[A comment on the editorial by R. W. Günther: Interventional radiology. RoFo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 155, 1 (1991) 1-3].
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Biomedical subjects
Publications and source records attributed to E Zeitler.
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Side effects experienced by patients up to 7 days after intravasal administration of nonionic contrast media were recorded with the help of questionnaires. These were completed by the patients themselves and compared with data recorded in patients examined without the use of contrast media. Of the 1000 questionnaires distributed, 499 were returned (271 in the contrast media group, 228 in the other group). A statistically significant difference between the two groups was found with regard to local pain at the injection site. The reactions correlated with the time of intervention. Another significant side effect was found in increased diuresis, which did not lessen during the 7 days of our survey. Increasing side effects were noted with higher contrast medium dosage and advancing age.
Positron emission tomography (PET) permits qualitative and quantitative measurements of tumor metabolism in the patient. In the clinical setting, the present studies suggest that tumors with a potential for proliferation can be differentiated from scar tissue, soft tissue and benign lesions. Accumulation of tracer by lymph nodes identifies them as metastatic. On the basis of a quantification of the accumulation of tracer and its metabolites, information can be provided about the biological activity of a tumor, and presumably also about the prognosis. The response of a tumor to treatment can be monitored, in particular in combination with CT. Possible selection of resistant parts of the tumor can be determined, so that modification of treatment is possible. Modes of application can also be individualized by identifying pre-treatment advantages of intraarterial or systemic administration; recurrent tumors can be detected with a high degree of accuracy. However, to date, only limited numbers of cases are available, so that, in view of the very promising aspects of this modality, more widespread application followed by the evaluation of larger numbers of patients is needed.
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The most important collateral pathways in the coronary artery system goes through the apex, the ventricular septum, left and right atrial branches and the ventricular wall of the left ventricle. In a collective of 52 patients who underwent aortocoronary-bypass surgery we controlled the collateral circulation and left ventricle function. Patients with multiple-vessel-disease had in 71% good collateral circulation and the collateral score was more than twice as high as in patients with one-vessel-disease. In addition we compared the LVEDP in these 52 operated patients and in 52, whose condition did not permit coronary surgery. The enddiastolic pressure is lower in patients with good collaterals and was also better in patients who underwent surgery.
The results of selective phlebography of the spermatic vein in patients with primary sterility and suspected varicoceles are reported. In 60% of those examined there was left-sided, and in 8.8% right-sided, spermatic vein insufficiency or a varicocoele. The value of spermatic vein phlebography is borne out by the large number of anomalies of the venous system (67%) and by the finding of 82 left-sided varicoceles.
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The normal flow values through healthy or moderately narrowed coronary arteries, which had been determined by a new method of cine radiography, together with a computer, were published in this Journal in 1976. In the present paper we report the results of further studies of flow velocity and flow volume through high-grade coronary artery stenosis of severity III and III--IV. Compared with the results obtained on normal and mildly stenosed arteries, measurements at rest through severely stenosed coronaries showed an almost constant flow. The first results on aorto-coronary vein graft measurement are described.
Starting from the observation of a post-traumatic thrombosis in the cervical portion of the carotid artery, with two subsequent similar findings, it is shown that angiography is of special importance in assessing these cases. Investigation of the cervical region of this artery should be considered in all cases of skull and cerebral trauma. On the other hand, the cases described by Sullivan show that the presence of a carotid lesion must be considered in all multiple injuries, just as injuries to vessels and organs must be excluded in patients with intracranial haematomas. Consultation between physician and radiologist is necessary for all injured patients in order not to omit any important steps during angiography.
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Attention is drawn to the incidence rate of the various types of obliterations of the carotid artery in the extracranial area. The evaluation is based on 242 carotid stenoses from a total of 1283 angiograms. Over and above this, the paper presents initial results of computertomography in 15 patients with obliterations of the carotid arteries in the cervical region.
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Aggregated forms of deoxyhemoglobin S were examined with a field emission transmission electron microscope. Images of isolated helical fibers were obtained from sickled cell lysates stained directly on the electron microscope grid. Optical and digital analyses of the electron micrographs showed that the fibers are similar to those characterized by J. T. Finch, M. F. Perutz, J. F. Bertles, and J. Döbler [(1973) Proc. Natl. Acad. Sci. USA 70, 718-722] in that they consist of stacked discs each composed of six hemoglobin molecules. The fibers exhibit an outer diameter of 160-170 A and an inner diameter of about 60 A with an axial spacing of 58 A per disc. The fiber can be described as a helix consisting of 56 discs per helical turn. We observed discs of six hemoglobin molecules, which may be stable substructural components of the fibers. They were observed in preparations of hemoglobin fibers and exhibited 6-fold symmetry by power spectrum analysis. A reconstructed image of a disc digitally filtered for 6-fold symmetry has a maximum external diameter of approximately 170 A and a central hole of 60 A diameter and is similar to the axial projection of a single disc from a low-resolution, three-dimensional reconstructed model of a fiber.
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