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Biomedical subjects

A Baert

Publications and source records attributed to A Baert.

At least 37 records · Page 2Linked to original sources

Computed tomography and lymphography in the presurgical staging of early carcinoma of the uterine cervix.

The value of bipedal lymphography and computed tomography (CT) in the presurgical staging of early carcinoma of the uterine cervix was analysed in 62 patients by histologic examination of pelvic lymph nodes and parametrial extension at the time of surgery. Macroscopic invasion of the lymph nodes was detected in 33% of the patients by CT and in 17% by lymphography. Microscopic invasion was suspected in 9% by CT scan and in 38% by lymphography. Physical examination with measurement of the tumor diameter was more predictive for regional extension of the disease as compared to lymphography and CT. CT may detect subclinical parametrial invasion but overestimation of the extent of the disease is common. Bipedal lymphography and CT add only limited information to the routine presurgical staging of cancer of the uterine cervix.

Adult↗

Transection of the pancreas demonstrated by ultrasound and computed tomography.

The early occurrence of peritoneal signs and hyperamylasemia in a 14-year-old boy, who had fallen off his horse, urged us to perform a sonographic and computed tomographic study of the upper abdomen. Both examinations showed a complete pancreatic rupture. Distal pancreatectomy led to a rapid and uneventful recovery.

Adolescent↗

Percutaneous transluminal angioplasty of the subclavian artery: early and late results.

Percutaneous transluminal angioplasty of 23 subclavian arteries was attempted in 22 patients. Dilatation was successful in 3 of 4 right subclavian artery stenoses and 18 of 19 left subclavian artery stenoses. The primary clinical indication was posterior fossa ischemia in 11 patients, upper limb ischemia in 14 and both symptoms in 6. In 2 patients, dilatation of an asymptomatic high-degree left subclavian artery stenosis was performed before coronary artery bypass surgery using the internal mammary artery. Eighteen patients on follow-up over 6-60 months (mean 25 months) are free of symptoms with equivalent systolic blood pressures in both arms. Three patients showed relapse of the stenosis after 8, 12, and 15 months; one was successfully treated with a second dilatation. Complications consisted of an occlusion at the left axillary artery puncture site and a distal embolus to a finger artery. Percutaneous transluminal angioplasty appears safe and efficient therapy for subclavian artery stenoses with excellent short- and long-term results.

Aged↗

Intraoperative angioplasty.

Of 768 angioplasties performed in our institute, 42 procedures (5%) in 39 patients were performed by a radiologist in the operating room in combination with vascular surgery; 15 ilial, 20 femoral, 5 tibial, 1 renal, and 1 brachiocephalic artery stenoses were treated. Immediate and late successes, as well as the complication rates, were comparable to those of the percutaneous approach. The main reasons for the intraoperative approach were absence of arterial pulsations, ulcerative lesions at the puncture site with risk of peripheral embolisation, and the opportunity of a surgical arteriotomy offering access to an otherwise unreachable stenotic artery. The advantages of intraoperative dilatation in combination with surgery over simple operation are the reduction of operative morbidity and mortality, shortening of the operative time, and improved results by reassuring the in- or outflow of the operated territory. The main disadvantages are the limited fluoroscopic field and the limited mobility of the fluoroscopy device.

Angioplasty, Balloon↗

Pregnancy after transcatheter embolization of a uterine arteriovenous malformation.

A 25-year-old woman with a congenital uterine arteriovenous malformation had a long history of repeated excessive vaginal bleeding. She was successfully treated with transarterial embolization. She had normal menstrual periods for 6 months and subsequently conceived. She was delivered of a normally grown baby at 35 weeks. To the best of our knowledge, this is the third pregnancy described after successful embolization of an arteriovenous malformation.

Adult↗

Hepatic echinococcosis ruptured into the biliary tract. Clinical, radiological and therapeutic features during five episodes of spontaneous biliary rupture in three patients with hepatic hydatidosis.

Three patients are described with hepatic involvement by Echinococcus granulosus, complicated by spontaneous rupture into the biliary tract. Clinical features consisted of upper abdominal pain, jaundice, fever, anorexia, and vomiting. Hepatomegaly and marked epigastric tenderness were consistently observed. Laboratory findings included obstructive liver function tests, leucocytosis, eosinophilia, and hyperamylasemia. Abdominal computed tomography, showing the cystic wall, the presence of wall calcifications, daughter cysts and wall enhancement, provided a correct diagnosis of hepatic hydatidosis in all patients. Dilatation of the bile ducts with the presence of intraluminal material was clearly shown by sonography and endoscopic retrograde cholangiography. These abnormalities were most frequently found in the common bile duct and in the left hepatic duct. On sonography, the intraluminal material appeared as amorphous, sludge-like hydatid sand, and as daughter cysts. On ERCP, the intrabiliary parasitic material appeared as non-homogeneous, irregularly shaped and mobile filling defects. Other findings at ERCP were displacement and distortion of intrahepatic bile ducts by the hepatic cysts and a mild dilatation of the pancreatic duct. In one occasion, evacuation of a daughter cyst through the papilla was observed. The therapeutic value of mebendazole and endoscopic sphincterotomy in our patients is discussed.

Adult↗

Recurrent aneurysms of the upper arteries of the lower limb: an atypical manifestation of fibromuscular dysplasia--a case report.

Fibromuscular dysplasia (syn. arterial dysplasia, fibromuscular hyperplasia, medial fibroplasia) is an arteriopathy of unknown etiology, most frequently involving the renal arteries. The string-of-beads appearance of these lesions seems to be a characteristic angiographic finding. We report atypical angiographic findings at an unusual site, which proved to correspond to fibromuscular dysplasia at histological examination.

Adult↗

Intraarterial low-dose streptokinase infusion in the treatment of acute renal thromboembolism.

A case of acute renal thromboembolism treated by intraarterial low dose streptokinase infusion is reported. The treatment appears effective, safe and less-invasive then surgery, with quick relief of pain and normalisation of blood pressure and renal function. It is concluded that intraarterial infusion of thrombolytic agents should be attempted first in the treatment of renal arterial thrombo-embolism.

Female↗

"Skip areas" in hepatic steatosis: a sonographic-angiographic study.

"Skip areas" in focal steatosis describes a newly proposed "subsegmental type" of focal steatosis, which differs in both extent and topography from the more classic "lobar or segmental type" of focal steatosis. In the subsegmental type of steatosis, fatty infiltration can be considered homogeneous throughout the liver, with the exception of small flattened portions of less affected parenchyma, called "skip areas." These regions are mainly located in the subcapsular areas or along the interlobar fissures or the gallbladder bed. Observations using ultrasound in vivo, as well as on postmortem in vitro angiograms, suggest that both the extent and topography of these skip areas can be explained by local differences in vascular anatomy.

Adult↗

High-resolution real-time sonography of the adrenal glands: a routine examination?

The feasibility of imaging the adrenal glands during routine upper abdominal examinations was studied for 100 consecutive patients, 47 males and 53 females. The mean patient age was 46 years and the mean weight 63 kg. The suprarenal areas were scanned in a slightly oblique frontal plane through the intercostal spaces with the patient recumbent. The right adrenal gland was detected in 92 per cent of the patients, with a mean examination time of less than one minute. Visualization of the left adrenal gland was more difficult and was successful in only 71 per cent, even where additional views in the right lateral decubitus or erect position were added. The mean examination time on the left was 2 1/2 minutes. Complete visualization of the adrenal gland is impossible in one single plane because of the complex shape of the organ, which necessitates multiple contiguous scan planes. In 13 per cent of the visualized adrenals, cortex and medulla could be differentiated.

Adolescent↗

Gastric leiomyoblastoma with metastases to the liver. A 36-year follow-up study.

A patient presented with large intrahepatic tumoral masses 36 yr after the initial detection of multiple liver metastases during a gastrectomy. The operation had been performed to remove four ulcerated polypoid gastric lesions. Reexamination of the previous liver and gastric biopsy specimens revealed a gastric leiomyoblastoma with metastases to the liver. The smooth muscle origin of this tumor was confirmed by positive staining for desmin intermediate filaments. This very long survival is extremely unusual in cases of metastatic gastric leiomyoblastoma.

Adolescent↗

CT of functioning tumors of the pancreas.

Thirty-three patients suspected of having a functioning tumor of the pancreas were studied with computed tomography (CT); 25 had angiographic studies also. Thirty-one cases were confirmed surgically; the other two were lost at follow-up and were excluded from the series. Of the 31 patients, 21 had insulinomas, five had Zollinger-Ellison syndrome, and five had assorted apudomas. CT was positive in 71% of the cases and negative in 29%; 22.6% of the studies were false negative and 6.4% were true negative. There were no false positives. Of the 21 patients with insulinomas, only one had false-negative CT and angiographic studies, caused by diffuse microadenomatosis. In one patient, two separate lesions of the pancreas were seen and identified correctly on both CT and angiography. All identified lesions smaller than 2 cm were seen only because of a hyperdensity on the enhanced CT scan. Lesions larger than 2 cm were identified either because their size distorted the pancreatic contour or because of their vascularity. The importance of proper CT technique using fast scanners and repeated bolus injections of contrast medium is stressed.

Aged↗