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S Dorph

Publications and source records attributed to S Dorph.

At least 37 records · Page 2Linked to original sources
PubMed1989

Porous-coated knee arthroplasty. A case report concerning bone ingrowth.

The area of bone-metal interaction in uncemented implants is regarded by many investigators as the key to the success or failure of the implant. The nature of the interaction is poorly understood because the zone is technically difficult to visualize and analyze. In order to test the power of modern imaging, analyzing, and metallurgical methods in this context, a well-functioning porous-coated knee prosthesis (tibial component) removed from the knee of a 65-year-old man was sectioned and examined by light microscopy, roentgenogram, scanning electron microscopy, and radiologic energy dispersive analysis. Independently, these methods demonstrated that the prosthesis was held in situ by collagenous tissue between and below the metal pellets of the prosthesis. Calcified bone did not appear to interact with the prosthesis and is probably not a major factor for prosthesis fixation. The various analytic methods described are suitable and sufficient for further exploration on a larger scale of the zone of bone-metal contact in cementless implants.

Aged↗
PubMed1988

Cardiovascular adjustments to pulmonary vascular injury in dogs.

The hemodynamic effects of blood volume augmentation and mechanical ventilation (MV) with positive end-expiratory pressure (PEEP) were studied in nine Beagles anesthetized with halothane before and after thrombin-induced pulmonary hypertension. The effect of therapy with dopamine, norepinephrine with and without nitroglycerin (NTG), and intraaortic balloon pumping (IABP) were studied in a second series of six Beagles. Before thrombin, dextran (35 ml.kg-1) caused a significant increase in right and left ventricular end-diastolic and end-systolic volumes (RV and LVEDV, and RV and LVESV). However, RV and LV performance, as estimated by ejection fraction, was unchanged during volume loading and MV with PEEP when the pulmonary vasculature was intact. The response to volume loading and MV with PEEP was altered significantly once PVR had been increased with the administration of thrombin. Stroke volumes were decreased, and remained so, despite volume loading and MV with PEEP. LVEDV decreased without a decrease in LVEDP, indicating a decreased LV compliance. Dopamine and norepinephrine with and without NTG increased stroke volumes and RV ejection fraction in contrast to IABP. Assessment of LV performance, according to the Frank-Starling mechanism, requires a measure of end-diastolic volume when diffuse pulmonary vasoconstriction leads to RV distension and LV hypovolemia secondary to septal shift. Measurement of LV filling pressures can provide misleading values to estimate changes in LV volume in this setting. Measurement of ventricular volumes is required for optimal management of patients with severe acute respiratory failure and pulmonary hypertension.

Animals↗
PubMed1988

Do contrast media aggravate Fanconi's syndrome in rats? A comparison of diatrizoate, iohexol, and ioxilan.

Urine profiles (albumin, glucose, N-acetyl-beta-D-glucosaminidase [NAG], lactate dehydrogenase [LDH], L-gamma-glutamyltransferase [GGT], sodium, and phosphate) were followed for seven days after intravenous (IV) administration of either diatrizoate, iohexol, ioxilan, or saline in 24 Wistar rats with a tubular dysfunction induced by IV sodium maleate. Ioxilan and saline had a similar effect on albumin excretion, iohexol had an intermediate effect, and diatrizoate increased it significantly from day 2 to day 7. Glucosuria was significantly greater after diatrizoate than after the nonionic contrast media (CM) or saline. Diatrizoate delayed normalization of enzymuria, whereas iohexol and ioxilan did not. None of the CM affected urinary sodium or phosphate excretion. It is concluded that Fanconi's syndrome is significantly aggravated only by diatrizoate.

Animals↗
PubMed1988

Urine profiles following intravenous diatrizoate, iohexol, or ioxilan in rats.

The effects of intravenous diatrizoate, iohexol, ioxilan, or saline on albumin, glucose, sodium and the enzymes N-acetyl-beta-D-glucosaminidase (NAG), lactate dehydrogenase (LDH), and L-gamma-glutamyltransferase (GGT) in the urine of 24 normal Wistar rats were followed for seven days. During the first two hours after administration of diatrizoate, all profile components changed markedly; the albumin excretion was significantly greater than following ioxilan and iohexol; glucose, LDH, and GGT excretions were significantly greater than following ioxilan. Iohexol and ioxilan caused a higher excretion of albumin, LDH, and GGT than saline. Iohexol also increased glucose and sodium levels. Glucose and GGT were significantly higher following iohexol than following ioxilan. Both high osmolar and low osmolar contrast media may cause temporary glomerular and tubular damage. Urine profile components are affected most by diatrizoate, less by iohexol, and least by ioxilan.

Animals↗
PubMed1986

Pelvic floor exercise versus surgery for female urinary stress incontinence.

Fifty consecutive female patients with genuine urinary stress incontinence were randomized either to surgery or to a pelvic floor training program. The operative procedure was chosen according to the type of bladder suspension defect on micturition cystourethrography. The training program was given 5 times in weekly lessons and the patients were guided by trained physiotherapists. Surgery was superior to the pelvic floor training program both subjectively and objectively. However, a significant improvement was found following the training program. Forty-two percent were satisfied with the outcome of the training and did not want operation. We find physiotherapist-guided pelvic floor exercise a realistic alternative to surgery in patients with mild degrees of stress incontinence. Also patients with residual symptoms after surgery are candidates for pelvic floor training.

Adult↗
PubMed1986

The value of dynamic ultrasound scanning in Crohn's disease.

In a prospective, blinded study we investigated 30 patients with Crohn's disease (CD) and 27 normal controls by means of dynamic grey-scale ultrasound scan. Within a few weeks the patients were also examined by radiography of the small bowel. Of the 30 patients, 21 had CD lesion of the small bowel as judged by radiography. A target lesion at the ultrasound scan indicating thickened bowel wall was seen in 15 CD patients, of which 14 showed radiographic signs of CD in the ileum and/or right side of the large bowel, whereas one had normal radiographic findings. Seven patients out of 15 without sonographic changes had radiographic signs of CD. The patients with discrepancy between the two examinations could not be clinically characterized as an entity. None of the 27 normal controls showed signs of intestinal disease at the ultrasound examination. We conclude that dynamic grey-scale ultrasound examination is a new tool in depicting the CD lesion, but it does not seem to be able to replace the radiographic examination. However, it may find a place in the follow-up study of patients with known CD, thereby avoiding repeated radiographic examinations. Furthermore, the possibility of diagnosing abscesses and fistulae by sonography is well known and has relevance in CD.

Adolescent↗
PubMed1985

New techniques for stenting severely strictured or occluded ureters.

Percutaneous stenting of the severely strictured ureter is facilitated by catheterization through a rigid curved tube leading through the kidney. Alternatively, bidirectional traction tensioning of a guide wire pulled through the entire urinary tract permits antegrade dilatation and stent drainage. Complete occlusion near the ureteric orifice may be bypassed by transureteral puncture of the bladder followed by stent insertion.

Aged↗
PubMed1984

Mammography is an objective diagnostic method.

Six hundred mammograms from 307 consecutive symptomatic patients with a firm retrospective diagnosis were evaluated blindly and independently by two observers. Each observer identified 43 of 47 tumors (91 per cent) with predictive values of 0.63 and 0.68, respectively, for the positive statement, and 0.98 for the negative statement. The overall interobserver agreement with respect to malignancy was 94 per cent (Kappa 0.84) and concerning the diagnosis of simple cysts 91 per cent (Kappa 0.60). The frequency of subclinical cancer demonstrated by mammography in this material was higher than the prevalence of mammary carcinoma found by screening of risk group populations. Thus, mammography remains an objective and reproducible diagnostic method with distinct complementary value to clinical examination. By utilizing certain mammographic criteria for benign lesions it may be possible to reduce the number of biopsies presently performed on the basis of unspecific palpatory findings.

Adolescent↗
PubMed1984

Subtraction nephrotomography during urography of transplanted kidneys.

Hypocycloid tomography with photographic subtraction was applied during the early nephrographic phase of urography in 48 transplanted kidneys. The quality of demarcation between cortex and medulla in the subtracted nephrotomogram was evaluated and categorized into 4 groups: Excellent, good, poor, and absent demarcation. The renal function determined by 24-h endogenous creatinine clearance did not correlate with the quality of demarcation. Among 30 cases with excellent or good demarcation only one patient experienced rejection within 8 days after the urography. In 18 cases with poor or absent demarcation 9 had an episode of rejection. Absence of demarcation was only observed in this group of patients. Segmental renal infarcts were demonstrated occasionally on the subtracted early nephrotomogram. Thus, tomographic demonstration of the initial distribution of contrast medium in a transplanted kidney may prove to be of value in the diagnosis both of rejection of transplanted kidneys and renal infarcts.

Creatinine↗
PubMed1983

Measurement of right and left ventricular ejection fraction in dogs.

Three techniques for measurement of right (RVEF) and two techniques for left (LVEF) ventricular ejection fraction were evaluated in five dogs. RVEF was measured with a first-pass radionuclide technique using erythrocytes labelled in vitro with Technetium-99m methylene disphosphonate (MDP) and compared with RVEF measured with a thermodilution technique. Thermodilution-determined RVEF was compared with RVEF values measured with cine angiocardiography. LVEF was measured with a radionuclide ECG-gated equilibrium technique and compared with cine angiocardiography. Measurements were performed before and during a continuous infusion of dopamine. There was an excellent correlation between RVEF measured with the first-pass and the thermodilution technique, rs being 0.86, n = 9, P less than 0.01. When RVEF measured with the thermodilution technique was compared with cine angiocardiography rs was 0.75, n = 10, P less than 0.01. LVEF measured with the ECG-gated equilibrium technique correlated well with cine angiocardiography (rs = 0.91, n = 10, P less than 0.01).

Angiocardiography↗
PubMed1983

Intrarenal backflow and renal perfusion during increased intrapelvic pressure in excised porcine kidneys.

The effect of increased intrapelvic pressure on renal perfusion was examined by simple magnified angiography of freshly excised artificially perfused kidneys of adult Danish Landrace pigs. In all kidneys control angiography was performed at normal intrapelvic pressure (0-5 mmHg). Intrapelvic pressure was raised by retrograde ureteral perfusion of saline in 9 kidneys. Repeat angiography was performed at an intrapelvic pressure of 30-35 mmHg (4 kidneys), 50-55 mmHg (5 kidneys) or 0-5 mmHg (4 kidneys). Angiography demonstrated a delay in arterial filling in kidneys with increased intrapelvic pressure. Perfusate flow measurements showed a corresponding fall in perfusion flow. Retrograde ureteral perfusion was repeated at similar pressures using contrast medium. Intrarenal backflow (IRB) was demonstrated in all 9 kidneys with elevated intrapelvic pressure. IRB localized to 84 per cent of the compound papillae and to 40 per cent of the simple papillae, and was independent of the level of elevated intrapelvic pressure. One-third of the papillae with IRB had absent or markedly decreased arterial filling in the corresponding lobe at angiography. A third retrograde ureteral perfusion was done with a mixture of barium sulphate and gelatin in 4 kidneys. Light microscopy demonstrated that the primary pathway for IRB was canalicular. The contrast medium entered the interstice by three routes: (1) Tubular leakage in the papilla and the corticomedullary region, (2) tears originating in the papilla itself and (3) tears in the calyceal fornix with extension into the parenchyma.

Animals↗
PubMed1982

Pyelorenal backflow in rabbits following clamping of the renal vein and artery: radiologic and microscopic investigation.

Retrograde pyelography was carried out in rabbits during and following temporary clamping of either the renal artery and vein together or the main renal vein alone. Pyelosinous backflow was observed in all kidneys and pyelovenous backflow in 16 of the 18 kidneys, occurring at intrapelvic pressures between 50 and 100 mmHg. During simultaneous complete renal artery and vein occlusion intrarenal backflow occurred in all 3 kidneys examined while it was observed in 3 of 6 kidneys when the pyelography was performed 5 min after removal of the clamp. During complete renal vein occlusion filling with contrast medium of the central intrarenal veins occurred in all 3 kidneys but only in 3 of 6 kidneys examined after the clamp had been removed. Microscopically, pyelosinous backflow was explained by vital tears in the fornix of the pelvic cavity. Tears extending into the kidney parenchyma were only observed in kidneys with intrarenal backflow at pyelography.

Animals↗
PubMed1981

Pyelorenal backflow during retrograde pyelography in adult patients.

In a consecutive series of 103 retrograde pyelographies in adult patients suspect of disease in the upper urinary tract, the overall incidence of pyelorenal backflow was 18%. Pyelosinous backflow--seen in 11%--was much more frequent in kidneys with obstructed ureter (20%) than in non-obstructed kidneys (3%). Intrarenal backflow, so far regarded as a rare form of backflow, was almost as frequent as pyelosinous backflow. It occurred in 13% of kidneys with obstructed ureter as opposed to 7% in non-obstructed kidneys. Intrarenal backflow mostly involved only a section of the kidney, in 75% of cases in the upper pole. It occurred both in diseased and in apparently normal kidneys. Pyelosinous and intrarenal backflow in the same kidney was seen in 2% of cases.

Adolescent↗
PubMed1980

Adverse reactions to urographic contrast medium. Rapid versus slow injection rate.

Adverse reactions following very rapid (ten seconds) and slow (two minutes) i.v. bolus injection of meglumine ioxitalamate (380 mg I/ml, 1.5 ml/kg bodyweight) for urography were compared. Except for warmth and a mild transient headache, rapid injection caused no higher incidence of adverse reactions. The rapid injection provides a high quality nephrogram. It may be hazardous in patients with pre-existing heart disease.

Adolescent↗