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Biomedical subjects

E J Ring

Publications and source records attributed to E J Ring.

At least 91 records · Page 5Linked to original sources
PubMed1983

Catheter dilatation of benign ureteral strictures.

Twenty-seven symptomatic, benign postoperative strictures of the ureter or ureteropelvic junction were dilated with balloon or angiographic catheters in an attempt to definitively treat the strictures without surgery. Twenty-three dilatations were performed in antegrade fashion in conjunction with or subsequent to percutaneous nephrostomy, and four strictures were dilated in retrograde fashion per urethra. Thirteen of 27 strictures (48%) were successfully dilated. Certain strictures were more amenable to dilatation than others. In general, the potential for success in dilating ureteral strictures appears to be more dependent on the nature of the stricture than either its duration or the method of dilatation. Based on our initial experience, suggested techniques and guidelines for patient selection are offered.

Constriction, Pathologic↗
PubMed1983

Blood pressure response to dynamic exercise in adolescents before and after percutaneous transluminal renal artery angioplasty.

The blood pressure response to maximal bicycle exercise was studied using the James protocol in two adolescents with renal artery stenosis before and after percutaneous transluminal renal artery angioplasty. Prior to angioplasty, one patient (pt A) had persistent and one patient (pt B) had labile elevation of the resting blood pressure above the 95th percentile for age; both patients had elevated systolic blood pressure at maximal exercise (pt A: 215 mm Hg; James expected 170 +/- 20; pt B: 228 mm Hg; James expected 156 +/- 15). Following angioplasty, both patients had resting blood pressures below the 95th percentile for age; patient A had improved systolic pressure at maximal exercise (195 mm Hg) while patient B had persistent elevation in the exercise systolic blood pressure (215 mm Hg). Angiography confirmed the presence of residual/recurrent renal artery stenosis in patient B. We conclude that measurement of blood pressure during exercise may reveal residual abnormalities not apparent at rest and thus may be useful in assessing the result of renal artery angioplasty in children with renal artery stenosis.

Adolescent↗
PubMed1983

Biliary stone removal: the interventional radiologist's role.

Despite the recent popularity of endoscopic techniques, the interventional radiologist retains an important role in the non-surgical management of biliary duct stones. In the cases where endoscopic sphincterotomy is difficult, the radiologist can be of great assistance to the endoscopist. When endoscopic stone removal is not feasible, the radiologist can treat patients percutaneously. When surgery is performed in patients with recurrent stone disease, the radiologist can maintain biliary toilet. The various approaches to biliary removal through non-surgical tracts are discussed.

Adult↗
PubMed1982

Applications and techniques of gastrointestinal intubation.

Gastrointestinal intubation has found increasing applications over the past several years. Although usually an uncomplicated procedure, passage of an intestinal tube may be impeded by ineffective peristalsis, obstructing lesions or surgical alteration of the normal anatomy. A variety of techniques are described for passing tubes into the stomach, duodenum and small bowel. These techniques are an outgrowth of those initially developed for manipulating tubes through the vascular, biliary and genitourinary systems. The characteristics of the various decompression and alimentation tubes as well as the dangers of gastrointestinal intubation are also discussed.

Enteral Nutrition↗
PubMed1982

Current status of percutaneous transluminal angioplasty.

With the development of a dilating balloon catheter that permits percutaneous treatment of many arterial stenoses and some occlusions, a definite advance in the therapy of peripheral vascular disease has been made. It is still too early to be certain what ultimate position this means of therapy will take in the overall treatment of vascular disease, as its use is still being extended and long-term results are not yet clearly known. When compared with surgical therapy, however, it has some striking advantages, although the durability of its effect appears to be less. Despite the fact that more time and experience are needed before its ultimate position is established, we believe that the evidence to date warrants inclusion of this form of therapy in the armamentarium of every major vascular center.

Angiography↗
PubMed1982

Percutaneous transluminal angioplasty treatment of renal transplant artery stenosis.

Since June 1979, percutaneous transluminal angioplasty (PTA) has been the procedure of choice for renal transplant artery stenosis (RTAS) at the Hospital of the University of Pennsylvania. Of 241 renal allograft recipients, 17 (7%) when studied by arteriogram because of suspected RTAS proved to have significant stenosis (the mean reduction in luminal width for the group being 68%) and underwent PTA. RTAS was equally prevalent in cadaver and related kidney allografts and was no less common in HLA-identical related donor grafts, arguing against the importance of immune factors in etiology. RTAS was equally prevalent whether the anastomotic technique was end to end or end to side. However, when RTAS occurred after end to side anastomoses, it was usually postanastomotic. Fifteen of 17 of the attempts at dilation by PTA were successful by angiographic analysis. Thirteen of the 15 successfully dilated patients had long-term allograft survival and in all of these instances blood pressure (BP) was decreased after PTA. After a mean of 67 weeks, BP decreased from a systolic of 184 +/- 24 mm Hg pre-PTA to 135 +/- 15 mm Hg (P less than 0.001) and from a diastolic of 115 +/- 10 mm Hg pre-PTA to 87 +/- 11 mm Hg (P less than 0.001). The majority of patients continue to require antihypertensive drugs but in a less vigorous regimen than pre-PTA. Serum creatinine level fell following PTA from 1.9 +/- 0.6 to 1.7 +/- 0.5 mg/100 ml (P less than 0.01). Repeat angiographic study was done in nine patients, an average of 61 weeks after PTA, and no recurrent RTAS was identified. Three minor complications of PTA occurred but none led to long-term sequelae. Thus, we believe PTA of RTAS is relatively safe, carrying less mortality and morbidity than operative treatment, and is capable of improving BP control and renal allograft function.

Adult↗
PubMed1982

Therapeutic alternatives in the treatment of intrahepatic biliary obstruction.

Intrahepatic biliary obstruction was treated in 60 patients (49 with cholangiocarcinoma and 11 with sclerosing cholangitis) who were classified according to the upper limit of their obstruction (Group I, proximal common hepatic duct; Group 2, right and left main hepatic ducts; Group 3, intrahepatic bile ducts). Thirty-six patients underwent percutaneous transhepatic biliary drainage, and 14 underwent catheterization through a T-tube track, Five of this latter group had the T-tube placed to establish a route of access for later interventional radiologic manipulations. Since most diseases that produce intrahepatic biliary obstruction are progressive, the use of any single approach is limited. The advantages of a surgically created route of access combined with the flexibility of interventional radiologic techniques help to maximize the therapy and extend the palliation that many of these patients receive.

Adenoma, Bile Duct↗
PubMed1982

Enterocutaneous fistulae: interventional radiologic management.

Twelve patients with high-output enterocutaneous fistulae were successfully managed by interventional radiologic therapy. Control of the bowel effluent was gained by anchoring a large-bore T tube in the lumen of the bowel and placing sump drains adjacent to the bowel wall. Abscesses communicating with the fistulous tract were also catheterized and drained. This approach afforded control of sepsis and allowed the formation of a mature, fibrous external tract that subsequently underwent spontaneous closure.

Abscess↗
PubMed1982

Percutaneous transluminal angioplasty in the treatment of abdominal angina.

Percutaneous transluminal angioplasty of the superior mesenteric artery was performed on seven patients with clinical and radiographic evidence of abdominal angina. The procedure was successful in six patients thereby avoiding a revascularization procedure. Clinical and angiographic follow-up to 28 months revealed marked improvement in symptoms and continued patency of the dilated vessel.

Abdomen↗
PubMed1982

Transgastrostomy jejunal intubation for enteric alimentation.

Malnourished patients who cannot maintain an adequate oral intake but have normal intestinal absorption and motility are candidates for enteric alimentation. When impaired gastric peristalsis or an increased risk for aspiration makes gastrostomy feeding unsafe, direct jejunal infusion is the preferred route of alimentation. Angiographic techniques were used to convert previously placed, simple gastrostomies to combined gastrostomy-jejunostomies in 14 patients. In 17 additional patients, a combined gastrostomy-jejunal tube was placed under local anesthesia; angiographic techniques assisted in the placement of 11 of these tubes.

Angiography↗