Biomedical subjects
Publications and source records attributed to W A Weidner.
Ten patients with metastatic disease to the liver were treated with difluoromethylornithine (DFMO) administered by continuous hepatic arterial infusion. Two of nine evaluable patients had an objective partial response. Stable disease was recorded in three patients. Ototoxicity was encountered in all patients who received a daily dose of DFMO equal to or greater than 1.0 g/m2.
We report a case of pheochromocytoma of the prostate. The clinical presentation, diagnostic evaluation, therapy and pathological findings are discussed.
Massive lower gastrointestinal bleeding is described in two patients with Crohn's disease. In case 1, extravasation of contrast material from the ileal branch of the ileocolic artery was seen during selective angiography. In case 2, results of an in vitro labeled 99Tc pyrophosphate red blood cell scan localized bleeding to the ileum. In both cases, medical management was unsuccessful, and surgical resection of the affected bowel was required to stop the bleeding. Angiographic appearance of Crohn's disease is discussed, and a review of the literature of this unusual feature of Crohn's disease is presented.
To determine if angiography results in arterial oxygen desaturation, we prospectively studied 40 clinically stable patients undergoing arterial angiography. Arterial oxygen saturation (Sao2) was monitored before, during, and for at least three minutes after contrast medium injection. The mean (+/- SEM) Sao2 was 94.2% +/- 0.39% before injection and fell to 92.6% +/- 0.66% following injection. Eleven patients (28%) demonstrated a decrease in Sao2 of more than 3%, with six (15%) having a postinjection Sao2 of less than 90%. To determine if the vascular route of injected contrast medium influenced the subsequent level of oxygenation, we similarly evaluated the Sao2 of 20 consecutive patients undergoing venous angiography. The Sao2 was 94.2% +/- 0.33% before contrast medium injection and fell to 92.5% +/- 0.78% following injection. Six patients (30%) experienced a fall in Sao2 of more than 3%, with four (20%) having a postinjection Sao2 of less than 90%. We conclude that arterial oxygen desaturation occurs frequently in patients undergoing angiography.
The renal, hepatic, or gastrosplenic arteries of eleven juvenile pigs were selectively injected intraarterially with 95% ethanol to evaluate its efficacy as an agent for use in permanent occlusion and infarction of the vascular bed supplied by the injected artery. A dose of 2.2 cc/5 kg (1 cc/5 lb) of 95% ethanol was injected over 30-45 sec. The animals were then killed at 1 to 91 days and all pigs demonstrated tissue infarction and vascular occlusion. Our results confirm that ethanol is an effective agent for the infarction of organs and that complications can result if catheter placement is not precise and normal tissue is inadvertently perfused.
Radioisotopes of I pose an important health risk to man in nuclear accidents associated with electric power generation due to their uptake by the thyroid glands. Topical application of tincture of I or povidone-iodine to the skin of rats has been found to be as effective as oral administration of potassium iodide in blocking thyroid uptake of parenterally administered 131I. If the same effectiveness can be demonstrated in humans, this may be an attractive alternative method of mass protection from radioisotopes of I following nuclear accidents.
We analyzed four personal cases and 51 reported cases of dissecting aneurysms of the arteries of the head and neck. Subintimal dissection more commonly affects the intracranial vessels before age 40. In contrast, medial dissection tends to affect extracranial vessels after age 30. Vertebrobasilar dissection more variably affects either arterial plane. The reasons for these differing patterns of dissection are still not clear. In young subjects, the subintimal layer appears to be more susceptible; in contrast, the media becomes increasingly vulnerable with age, particularly in the presence of acquired medial disease.
Three patients (two of them siblings) had Leber's congenital amaurosis and cerebellar disease. Despite blindness and severe motor deficits, all three patients have achieved relatively normal intellectual and psychosocial milestones. Computed tomographic scans, performed in two patients, demonstrated hypoplasia of the cerebellar vermis in both. The presence of delayed speech and motor development as well as structural CNS abnormalities in children with Leber's congenital amaurosis does not necessarily imply that severe intellectual impairment will be present.
Brain-injured children who progress from coma to a sleeplike state of akinetic mutism are often misinterpreted by their parents as having improved. In children with akinetic mutism caused by extensive destruction of the cerebral gray matter, the computed tomographic scan may demonstrate the irreversible nature of the pathologic changes.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A retrospective study was designed to determine the diagnostic value of spot lateral and oblique lumbar spine radiographs in 782 patients. In only 2.4% of patients examined were these views uniquely diagnostic. Considering the additional cost, significant gonadal radiation, and limited diagnostic value, these views should be eliminated from routine lumbar spine series.
The experiences of the radiology department at the Milton S. Hershey Medical Center of the Pennsylvania State University College of Medicine during the Three Mile Island Nuclear Power Plant accident are presented. Emergency plans are reviewed.
If a collimated radiation detector (sodium iodide crystal) and a collimated X-ray source are positioned at right angles, scattered radiation will be sensed and the detector will generate a signal as tissue enters and leaves the "sensitive volume" formed by the intersection of the field of view of the detector and incident beam. This technique, called dynamic radiography, was used to identify and quantify the components of epicardial motion in anesthetized open-chested dogs. The data so obtained were validated by two independent optical methods: biplane cinematography and a technique that measures the shadow cast by the heart using a light beam-cadmium sulfide photocell. Displacement measured by dynamic radiography appeared to be the time integral of the scalar product of the velocity vector and the vector normal to the surface area within the sensitive volume, i.e., that component of displacement of myocardial mass that was perpendicular to the surface of the myocardium. In other words, the dynamic radiographic signal was proportional to the mass of tissue within the sensitive volume. Good agreement in terms of absolute motion, its direction, and phase was noted between predicted dynamic radiographic signals and those observed. Thus validated, this technique was found to be reliable in quantifying motion abnormalities produced by acute coronary ligation.
Radionuclide blood flow studies were employed to evaluate the success or failure of preoperative Gelfoam embolization in two patients with intracranial meningiomas. In both cases, the initial radionuclide blood flow study showed tumor visualization during the arterial phase. Immediately following the embolization procedure, the radionuclide blood flow study showed no visualization of the meningioma during the arterial phase, indicating a successful embolization procedure in preparation for removal of the tumor in a relatively bloodless field.
This report describes the management of a woman with multiple pulmonary emboli secondary to a large right atrial clot which had formed around her permanent transvenous pacemaker. She continued to have pulmonary emboli despite adequate anticoagulation. Removal of the catheter and pacing required right atriotomy under cover of cardiopulmonary bypass. Additionally, eight English language case reports of symptomatic pericatheter thromboses are reviewed. In these cases, pericatheter clot resulted either in right-sided inlet obstruction or pulmonary emboli. The mortality rate was 75%. Although the cause for our patent's thromboembolic events is uncertain, congestive heart failure was a predisposing factor in 75% of the other reported cases. We suggest that pacemaker patients in congestive heart failure might benefit greatly from chronic anticoagulation.
Explore the source record for details and available documents.
Explore the source record for details and available documents.