Biomedical subjects
Publications and source records attributed to H K Pedersen.
Angiography of 169 patients who had been treated successfully with PTCA showed restenosis in 61. Of these, 38 were successfully treated with a new PTCA, and six developed a new restenosis. Restenosis usually appears during the first four months after PTCA in vessels with a diameter less than three millimeters. The authors emphasize the importance of careful clinical follow-up.
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Three hundred and twenty consecutive patients with hypertension were referred to examination with intravenous urography. Only 2 of the 320 urograms performed showed abnormalities possibly related to hypertension. Renal angiography was performed in 39 (12%) of the patients. Seventeen (7%) subjects had renal artery stenosis, of whom 8 (2.5%) were referred to surgery. Four became normotensive and the other 4 had a more treatable hypertension. Urography is an expensive and insensitive method for evaluation of patients with hypertension and should be abandoned. Proper treatment of renovascular hypertension demands the performance of renal angiography. We therefore suggest a program for primary use of renal angiography in the examination of patients with suspected renovascular hypertension.
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This report derives from Tromsoe in northern Norway. In a retrospective study of the indications for intravenous urography (IU) and the findings at IU in 740 patients (451 girls and 289 boys) aged 0-19 years, we found that urinary tract infections accounted for 69.4% of the IU in females 30.1% of the IU in males, most often seen in the youngest patients. The pathological findings most frequently seen were anomalies (17 females and 10 males) and urinary tract obstruction (3 females and 15 males). The present study indicates the following: first, that the yield of IU in the primary investigation of children and youth suffering from enuresis and non-specific abdominal disturbancies is small; and second, that the use of IU in children and youth with urinary tract infection and haematuria should be questioned and reconsidered.
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Intravenous urography (IU) was performed in 489 patients aged 0-9 years during 1980-1983. A total of 35 (7.2%), 19 (13.1%) boys and 16 (4.7%) girls had pathological changes at IU. Of these, 11 boys and 5 girls had findings with therapeutic consequences. We have analysed the results of IU and voiding cystoureterography (VC) in 62 patients and show that a normal IU does not exclude vesicoureteral reflux into the renal pelvis. By performing only VC hydronephrosis, pyelonephritic scarring and anomalies may be missed.
In a retrospective study on diagnostic imaging of the stomach and large bowel, we evaluated the examination routines in six Norwegian hospitals for the period between 1975 and 1992. For both organ systems, a shift in routines from radiological examination toward endoscopy was observed. For the stomach there was a significant correlation between an increase in the use of endoscopy and a decrease in the use of X-ray examinations. Additionally, the total number of stomach examinations had declined. For the large bowel, the total number of endoscopic and radiological examinations had increased for all hospitals studied. While not as prominent as for the stomach, an obvious shift from X-ray examinations toward endoscopy was observed. These results should be considered when planning new imaging departments and hospitals in Norway.
Diagnostic imaging routines have changed rapidly during the last two decades. The real revolution started with the introduction of computed tomography into routine clinical work in the middle of the 1970s. Simultaneously, a tremendous sophistication of ultrasonography took place, and shortly later, magnetic resonance imaging started its "career." The present report explores how the introduction of computed tomography changed imaging routines in two major Norwegian hospitals during the last 10 to 15 years.
It has been assumed that the introduction of ultrasonography in diagnostic imaging has led to dramatic changes in imaging routines by replacing other modalities like angiography, intravenous urography, and computerized tomography in several diagnostic procedures. The present retrospective study from five Norwegian hospitals during the period from 1978 to 1991 confirm this assumption, showing how ultrasonographic examinations have influenced diagnostic routines.
The roles of liver scintigraphy in addition to other imaging modalities of the esophagus and the small bowel and the use of abdominal flat films were studied in six Norwegian hospitals between 1975 and 1993. Parallel to the introduction of ultrasonography, the use of liver scintigraphy disappeared almost completely. Barium studies of the esophagus, to some degree, have been replaced by endoscopy, whereas use of barium studies of the small bowel remained unchanged or increased. The number of flat-film studies of the abdomen performed remained unchanged.
In a six-year period (1982-1987), 248 patients were treated with 297 procedures (percutaneous transluminal coronary angioplasty, PTCA) on 282 vessels. Two hundred and fifty-nine (87.2%) of the procedures in 210 (76.7%) of the patients appeared successful angiographically. Thirty-eight procedures were unsuccessful due to failure to pass the stenosis in 18 patients, dissection or occlusion of the treated vessel in 11, and significant residual stenosis in 9 patients. Emergency operations were performed after 11 (3.7%) of the procedures. Two patients died postoperatively. Myocardial infarction was seen in 13 patients, of whom 4 developed pathologic Q-waves in their ECG. Restenosis occurred in 60 (28.6%) of the patients. In the last year of the study, the patients selected for PTCA were in a poorer state angiographically, but the results of PTCA were better, without any increase of the complication rate. Our results, which are in accordance with others, support the concept that PTCA is a relatively safe procedure with a primary success rate of almost 90 percent. However, approximately one third of the patients developed restenosis, which in most cases occurred within 3 months.