

Recurrent occlusive disease was found by noninvasive methods and confirmed arteriographically in 7 patients who had undergone endarterectomy for stenosis of one [5] or both iliac arteries [1] or the subclavian artery [1]. Three patients with iliac artery stenosis had percutaneous transluminal angioplasty (PTA) 1 to 5 years after endarterectomy. One patient with stenosis of the external iliac artery had PTA 4 years after endarterectomy, and dilatation was repeated 7 months later because of recurrence. One patient had 2 endarterectomies and 2 PTAs within 8 years for stenosis of the right common iliac artery. One patient had recanalization of the left common iliac artery 6 years after endarterectomy with low-dose streptokinase followed by PTA. Another patient underwent endarterectomy of the left subclavian artery 3 months after PTA and required further dilatation at 5 and 10 months because of recurrence. The authors conclude that endarterectomy does not preclude PTA (or vice versa) in patients with recurrent arterial occlusive disease.

Adult↗
PubMed1984

Ascites: comparison of plain film radiographs with ultrasonograms.

Plain film abdominal radiographs of 100 cases of ultrasound-proved ascites were reviewed for findings of ascites. In addition, 100 nonascitic cases proved by sonography were reviewed to evaluate the specificity of these findings. We found that all the described plain film radiographic signs of ascites except the hepatic angle sign are insensitive though specific. The hepatic angle sign has a sensitivity of 84% and a specificity of 70%.

Ascites↗
PubMed1983

Radiographic findings in the chest of patients following cardiac transplantation.

The postoperative chest radiographic findings in 38 patients undergoing orthotopic (37 patients) and heterotopic (1 patient) cardiac transplantation were evaluated. Findings were correlated with those of echocardiograms, sputum and blood cultures, and lung and heart biopsies. The radiographic manifestations in the chest of these patients are classified in the following three main categories: (1) Newly formed cardiac silhouette findings due to the transplanted heart itself, i.e., changes in size and shape of the new heart and pericardial effusion resulting from the placement of a smaller heart in a larger pericardial sac. (2) Infectious complications due to bacteria, fungal, and other opportunistic agents secondary to immunosuppressive therapy, and (3) Usual postoperative complications following thoracotomy and open-heart surgery.

Adolescent↗
PubMed1983

Percutaneous unknotting of intravascular catheters and retrieval of catheter fragments.

During a 5-year period, percutaneous unknotting of knotted catheters or retrieval of intravascular catheter fragments was performed in 21 patients by various interventional radiologic techniques. Eight of nine knotted Swan-Ganz catheters were successfully released, whereas one required the assistance of a surgical cutdown under local anesthesia; 10 of 11 embolized catheter fragments in various locations were retrieved successfully. One failure occurred with complication of peripheral embolization in the lung. Four case reports are presented. The overall success rate was 95%.

Adolescent↗
PubMed1982

Fibrodysplasia of the popliteal arteries.

Fibrodysplasia is a generalized arterial dysplasia of unknown etiology. We report a case involving both popliteal arteries. The patient presented with microemboli of the toes of both feet originating in the dysplastic popliteal arteries. The clinical significance of popliteal artery fibrodysplasia is briefly discussed.

Aged↗
PubMed1982

Use of isosulfan blue for identification of lymphatic vessels: experimental and clinical evaluation.

Use of vital dyes for identification of lymphatic vessels before cannulation has heretofore not been approved by the Food and Drug Administration (FDA). The suitability of isosulfan blue, the 2,5 disulfonic acid isomer of Patent Blue, for this purpose was evaluated experimentally in the rat and clinically in 11 volunteers and 543 patients under an investigational new drug application. FDA approval for this drug has been obtained. Volunteers and patients received up to 15 mg of a 1% sterile, pyrogen-free solution per extremity (total dose of 0.4 mg/kg in the average patient). Excellent identification of lymphatic vessels was achieved in 100% of volunteers and in 97.4% of patients. In the other 2.6%, lymphatic vessels were not identified mainly due to congenital lymphatic vascular (Milroy) disease. Baseline blood chemistry in volunteers was not altered after administration of the dye. No adverse reactions were found in volunteers and minimal allergic reactions occurred in less than 1% of patients. Acute toxicity studies demonstrated an LD50 greater than 150 mg/kg in the rat. Isosulfan blue was excreted unchanged in the urine (7%) and feces. Comparable excretion was found in volunteers. Isosulfan blue is a safe and efficacious vital dye for lymphangiography.

Adult↗
PubMed1982

Carcinoma of the esophagus: assessment of submucosal extent.

Submucosal extension of carcinoma of the esophagus is common, often presenting as a varicoid pattern on the esophagogram. Forty-two per cent of our 153 patients with carcinoma of the esophagus showed area(s) of a varicoid pattern in association with the other usual pattern(s) (fungating, ulcerating or infiltrating). A few of the patients have findings similar to those associated with esophageal varices on the esophagogram. Such patients are identical to those with "varicoid carcinoma" reported in the literature. The differentiation between varicoid carcinoma dn esophageal varices may be made on fluoroscopy, where the former is characterized by rigidity and the latter by flexibility.

Aged↗
PubMed1981

Round (helical) atelectasis.

Round (helical) atelectasis is a little-known form of pulmonary collapse. It is thought to occur secondary to lung compression from pleural effusion or following therapeutic pneumothorax. Its occurrence is favoured in patients with exudative pleural effusions and extensive pleural thickening. It presents radiographically as a pulmonary pseudotumour, and experience with this entity and its pathogenesis are discussed.

Humans↗
PubMed1981

Bead-chain cystourethrogram: an evaluation.

The role of cystourethrography in the evaluation of urinary incontinence is controversial. This study evaluates the significance of 5 radiologic landmarks described in the literature as characteristic of stress urinary incontinence. It was expected to determine how often these landmarks were read similarly by independent observers and whether these radiologic findings in patients with stress urinary incontinence differ from those in patients with idiopathic detrusor instability. Eight-three cystourethrograms of patients having either stress urinary incontinence of idiopathic detrusor instability were reviewed. Three radiologists interpreted 5 radiologic landmarks on each study. Lack of identification and of agreement in interpretation by all 3 investigators varied from 19.3 to 54.2%. There were no statistically significant difference in the distribution of radiographic characteristics between patients with stress urinary incontinence and those with idiopathic detrusor instability.

Adult↗
PubMed1980

Dysphagia aortica.

A tortuous thoracic aorta is common in the elderly, often displacing the esophagus without causing organic obstruction. The potential for this complication is present, and a case is reported which required surgical relief of this problem.

Aged↗