Biomedical subjects
Publications and source records attributed to C Gospos.
Giant cell reactions in the short tubular bones comprise mainly enchondromas, aneurysmal bone cysts and giant cell tumours. In both cases a history of trauma can be related. We therefore agree with Aegerter and Lorenzo that an intra-osseous haematoma due to minor trauma is likely to be of pathogenic significance.
A study comparing the effects of diatrizoate, ioxitalamate, metrizamide, ioxaglate, iopamidol and a hyperosmotic sorbitol and sodium chloride solution on the endothelium of the vena cava of the rat was performed. In each case 1 ml. of the respective solution was injected intravenously. Endothelial damage was seen after injection of metrizamide, diatrizoate and ioxitalamate. After injection of ioxaglate only minor endothelial changes were observed, whereas after administration of both hyperosmotic solution no endothelial damage could be observed.
The effect of diatrizoate, ioxitalamate, metrizamide, and ioxaglate on the aortic endothelium of the rat was investigated using transmission electron microscopy and DNA synthesis autoradiography. One milliliter of each contrast medium, containing 300 mg iodine per ml, was injected into the aorta. The types of lesions seen on electron microscopy and the rate of DNA synthesis seen on autoradiography established the degree of endothelial damage that had been produced. Of the four contrast agents tested, ioxaglate produced the least amount of cellular change.
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In a comparative study the validity of angiographic, sonographic and urographic findings for evaluation of 204 renal tumors was investigated. Angiography showed 97% correct results, sonography 96% and urography 93%. Mean tumor size was 8.4 cm. 25% of all tumors caused renal vein occlusion. On the one side there is a striking correlation between tumor growth and vein occlusion, and on the other side between vein occlusion and urographic silent right kidney. 20% of all tumors had metastasized at the time of diagnosis. In 4.5% of all cases we found a left sided symptomatic varicocele of the left side with invasion of the left renal vein by tumor masses.
68 patients have undergone augmentation mammaplasties in the last 6 years in our Dept. of Surgery. 15 reoperations (capsulotomy, capsulectomy, change of the implant) had been necessary. We observed unfavorable results causing patient dissatisfaction in 22%, mostly due to capsular contracture. It should be mentioned that satisfaction was much greater in the group of unilateral hypoplasia (10 cases). Reoperation have not been necessary in this group. The range of indications for augmentation mammaplasties should be limited.
Percutaneous transluminal angioplasty was performed in 15 patients with supra-aortic obstructions. One of two subclavian artery occlusions could not be recanalized. the intervention did ot improve the circulation disturbance in two patients. A favorable treatment effect was observed in 80% of the cases, a result not very different from operative corrections. No complications occurred. The risk of angioplasty of the carotid bifurcation is unknown and, therefore, vascular surgery will remain the preferable method of treating atherosclerotic lesions of this location. In our opinion, angioplasty should be considered when operative correction requires thoracotomy and when the operative risk is increased. This is especially valid in proximal subclavian artery stenosis with and without subclavian steal syndrome, as well as in stenosis at the origin of the vertebral artery.
Investigations have been carried out on the endothelial damage produced by diatrizoate (Angiografin) during the course of endotoxin shock. A single injection was given directly into the aorta of 1 ml of the contrast medium, with an iodine content of 300 mg/ml. The increased proliferation of the aortic endothelium could be shown to be due to the endotoxin shock, but was not further increased by administration of the contrast medium.
Four cases of malignant fibrous histiocytomas are reported. An attempt is made to determine some characteristic roentgenologic features of this disease. There is no pathognomonic radiologic sign; however, angiographic documentation of hypervascularization together with neovascularity and absorption values of about 35 HE in computed tomography suggest a predominantly fibrous sarcoma. Differential diagnosis on abscess formation, tumours of the fat tissue and primary vascular neoplasms should be performed and these conditions ruled out if not applicable.
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3 cases of unilateral angiomyolipoma of the kidney are presented. Angiography was unsuccessful in diagnosing angiomyolipoma in these cases observed by us. The diagnostic problems of the angiomyolipoma are discussed on the basis of histologic and angiographic findings. No patient showed simultaneously tuberous sclerosis.
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The damaging effect of methylglucamine diatrizoate on the aortic endothelium is tested and compared to the action of a 22% sorbit solution both with the same hypertonicity. In the first group the contrast medium is injected into the aorta once. In a second group three consecutive injections 5 minutes apart are performed. Aortic specimens are investigated by the "Häutchen" method. The degree of endothelial lesion due to contrast medium is direct proportional to the rate of proliferation of endothelial cells as analized by autoradiography. The damage to the aortic endothelium is independent of number of injections (once or three times). The sorbit solution caused no injury to the aortic endothelium. A generalized endothelial damage--as it is seen in shock--could be excluded.
Tangled whorly calcifications were seen in the abdominal subcutaneous tissues of a negro patient from Africa. The differential diagnosis of such calcifications - rarely observed in Europe - includes a variety of parasities. In this patient, dracunculus medinensis (guinea worm disease) was the cause.
There was a marked decrease in the RES phagocytic activity during the first 12 hours after injection of high concentrations of endotoxin in rats. Phagocytic activity then increased considerably, reaching maximum values on days 3 to 5 and it was still higher than in control animals 20 days later. Parallel studies on 3H thymidine incorporation showed a significant increase in the rate of DNA-synthesis of reticulum cells of the liver during the 5 days period following endotoxin injection. Peak values were obtained on day 2 when the number of labelled cell were 50 times higher than in the controls. A likely reason for the increased DNA-synthesis is a repair of RES following endotoxin induced damage but it may also represent an endotoxin induced proliferation of reticulum cells that may at least partly account for the enhanced phagocytic activity.