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Biomedical subjects

O H Gutierrez

Publications and source records attributed to O H Gutierrez.

At least 37 records · Page 2Linked to original sources
PubMed1985

[Production of nonsurgical intrahepatic portacaval shunt in portal hypertension using a Gruntzig balloon dilatation catheter].

Nonsurgical intrahepatic shunts between the left portal and left hepatic vein were successfully produced in 14 dogs with portal hypertension. Dilatation of the intrahepatic tract was achieved by means of a Grüntzig angioplasty catheter with an inflated balloon diameter of 12 mm. This catheter was coaxially introduced into the portal vein, through the 18 French catheter of a Dotter's coaxial catheter system placed initially into the portal system via transjugular approach. The intrahepatic portocaval shunts created in this fashion, proved to be effective in immediate reduction of increased portal pressure and no significant complications were encountered.

Angioplasty, Balloon↗
PubMed1984

Direct fibrinolytic therapy for renal vein thrombosis: radiographic followup.

Renal vein thrombosis is a rare entity whose true incidence is unknown. The disease occurs most frequently in patients with the nephrotic syndrome but it also can occur in the presence of other hypercoagulable states. Previous modes of therapy have been limited to systemic anticoagulation or surgery. We report a case of successful dissolution of acute renal vein thrombosis using direct fibrinolytic therapy, which was documented radiographically during treatment and at 3-month followup.

Female↗
PubMed1984

[Production of an intrahepatic portocaval fistula in the dog with liver cirrhosis and portal hypertension].

Non-Operative intrahepatic shunts between the left branch of the portal vein and hepatic vein were produced in 14 dogs with periportal cirrhosis and portal hypertension. Dilatation of the intrahepatic fistula was achieved with a Grüntzig catheter with a balloon diameter of 12 m. The catheter was introduced into the left branch of the portal vein passing through the right jugular vein, vena cava and hepatic vein by means of a co-axial system, using a stiff Teflon catheter with an external diameter of 6 mm. Repeated maximal inflation of the balloon, which was placed across the portal vein and inferior vena cava, produced an intra-hepatic portocaval shunt in all dogs. This resulted in immediate abolition of previously stable portal hypertension. The only significant complication was shunt occlusion within a week. In such cases the shunt was reopened by the same technique. The procedure had to be repeated at weekly intervals up to five times before a permanent intrahepatic shunt was established.

Animals↗
PubMed1982

Intravenous versus superior mesenteric artery vasopressin infusions for the treatment of variceal bleeding.

The effects of 30-minute intravenous and superior mesenteric artery (SMA) infusions of vasopressin in dosages of 2.75 mU and 14 mU per min per kg were compared in five dogs that had cirrhosis and portal hypertension induced by fractionated intraportal polyvinyl alcohol injections. A reduction in portal pressure of approximately 35% was found with both SMA doses and the larger intravenous vasopressin dose, while the smaller intravenous dose reduced portal pressure only 18%. A significantly larger decrease in portal blood flow was found with SMA than intravenous vasopressin administration. Cardiovascular side effects were dose-dependent but independent of the administration mode. Liver enzymes were not affected. Portal vein thrombosis occurred in one dog after the larger SMA dose.

Animals↗
PubMed1982

Angiographic, hemodynamic, and histologic evaluation of portal hypertension and periportal fibrosis induced in the dog by intraportal polyvinyl alcohol injections.

Intrahepatic periportal fibrosis and portal hypertension were produced in the dog by repeated intraportal injection of a polyvinyl alcohol suspension over a two- to six-month period. Progressive hepatic fibrosis originating in the portal triads around occluded portal vein radicles occurred during the first year. Porto-systemic venous collaterals developed at the earliest three to four weeks after initial embolization. Angiographic changes included an increase in number and diameters of opacified hepatic arterial branches and a more dense arterial hepatogram than on the baseline studies, but these were only evident in advanced hepatic fibrosis. Decreases in portal and total hepatic blood flow of 53 +/- 15% and 17 +/- 7%, respectively, were observed after development of periportal fibrosis and stable portal hypertension, while the compensatory increase in hepatic arterial flow was a slowly evolving process resulting in an increase of 135 +/- 51% in the fibrotic stage. Animals with advanced hepatic fibrosis and portal hypertension remained in good general health, allowing extensive follow-up examinations at regular intervals over a prolonged period of time.

Animals↗
PubMed1981

Clinical study of pheochromocytoma.

Seventeen patients underwent 22 operations for pheochromocytoma over a 26 year period. The patients included 11 in three kindreds of familial pheochromocytoma and 6 with sporadic tumors. The diagnosis was usually suggested by the patient's history. Confirmation of the diagnosis frequently required repeated testing for urinary or plasma catecholamines. Arteriography was the most effective method of preoperative tumor localization. Two tumors were proven nonfunctional. Others secreted either norepinephrine or epinephrine and norepinephrine. The familial patients showed a high incidence of multiple, bilateral and extraadrenal lesions. In contrast to previous reports, the familial tumors were found more often in the right than in the left adrenal gland. HL-A genotyping analysis of the sporadic and familial patients failed to demonstrate any HL-A antigen association or interdependent segregation of tumor and HL-A antigens within kindreds.

Adolescent↗
PubMed1981

Percutaneous kidney biopsies. Complications and their management.

Six hundred thirty-two percutaneous renal biopsies were performed in 479 patients between 1965 and 1978. Complications occurred with 86 biopsies, an incidence of 8.5 per cent. Most complications (seventy-six of eighty-six) were minor, and either resolved spontaneously or did not require intervention. There were ten major complications, including 6 patients with gross hematuria requiring blood transfusions, 3 with hemorrhage treated with arterial embolization, and 1 with a symptomatic arteriovenous fistula that was treated with partial nephrectomy. Major complications of percutaneous renal biopsy and the modes of therapy are discussed.

Adolescent↗
PubMed1981

Complications and hazards with angiographic occlusion balloon catheters.

Twenty angiographic procedures involving the superior mesenteric artery (SMA) were performed with balloon occlusion catheters in dogs with chronic liver cirrhosis and portal hypertension. The following complications were found: (a) rapid balloon inflation during angiography due to a leak between the two catheter lumens (two cases); (b) failure to deflate a balloon located in the SMA (two cases); (c) balloon detachment intravascularly and during catheter insertion (one case each); and (d) rupture of the SMA (one case). Balloon detachment occurred only with re-used catheters. The safety of angiographic occlusion balloon catheters for general use is questioned. Under no circumstances should catheters be re-used.

Angiography↗
PubMed1979

[Nonsurgical production of intrahepatic portosystemic venous shunts in portal hypertension with the double lumen balloon catheter (author's transl)].

A nonsurgical production of intrahepatic shungs between the left portal and left hepatic vein was evaluated in twelve dogs with acute portal hypertension. Dilatation of the intrahepatic tract was achieved by means of a double lumen balloon catheter introduced into the portal system with the transjugular approach. The shunts proved to be effective in immediate reduction of increased portal pressure and no significant complications were encountered.

Animals↗
PubMed1979

Production of nonsurgical portosystemic venous shunts in dogs by transjugular approach.

Intrahepatic shunts between the left portal and hepatic veins were performed in 50 dogs (20 acute, 30 chronic experiments) using the transjugular approach with Dotter's coaxial catheter system. All shunts were occluded within two days; significant complications arose only after a shunt stayed in the animal a prolonged period. The intrahepatic tract wall was completely organized and fibrosed after three weeks.

Animals↗
PubMed1979

Pancreatic pseudocyst involving the spleen.

A case of pseudocyst of the tail of the pancreas involving the spleen is presented. Diagnosis of splenic involvement by pseudocyst was made by angiography followed by immediate (elective) surgical intervention with distal pancreatectomy and splenectomy without pre- or postoperative complications.

Adult↗
PubMed1977

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↗
PubMed1976

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↗
PubMed1976

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↗
PubMedDate not supplied

Abdominal aortic dissection with retrograde extension into the thoracic aorta: case report.

A case of spontaneous dissection originating in the infrarenal abdominal aorta with retrograde extension into the thoracic aorta is reported along with the computed tomography and angiographic findings. Surgical repair resulted in the obliteration of the false lumen, healing of the thoracic hematoma, and clinical recovery. The principles for radiologic evaluation and therapeutic management are discussed.

Aortic Dissection↗
PubMedDate not supplied

Reevaluation of plain radiographic findings in the diagnosis of aortic rupture: the role of inspiration and positioning on mediastinal width.

Despite the advent of newer imaging modalities, conventional radiography and clinical examination remain the primary screening method in evaluation of the mediastinum following blunt thoracic trauma. Mediastinal width (MW) is generally considered an important finding in assessing for aortic rupture. The degree of inspiration and patient positioning clearly affects MW, but is largely ignored in the literature. This study investigates the mediastinal widths of normal volunteers with differing degrees of inspiration and positioning, and compares them to radiographs of patients with known aortic ruptures. Mediastinal widths were obtained from chest radiographs of 16 patients with known aortic rupture, and from 50 volunteers using AP-inspiratory-supine, AP-expiratory-supine, and PA-inspiratory-upright technique. Upper 95% confidence limits were obtained for normals. A statistically significant difference in MW of normals was found between inspiratory-supine, expiratory-supine, and upright-inspiratory techniques. Compared to the same degree of inspiration in normals, 12 of 16 patients with aortic rupture had a MW above the upper 95% confidence limits. It is concluded that mediastinal width in normals is significantly affected by the degree of inspiration and positioning. When comparing mediastinal widths for normals and ruptures, there was a significant difference in MW for most degrees of inspiration. As depth of inspiration increased, differences between MW in controls and rupture patients increased. We conclude that patient positioning and degree of inspiration are important factors in assessing the mediastinum, and every effort should thus be made to obtain an upright-inspiratory film if clinically feasible prior to declaring a mediastinum as abnormal.

Adolescent↗