[Reporting of incidents. A practical method for quality assurance].
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Accidents↗
Biomedical subjects
H Jorulf
Publications and source records attributed to H Jorulf.
Experimental tissue transplantation using a biopsy instrument and radiologic methods.
RATIONALE AND OBJECTIVES: The liver is the most common site for metastases from gastrointestinal tumors, malignant melanoma, and primary liver tumors. Early detection or exclusion of a neoplasm is important for appropriate treatment. The authors introduce a method for tumor transplantation into the rabbit liver for experimental purposes. METHODS: VX2 tumor cells initially were grown intraperitoneally in a New Zealand white rabbit. Using an automated biopsy instrument with an ultrathin-wall biopsy needle, standardized tumor samples were taken from the peritoneal tumor. Using the same technique, a tumor sample was transplanted into the left liver lobe in a series of seven rabbits. RESULTS: Tumor growth was achieved in all cases at the implantation site. The tumors were well delineated from the surrounding liver parenchyma. Metastases occurred only at later stages. CONCLUSION: The method is almost nontraumatic to the animals, and the technical procedure is simple, time-saving, and provides well-localized tumor growth.
Adenocarcinoma↗
[Shortage of pediatric radiologists].
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Humans↗
Adjustable automated biopsy device.
The authors describe a device for soft-tissue core biopsy with core length of 3-19 mm. Excellent results were obtained in combination with a new needle design in a series of 119 renal biopsies in pediatric and adolescent patients. With ultrasound guidance and adjustment of the core length in relation to kidney size, renal biopsy in pediatric patients can be safely performed with this device.
Adolescent↗
MRI in distal vaginal atresia.
Magnetric resonance imaging in two young females with abdominal pain revealed vaginal atresia with massive hematocolpos but a normal cervix and uterine body. Information obtained with MRI was superior to ultrasound and CT and is suggested as the examination of choice prior to surgical correction.
Adolescent↗
Miscellaneous adverse effects of low-versus high-osmolality contrast media: a study revised.
The authors analyzed data from two recent articles in Radiology in which the quality and results of randomized control trials (RCTs) comparing the efficacy or safety of the low-osmolality contrast media (LOM) iopamidol, iohexol, and ioxaglate with that of the high-osmolarity contrast media (HOM) diatrizoate, iodamide, iopamide, iothalamate, and metrizoate were assessed. One conclusion in the source articles was that no differences were seen between the two groups of contrast media in frequency of nausea, vomiting, and urticaria. However, the LOM group included both nonionic LOM (NIM) and the ionic contrast medium ioxaglate. The authors found that various complications associated with the use of contrast media were much less common with NIM than with HOM; statistically this lower frequency is highly significant. This difference was obscured in the previous studies by the pooling of RCTs in which the less toxic NIM were used and RCTs in which the more toxic ionic contrast medium ioxaglate was used.
Contrast Media↗
Nonionic versus ionic contrast media in intravenous urography: clinical trial in 1,000 consecutive patients.
A double-blind clinical trial was performed in 1,000 consecutive patients to compare the safety and efficacy of intravenously administered nonionic (iohexol) and ionic (metrizoate) urographic contrast media. The patients ranged in age from 10 to 80 years. The incidence of mild to moderate adverse effects was 7.7% with iohexol and 31.2% with metrizoate. No serious reactions were recorded with either of the contrast media. Urography with iohexol was found to give better parenchymal opacification, pelvocalyceal opacification, and overall quality. The sum of examinations with good and excellent overall quality was 97.8% with iohexol and 91.1% with metrizoate. The frequency of poor overall quality urograms was 1.6% with iohexol and 7.5% with metrizoate. The data suggest that iohexol is safer and more frequently produces urograms of better quality.
Adolescent↗
Lethal and non-lethal diastrophic dysplasia. A study of 14 Swedish cases.
A clinical study was performed on 14 patients with diastrophic dysplasia (DD), including three pairs of sibs. Six of these patients, including two pairs of sibs, died shortly after birth of respiratory and circulatory insufficiency. We consider these six patients to represent a special lethal variant of DD. In all infants with the lethal variant of DD the birth weight was lower than in those with the non-lethal variant. There were also roentgenological differences between these two groups. Overlapping in joints and dislocation of the cervical spine were seen in all the lethal cases. In addition, four of the six patients with lethal DD cases had a congenital heart defect, and none in the non-lethal group.
Dwarfism↗
Urogenital schistosomiasis: CT evaluation.
Computed tomography (CT) was compared with plain films and intravenous urography in 20 male patients with schistosomiasis. CT better demonstrated the extent of calcifications, which were recorded in the urinary bladder in all cases. The anterior wall of the bladder is first affected. The length and nature of stricture of the ureter can be estimated with CT, and ureteral reflux may be demonstrated when fatty emulsion is used for filling the bladder and the ureter is dilated. Punctate ureteral wall calcifications may be distinguished from intraureteral stones. CT is also helpful in establishing the presence and the staging of bladder tumors.
Adolescent↗
Oro-facio-digital syndromes I and II: radiological methods for diagnosis and the clinical variations.
In view of the different modes of inheritance and the different prognoses of the two oro-facio-digital syndromes, type 1 (OFD-I) and type 2 (OFD-II), it is important to establish a correct diagnosis in these patients. In this report two new patients with the OFD-I syndrome are presented. One of them (Case 1) had multiple congenital malformations and never made any mental contact. She died at the age of four months and autopsy of the brain revealed abnormalities typical of the syndrome, which are discussed. The other patient (Case 2) has so far had normal mental development. Although these two patients were affected to a very different degree, they both presented the clinical and radiological characteristics of the OFD-I syndrome. These two patients and previously reported cases of the OFD-I and OFD-II syndromes were compared with a patient with the OFD-II syndrome (Case 3), a patient reported earlier who is undergoing follow-up. The radiological features of the skeleton in the two syndromes are presented. The irregular mineralization of the hands and feet characteristic of OFD-I, but not of OFD-II, seems to offer a good opportunity to distinguish between these two syndromes. It is suggested that this finding is pathognomonic for the OFD-I syndrome.
Abnormalities, Multiple↗
Comparison of different clearance estimates for metoprolol in the rhesus monkey.
After oral administration, the fraction of unchanged drug available systemically is predominantly governed by hepatic drug-metabolizing enzyme activity and/or binding to the liver. If the "well stirred" model for hepatic elimination mimics reality, the apparent oral clearance (Clo) of metoprolol, a drug which is completely absorbed and metabolized only by the liver, should reflect the intrinsic clearance (Cli), i.e., the maximum enzyme activity in absence of blood flow limitations. According to theory, the hepatic venous (hv) drug concentrations after an i.v. dose are also a function of Cli. This postulate has previously been verified in the isolated perfused rat liver by others and has now been tested by us in the intact rhesus monkey. We have compared Clo, Cli and the systemic clearance (Cls) of metoprolol in six rhesus monkeys catheterized in the hepatic and femoral veins (hv; fv). They were given simultaneously 37 to 73 micrograms of [3H]metoprolol i.v. and 9 mg of metoprolol per kg b.w. orally. Unlabeled drug was analyzed in plasma by gas chromatography and 3H-labeled metoprolol by liquid scintillation after liquid chromatography separation. The Cls [dose i.v./area under the blood concentration vs. time curve in the femoral vein (AUCs)] varied between 27 and 32 ml X kg-1 X min-1. As expected, the Clo (doseo/AUCs) was considerably higher and ranged from 89 to 147 ml X kg-1 X min-1. The Cli (dosei.v./AUChv) was in the same range as Clo (46-163 ml X kg-1 X min-1). The determined oral availability was 19 to 31% with a mean of 25.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Morphine glucuronidation in the rhesus monkey: a comparative in vivo and in vitro study.
The kinetics of morphine in the rhesus monkey after i.v. or oral administration including the hepatic extraction ratio determined directly in the portal and hepatic veins were compared with the glucuronidation of morphine in liver microsomes from the same animals. The plasma half-lives varied between 102 and 202 min and the apparent volume of distribution was 2.68 to 3.15 l X kg b.wt.-1. The systemic blood clearance (9.2-21.3 ml X min-1 X kg b.wt.-1) was in the same range as the estimated hepatic blood clearance (9.7-23.9 ml X min-1 X kg b.wt.-1). After i.v. administration, the blood concentrations of morphine-3-glucuronide ( M3G ) were 8 to 11 times higher than those of morphine. The molar blood concentration ratio between morphine-6-glucuronide and M3G was 0.04 or less. The ratio between the metabolite levels in blood was similar to the relative formation rates for M3G and morphine-6-glucuronide in liver microsomal preparations (less than .039). The intrinsic hepatic metabolic clearance of morphine as estimated from the apparent enzyme kinetic constants Vmax and Km for the formation of the major M3G metabolite was used to predict the hepatic extraction ratio. The predicted values of the hepatic extraction ratio (0.09-0.14) were, however, underestimates of the experimentally determined hepatic extraction ratio, which varied between 0.61 and 0.74. This indicates that unknown factors in the liver microsomal glucuronidation preclude the use of enzyme kinetics parameters obtained in vitro for the prediction of the hepatic extraction ratio of morphine. For some drugs that are oxidized it has been shown previously that such prediction from in vitro data is possible.
Animals↗
Iohexol compared with diatrizoate in pediatric urography.
Iohexol (300 mg I/ml) was compared with meglumine-Na diatrizoate (290 mg I/ml) in a randomized, single blind, parallel investigation in pediatric urography. Urography with iohexol was performed in 25 infants and with diatrizoate in 26. No changes of clinical importance were observed in blood or urine. No patient reactions were observed in the iohexol group, while 3 patients in the diatrizoate group had reactions assessed to be caused by the contrast medium. Iohexol gave somewhat better diagnostic information than diatrizoate.
Adolescent↗
Experience of the Cohen method for ureteral reimplantation in complicated cases.
Thirty-seven infants and children (41 ureters), a majority with complicating factors (low age, neurogenic bladder, duplication, reoperative surgery), were treated with ureteral reimplantation according to Cohen. The results were good in 90% of the cases. Minor deviations from the original technique, i. e. Dexon instead of chromic catgut as suturing material, catheter splinting of ureter in only 40% and short length of submucosal tunnel in some cases, did not seem to have a negative influence on the results. The method, which is easy and safe to perform, is recommended, particularly in complicated cases.
Adolescent↗
Comparative study of angiography, computerized tomography and ultrasound in abdominal tumors of children.
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Abdominal Neoplasms↗
Trisomy 8 syndrome. The rib anomaly and some new features in two cases.
Two further cases of trisomy 8 syndrome are reported. Both displayed characteristic anomalies of the ribs. An index of variation in rib diameter was constructed, and the value was found to differ from that in normal children. Our first patient, who was examined post mortem, had an atresia of the gallbladder and common mesentary. Patient 2 had muscular hypotonia and atrophy. She also showed an anomaly of the perineum, where the posterior commissure of the vulva was absent and the mucosae of the vulva and anus met at the midline, a defect which has not been described previously as a part of the syndrome. Otherwise, both present patients had abnormalities already known typical for the syndrome. The literature is reviewed, and the features of the trisomy 8 syndrome are divided into three groups - major, minor and inconstant, to facilitate the diagnosis.
Abnormalities, Multiple↗
A new treatment of anal incontinence in children: free autogenous muscle transplantation.
A new method is presented for the treatment of anal incontinence in children, including free autogenous muscle transplantation. The primary step is denervation of a skeletal muscle, which 2 wk later is transplanted and placed as a U-sling around the rectum, imitating the position and function of the puborectalis muscle. The transplant is placed in close contact with innervated muscles, which act as reinnervation sources. The results in five consecutive patients are highly promising. An early sign of improvement is the occurrence of a sensation of rectal fullness. All the patients reached an acceptable degree of continence, including abandonment of the use of napkins, 4-12 mo after surgery.
Adolescent↗