Biomedical subjects
Publications and source records attributed to G Lund.
CT-scans of 12 patients with tumour-induced occlusion of the inferior vena cava were studied with regard to collateral veins. A comparison was performed with findings at phlebography in 10 patients and at autopsy in 2. The site and appearance of the main collateral pathways are presented. A close study of vascular structures renders useful information on collateral circulation in occlusion of the inferior vena cava.
Twelve patients with left renal vein stenosis from tumor compression were studied with CT. All had distended collateral veins in the perirenal space which either formed a radiating or a cobweb pattern or appeared as marked longitudinal veins. Inferior phrenic vein branches were seen in seven patients and were considerably enlarged in two. Other major veins possibly taking part in collateral circulation could not be recognized due to obliteration of fat planes. The renal fascia was thickened in eleven patients, probably due to edema. A close study of the perirenal space with CT may give valuable information about collateral development.
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The subjective and objective response was evaluated retrospectively in 27 patients (30 radiotherapy series), who were treated by irradiation to metastatic lesions from renal cancer. Subjective response was noted in 16 of 19 evaluable patients. Objective regression was documented in 13 of 26 patients in whom the response could be judged using objective parameters. 30-40 Gy given over a 2- to 4-week period were enough to result in a response in most of the patients. Irradiation of mestastases from renal cancer represents an effective palliation treatment and should be considered in cases of painful local symptoms due to metastatic lesions.
CT was performed in 299 patients with possible pulmonary metastases. Metastases were found in 74 and at CT lesions were demonstrated in all of them. CT was the most sensitive non-invasive examination, demonstrating metastases in 2 patients considered normal at standard chest radiography and bilateral disease in 4 patients thought to have unilateral disease at standard examination. More nodules were resected at thoracotomy than were shown by CT. These extra nodules were small (less than 6 mm) and the majority represented non-metastatic fibrous lesions.
Computed tomography of the azygo--oesophageal recess was performed in 85 normal subjects. The recess was convex towards the left or had an approximately straight left wall. Convexity towards the right did not occur. Localized bulges caused by the azygos vein, oesophagus and aorta were frequent. The recess became gradually deeper caudally in patients below 50 years of age. Above that age a marked posterior extension of the heart and a prevertebral position of the aorta often caused a localized shallowing at the level of the inferior pulmonary veins or the ventricles.
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PURPOSE: To evaluate patency rates after guide wire directed manipulation of malfunctioning continuous ambulatory peritoneal dialysis (CAPD) catheters. MATERIALS AND METHODS: During a 58-month period, 23 patients underwent 34 outpatient guide wire directed manipulations of their CAPD catheter to improve function (n = 30) or reduce pain and improve function (n = 4) during dialysis. Catheter patency rates were subsequently determined by review of departmental, hospital, and dialysis center charts; procedural reports; and patient telephone interviews. RESULTS: Among 12 patients who underwent a single guide wire directed manipulation, long-term (> 30 days) catheter patency was achieved in seven (58%). With use of the Kaplan-Meier survival method, the 3-, 6-, and 12-month probability of patency after a single guide wire manipulation was 0.61, 0.54, and 0.11, respectively. The mean duration of patency achieved in this group was 131 days (range, 2-421 days). In those patients (n = 8) who underwent multiple catheter manipulations (n = 19), 11 (58%) procedures resulted in long-term patency, with each patient (100%) achieving at least one such period. The Kaplan-Meier survival method determined the probability of patency in this group at 3, 6, and 12 months to be 0.75, 0.69, and 0.54, respectively. The mean secondary catheter patency was 235 days (range, 2-646 days). Overall, 75% of patients followed up achieved at least one period of long-term catheter patency during the time of this study. One (3%) episode of postprocedure peritonitis occurred. CONCLUSION: Guide wire directed CAPD catheter manipulation is a relatively simple outpatient procedure that restores long-term catheter function for most patients with minimal risk for a major complication. Patients with nonfunctioning CAPD catheters who do not have peritonitis or sepsis will most likely benefit from at least one attempt at radiologic manipulation of their catheter.
Normal lymph nodes of the mediastinum are often not visible at CT. Some nodes may become contrast filled after foot lymphography, and these are easily seen in the CT sections. In the present report contrast filling is used to locate the main groups of mediastinal nodes at CT. The anatomy is reviewed and involvement of different nodes in various diseases is discussed.
Myocardial proton T2 relaxation measurements were performed on five normal subjects over 4 weeks (20 measurements) and on nine heart transplant recipients (35 measurements). All magnetic resonance measurements were performed with a 1 T system. All patients had endomyocardial biopsy the same day as magnetic resonance imaging. Results of biopsies were normal on 32 occasions and abnormal three times (two cases of acute rejection and one case of myocardial edema). T2 values for normal subjects were 46.6 +/- 8.1 and 46.9 +/- 4.9 msec (septum and left ventricular free wall, respectively). T2 values for transplant recipients with normal results of biopsies were 44.5 +/- 7.8 and 43.1 +/- 7.5 msec. T2 values in three patients with abnormal results from biopsies were elevated (69 +/- 7.6 msec, range 59.7 to 77.6 msec). The results show similar values in normal subjects and transplant recipients with normal results from biopsies. Increased T2 values in three patients with abnormal results from biopsies indicate that relaxation time measurements may be of value to identify patients at risk of rejection.
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