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Biomedical subjects

R K Kerlan

Publications and source records attributed to R K Kerlan.

At least 91 records · Page 5Linked to original sources
PubMed1984

Bile flow through drainage catheters: an in vitro study.

An in vitro model was developed to measure bile flow at varied pressures through several commonly used transhepatic drainage catheters. As expected, larger catheters conduct more bile flow at a given pressure. All catheters studied conduct adequate amounts of bile at normal physiologic pressure gradients. The clinical observation that large catheters (10-12 French) are necessary for adequate antegrade drainage in some patients must be explained by an abnormal bile viscosity, increased duodenal pressures, or reduced biliary secretory pressure.

Bile↗
PubMed1984

Magnetic resonance imaging of aortic disease: preliminary results.

Fourteen patients with a variety of aortic diseases were evaluated with magnetic resonance imaging (MRI). These included abdominal aortic aneurysms (eight cases), aortoiliac aneurysm (one), thoracoabdominal aneurysm (one), aortic dissections (four), and Takayasu arteritis (one). The size and extent of aneurysms, the presence of thrombus or atherosclerotic debris, the relation to renal and iliac arteries, and the effect of aneurysms on adjacent structures were readily demonstrated by MRI. The size of the residual lumen in a variety of vascular diseases and abnormal blood flow patterns could be assessed. In aortic dissection, MRI permitted identification of intimal flaps and determination of the origin of aortic branches from either of two lumina. Thickening of the wall and luminal narrowing of the aorta and arch vessels in Takayasu arteritis were clearly defined. These early results indicated that MRI achieved precise and complete assessment of a number of aortic abnormalities without the administration of any type of contrast material. Thus, early experience suggests that an important application of MRI will be as a totally noninvasive and reliable method for evaluating aortic disease.

Adult↗
PubMed1983

Occlusion of a hepatic artery to portal vein fistula with bucrylate.

A 49-year-old woman with cirrhosis and portal hypertension was evaluated for a portal-systemic shunt procedure following recurrent variceal hemorrhage. The preoperative visceral angiogram demonstrated a hepatic arterial to portal venous fistula, presumably a complication of a previous liver biopsy. The fistula was successfully closed using isobutyl-2-cyanoacrylate (Bucrylate) delivered through a flow-directed, calibrated-leak balloon microcatheter.

Angiography↗
PubMed1983

Clinical responsibility in interventional radiology.

The growing use of interventional radiologic techniques signals a need to redefine the radiologist's role in patient management. Radiologists must decide whether they want to participate more fully in clinical matters such as patient selection and follow-up care. The authors suggest that further development in the field will be slowed if radiologists do not take a more active clinical role. Training standards in radiology must also reflect the evolving role of the radiologist.

Angioplasty, Balloon↗
PubMed1983

Radiographic abnormalities of the iliac apophysis in adolescent athletes.

Nine of thirteen adolescent patients with a diagnosis of a so-called hip-pointer injury demonstrated a discontinuity of the anterior part of the iliac apophysis on radiographs. Eight of the nine patients improved with conservative treatment and there was total resolution of symptoms in one to eight months. The remaining patient, who was skeletally mature at the time of writing, continued to have recurrent symptoms of discomfort over the iliac crest during athletic activity. Other reports have described the discontinuity as a stress fracture, but the natural history in our patients did not reveal evidence of fracture-healing. However, the discontinuity disappeared at skeletal maturity in all patients. The radiographic discontinuity may be an anatomical anomaly, since it was present bilaterally in all nine patients although only two had symptoms on both sides.

Adolescent↗
PubMed1981

Medially deployed thoracostomy tubes: cause of aortic obstruction in newborns.

It was observed that severe aortic displacement, narrowing, and obstruction can occur when thoracostomy tubes abut the mediastinum. To further investigate this previously undescribed phenomenon, aortography was performed with intraluminal pressure measurements in newborn puppies and aortograms obtained in two infant cadavers. In the puppies, when the tube tip pressed against the descending thoracic aorta, aortic pressure below that site decreased and aortic arch pressure rose. When the tube tip pressed against the ascending aorta, pressures in the aortic arch and abdominal aorta decreased. Aortography in the puppies and infant cadavers demonstrated aortic displacement, narrowing, and obstruction when the thoracostomy tubes abutted the mediastinum. The clinical consequences of malpositioned thoracostomy tubes were observed in two premature infants. When the posteromedially deployed tubes were partially withdrawn, systolic arterial pressures, which had been exceptionally low, suddenly and significantly increased distal to the tube tip. Medially deployed thoracostomy tubes may represent a potential hazard to the newborn infant.

Animals↗
PubMed1979

Isolated lateral meniscectomy. A study of twenty-six patients with isolated tears.

To better define the role that the lateral meniscus plays in stabilizing the knee, a study was made of twenty-six patients who had an uncomplicated lateral meniscectomy between 1972 and 1977. Patients with any degree of ligament instability, cruciate or collateral, prior to lateral meniscectomy were eliminated from the study. Also eliminated were any patients with roentgenographic evidence of degenerative arthrits, osteochondritis dissecans, or loose bodies. Only patients whose operative reports stated that the articular cartilage of the lateral compartment was either grossly normal or showed Grade-1 chondromalacia (less than one centimeter in diameter and only softening of the cartilage) at the time of surgery were included in the review. The meniscal lesions included bucket-handle tears, horizontal cleavage tears, and multiple linear defects. No grossly cystic menisci were included in the study. Two menisci demonstrated cystic degenerative changes on histological section. In sixteen patients some degree of ligament instability developed. The longer the interval between injury to the meniscus and its excision, the less satisfactory the result. Only fifteen (54 per cent) of the patients reported satisfactory results, and twenty lost some motion of the knee. We concluded that stability of the knee joint is a multifactorial problem, in which the lateral meniscus certainly plays an important part.

Adolescent↗
PubMed1976

The modified Bristow procedure for recurrent dislocation of the shoulder.

A review of fifty-one cases of the modified Bristow procedure for recurrent anterior shoulder instability is presented. The results were favorable. The redislocation rate was 2% with few complications. The average limitation of motion was 11 degrees of external rotation. Athletic individuals with involvement of the dominant shoulder were not capable of returning to high performance levels of overhead sports activity (particularly throwing) after the operation.

Adolescent↗
PubMed1975

Degeneration and rupture of the Achilles tendon.

An analysis was perfomed on 32 operative cases of Achilles tendon disease. Two patient classifications emerged. One group suffering an acute rupture of the Achilles tendon with no antecedent complaints, and the second group had a history of chronic pain, weakness and functional loss. This latter group could be further differentiated by the occurrence of tendon failure in 10 of 22 cases. Surgical exploration in the group with chronic complaints demonstrated a high incidence of diffuse reactive changes such as fibrinoid and myxomatous degeneration, fibroisis and metaplastic calcification. Degenerative disease of the Achilles tendon should be recognized and treated not as a simple injury but as a pathological lesion.

Achilles Tendon↗