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Biomedical subjects

E C Martin

Publications and source records attributed to E C Martin.

At least 55 records · Page 3Linked to original sources
PubMed1984

Percutaneous drainage of abscesses: a report of 100 patients.

One hundred patients had abscesses drained percutaneously in a variety of sites. Eighty-five per cent were treated successfully with a 6% mortality. There are now several large series in the literature, totalling over 250 patients with an average cure rate of over 80% and a mortality of under 5%. Percutaneous drainage of abscesses should become the treatment of choice in a vast majority of patients in whom the abscess can safely be reached.

Abscess↗
PubMed1983

Validation of the angiographic accuracy of digital left ventriculography.

Digital subtraction angiography enhances the contrast to background signal, enabling the performance of angiography with reduced doses of contrast medium. The objectives of the present study were (1) to validate the accuracy of digital left ventriculography for measurement of left ventricular volumes and segmental contraction; and (2) to compare the hemodynamic effects resulting from low-and high-dose intraventricular contrast injections. Twenty-eight patients underwent digital left ventriculography, performed by intraventricular injection of 7 ml of contrast medium diluted in saline solution, followed by conventional cineangiography of the left ventricle performed with 45 ml of undiluted contrast medium. Left ventricular volumes calculated from digital ventriculograms correlated well with volumes calculated from conventional ventriculograms: end-diastolic volume (r = 0.97, standard error of estimate [SEE] 23.4 ml; end-systolic volume (r = 0.97, SEE 15.4 ml); stroke volume (r = 0.95, SEE 14.7 ml); and ejection fraction (r = 0.97, SEE 3.8%). Segmental left ventricular contraction, measured as percent chordal shortening of hemiaxes, correlated moderately well (r = 0.81, SEE 11.5%). After injection of undiluted contrast medium, left ventricular systolic pressure decreased (133 +/- 31 to 123.5 +/- 27 mm Hg; p less than 0.01) and left ventricular end-diastolic pressure increased (12.0 +/- 7 to 16.9 +/- 10 mm Hg; p less than 0.001). Left ventricular systolic and end-diastolic pressures did not change significantly after injection of diluted contrast medium, and patients had no discomfort. Thus, digital subtraction angiography permits the performance of left ventriculography with markedly reduced doses of contrast medium, obviating the hemodynamic effects resulting from injection of conventional doses of contrast medium. This new approach to left ventriculography provides high resolution ventriculograms for accurate measurement of left ventricular volumes, stroke volume, and ejection fraction.

Adult↗
PubMed1983

The radiological management of malignant biliary obstruction.

Percutaneous transhepatic biliary drainage has become widely accepted as a safe and effective palliative therapy for malignant biliary obstruction. The results of drainage were reviewed over a 3-year period and patients divided by the response to decompression as measured by change in serum bilirubin. Patients with good response survived an average of 198 days, while patients with a poor response survived an average of 12 days. No procedural mortality was encountered. However, despite the generally good results, a 30-day mortality rate of 28% was seen, with good responders having a mortality of 10% and poor responders a mortality of 88%. Patients with hepatic metastatic disease as documented by liver-spleen scan, ultrasonography or computed tomography do poorly, surviving an average of 39 days, despite a good biochemical response. The success of percutaneous biliary decompression has allowed surgeons to select cases for cholecystenterostomy from the group of good responders. A more selective clinical approach is suggested for radiologists on the basis of these results.

Aged↗
PubMed1983

Serial lung scintigraphy: utility in diagnosis of pulmonary embolism.

Pairs of sequential perfusion lung scans and pulmonary angiograms obtained in 45 patients were reviewed to investigate the utility of short-term, sequential scintigraphy in the diagnosis of pulmonary embolism (PE). Forty-six sequential scan pairs were reviewed; 13 were ventilation-perfusion (V-P) pairs. Angiograms were obtained within 48 hours of either the first (65%) or second (35%) perfusion scan in each pair. Sequential scintigraphic patterns were classified as showing change (i.e., improvement in defects, new defects), no change, or as being indeterminate. A changing perfusion pattern was associated with a high (20/23) likelihood of PE, but seven of 16 patients with stable perfusion patterns also had PE. The sensitivity of a changing perfusion pattern for PE was 0.74 (20/27) and its specificity was 0.75 (9/12). In two of six patients who had serial V-P studies that showed changing perfusion defects, there were matched changes in regional ventilation and angiograms were negative. The findings suggest that short-term serial perfusion lung scanning may aid the scintigraphic diagnosis of PE in certain circumstances. Serial V-P imaging is needed, however, to maximize diagnostic specificity.

Adult↗
PubMed1982

Percutaneous drainage of pancreatic pseudocysts and abscesses.

The use of percutaneous drainage is reported in 6 patients with pancreatic pseudocysts and 6 patients with pancreatic abscesses. There have been no recurrences in the patients with pseudocysts. The success of the procedure is attributed to providing catheter drainage until the cavity was obliterated (mean time, 8 days), rather than using a single-needle aspiration. Percutaneous drainage of 6 pancreatic abscesses allowed desperately ill patients to improve enough to undergo elective surgery, and obviated surgery in 3 patients. The technique was performed without complications in all cases. Percutaneous drainage should find a significant place in the management of patients with complications of pancreatitis.

Abscess↗
PubMed1982

Percutaneous drainage of postoperative intraabdominal abscesses.

Twenty-two major intraabdominal abscesses in 19 postoperative patients were drained percutaneously using cross-sectional imaging techniques (computed tomography and sonography) for localization. Sixteen lesions were cured in 14 patients without reexploration. All patients were palliated by the percutaneous drainage procedure. All 22 abscess cavities were entered without complication or compromise of adjacent normal organs. Percutaneous abscess drainage is recommended as a safe, effective method of treating a major intraabdominal abscess in the postoperative patient.

Abdomen↗
PubMed1982

Percutaneous abscess drainage.

Forty-two abscess collections in the abdomen, pelvis and mediastinum were drained in 40 patients. Thirty-two were drained completely and required no operative treatment. The high success rate combined with the low morbidity rate and low mortality suggest that, if possible, percutaneous drainage of abscesses is preferable to operative drainage.

Abscess↗
PubMed1981

Accessory mitral valve tissue causing left ventricular outflow tract obstruction in D-transposition of the great arteries.

Two patients with D-transposition of the great arteries (D-TGA) were found to have an unusual form of left ventricular outflow tract obstruction. Both had ball-like accessory mitral valve tissue that partially occluded the outflow tract. In one patient there was an intact septum, while in the other there were ventricular septal defects. The appearances have been described previously, although not in D-TGA. Recognition of accessory mitral valve tissue may allow resection of the tissue at the time of repair of the transposition complex.

Female↗
PubMed1981

Non-surgical drainage of intra-abdominal and mediastinal abscesses: a report of twelve cases.

Twelve patients with intra-abdominal or mediastinal abscesses were treated by percutaneous drainage. Three abscesses were subphrenic, three were adjacent to enteric leaks, two were intrahepatic, two were pancreatic pseudocysts, one was a pancreatic abscess extending to the lesser sac, and one was an infected adrenal hematoma. All 12 lesions were entered percutaneously using fluoroscopic guidance without traumatizing the adjacent normal tissue. Localization was frequently aided by computed tomography. Various catheters were positioned using basic angiographic techniques. Following drainage all patients had a favorable clinical response. Seven of the 12 patients required no surgical management. Careful radiologic follow-up and frequent changing of catheters was necessary in six of the patients. Two patients benefited from the addition of auxiliary drains. Five of the 12 patients were electively operated upon because of incomplete drainage of the abscess cavity. Causes of failure were: persistent anastomotic leak (two patients), sequestered, loculated extension of abscess cavity (two patients), or necrotic, viscous hepatic tissue requiring removal at laparotomy (one patient).

Abscess↗
PubMed1981

Use of the electrohydraulic lithotriptor in the biliary tree in dogs.

The electrohydraulic lithotriptor, a machine which breaks up stones by generating a hydraulic shock wave, was assessed as a means of facilitating percutaneous extraction of biliary calculi. Tissue exposed to the lithotriptor showed no mucosal damage when studied histologically; however, round-cell infiltration was seen in one dog, raising the possibility of long-term stricture formation. Eighty per cent of the calculi could be fragmented with the lithotriptor. The application and limitations of the system are discussed.

Animals↗
PubMed1981

Radiation exposure to the pediatric patient during cardiac catheterization and angiocardiography. Emphasis on the thyroid gland.

Thermoluminescent dosimetry was used to measure the radiation exposure to the skin, thyroid and gonads in 50 consecutive pediatric patients undergoing cardiac catheterization and angiocardiography using cine photofluorography. Average exposures were 17.1 R to the skin, 2.3 R to the thyroid and 0.1 R to the gonads. Fluoroscopy accounted for approximately 80% of the skin and thyroid exposure and cine photofluorography for 20-25%. Occasional primary-beam irradiation was the major contributor to gonad exposure. Internal scatter of the incident x-ray beam was primarily responsible for thyroid exposure, so that infants received relatively high exposures; one receiving 7.3 R. The thyroid was not frequently in the primary beam. The significance of high radiation exposure to the thyroid, and in particular its relationship to thyroid carcinoma, are discussed. The results are compared with other series in the literature and relative exposures of cine photofluorography and serial filming are contrasted.

Angiocardiography↗