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Biomedical subjects

H P Jander

Publications and source records attributed to H P Jander.

At least 19 recordsLinked to original sources
PubMed1983

The coexistence of renal artery stenosis and pheochromocytoma.

The coexistence of renal artery stenosis and pheochromocytoma has been recognized since 1958 and a total of 36 patients reported. This article provides an additional patient with an extra adrenal pheochromocytoma and fibrous bands constricting the left renal artery. Hypertension was confirmed to occur from both excess catecholamine production and hyperreninemia from the left kidney. Surgical removal of the functioning paraganglioma and correction of the renal artery stenosis restored the postoperative plasma catecholamine, renin, and blood pressure to normal. A literature review confirmed the coexistence of these two lesions but failed to provide a common etiology to explain the pathophysiology encountered. However, when the two diseases occur simultaneously, both must be diagnosed accurately and treated in a definitive manner.

Adolescent↗
PubMed1980

Balloon dilatation of urethral strictures.

Postinflammatory and posttraumatic urethral strictures present a significant clinical problem. Conventional dilatation techniques are usually associated with recurrence and aggravation of the strictures. This is attributed to the mucosal and periurethral trauma associated with conventional dilatation methods. The initial results in seven patients undergoing balloon dilatation for urethral strictures are presented. The method is relatively atraumatic and painless, and better long-term results are anticipated.

Aged↗
PubMed1980

Percutaneous transhepatic cholangiography using the Chiba needle: comparison with retrograde pancreatocholecystography.

We have reviewed 103 consecutive percutaneous transhepatic cholangiograms (PTC). Although 70% of these examinations were performed by inexperienced radiologists, the success rate for entering bile ducts (overall 87.4%; in obstruction 98.5%; in nonobstructed cases 65.7%) and the complication rate (12.6%) is similar to that reported in large series by experienced workers. While examiner expertise therefore apparently has little or no influence on the success rate of PTC, the reverse is true for endoscopic retrograde cholangiopancreatography (ERCP). Here the success rate is directly proportional and the complication rate inversely proportional to examiner experience. Since PTC is easier to perform and is more accurate and much less time-consuming and costly than ERCP, it should be the method of choice in the differentiation of obstructive and parenchymal jaundice.

Biliary Tract Diseases↗
PubMed1980

Transcatheter gelfoam embolization in abdominal, retroperitoneal, and pelvic hemorrhage.

Clinical experience with Gelfoam embolization for arterial hemorrhage in 55 patients is described. This technique controlled hemorrhage in 51 patients (92.7%). Two patients (3.6%) died of complications related to embolization. Gelfoam can be a permanent occluding agent which does not require subselective catheter position for effectiveness and safety. The advantages of Gelfoam are its availability, low cost, the ease and speed with which it can be applied through conventional catheters, and its safety and effectiveness if properly applied. The data presented here, and those in the literature, indicate that transcatheter therapeutic embolization for arterial bleeding below the diaphragm is by far the safest and most effective method available.

Abdominal Injuries↗
PubMed1980

The parathyroid artery.

Each parathyroid gland is supplied by a single individual artery, the parathyroid artery. Although discovered over 80 years ago, this fact has been ignored in anatomic texts and angiographic literature. The origin and length of the parathyroid artery very with the location of parathyroid tissue. If the parathyroid tissue is located posterior or caudal to the thyroid gland in the lower neck or mediastinum, the parathyroid artery arises as a prominent proximal branch of the inferior thyroidal artery. In this situation it is easily recognizable angiographically and can be useful in identifying low-lying parathyroid lesions. Of 35 angiograms obtained in 19 patients, the parathyroid artery supply in another low cervical and a mediastinal lesion. In two lesions, one of which was intrathyroidal, the blood supply was indeterminate. The parathyroid artery was recognized in eight of nine low cervical or mediastinal parathyroid lesions, but only in four of 10 lesions at or above the thyroid level. The parathyroid artery does not contribute to thyroidal blood supply.

Adenoma↗
PubMed1980

Toxic megacolon due to ischemic enterocolitis associated with retroperitoneal fibrosis.

A 46-yr-old man, in whom retroperitoneal fibrosis had been found 4 yr previously, presented with abdominal pain, fever, diarrhea, and marked dilation of the transverse colon with superficial ulceration. The megacolon was unresponsive to nasogastric suction, corticosteroids, antibiotics, and total parenteral nutrition. Arteriograms revealed total occlusion of the celiac axis and superior and inferior mesenteric arteries. Laparotomy showed encasement of the retroperitoneal vessels by dense fibrous tissue. A vascular bypass graft was performed, connecting the distal superior mesenteric artery to the right external iliac artery. This led to complete and lasting resolution of gastrointestinal complaints.

Aortography↗
PubMed1979

Epinephrine enhanced renal angiography in the diagnosis of hamartoma (angiomyolipoma): a reevaluation.

The vlue of epinephrine enhanced angiography in the preoperative distinction of isolated hamartoma (angiomyolipoma without stigma of tuberous sclerosis) from hypernephroma has been largely discounted in the past. The authors performed this procedure in 6 patients (4 with isolated hamartoma and 2 with tuberous sclerosis complex). Vasoconstriction of the tumor vessels in the isolated group suggested the benign nature of the hypervascular mass in all cases. Vasoconstriction stronger than that of normal parenchymal vessels suggested the diagnosis of isolated renal angiomyolipoma. This form of pharmacoangiography should be part of the routine preoperative workup of all solid renal masses.

Adenocarcinoma↗
PubMed1979

Selective angiography in renal and peri-renal inflammatory lesions: correlation with histopathology.

We have correlated the angiographic and pathological findings in renal and peri-renal inflammatory disease in acute, sub-acute and chronic phases. In all stages of renal infection, the renal vasculature is attenuated. This corresponds in acute inflammation to vasospasm, acute vascular necrosis and post glomerular peritubular capillary congestion. In sub-acute inflammation, the reduction in vascularity is due to peri-vascular fibrosis and intimal and medial hyperplasia. In chronic infections, the renal vessels are completely destroyed and replaced by fibrotic tissue. In contrast to this, peri-renal inflammatory disease leads to vaso-dilatation and enlargement of the renal capsular arterial complex, and of retroperitoneal arteries. If both renal and peri-renal inflammation occurs simultaneously, a discordance between the renal cortical and capsular arterial filling results: this striking phenomenon is highly suggestive of inflammation, and extremely rare in tumours. Three types of inflammatory vascularity are described, two of which can be easily distinguished from tumour vascularity. An inflammatory blush, slow emptying of vessels and a mottled nephrogram with loss of cortical definition are highly suggestive signs of renal inflammation. It is concluded that angiography is a sensitive and accurate method for the early diagnoses of renal and peri-renal flammatory conditions.

Acute Disease↗
PubMed1979

The hypernephroma halo.

Most renal adenocarcinomas (hypernephromas) are characterized histologically by a dense, avascular, fibrous capsule. This capsule is rare or nonexistent in other benign or malignant renal tumors. The capsule was identified as a thin radiolucent stripe surrounding parts of the tumor periphery in 30 renal angiograms performed on a group of 70 patients with pathologically proven hypernephromas. Only one of 65 normal kidneys and 137 other benign or malignant renal tumors or pseudotumors exhibited angiographic evidence of this lucent stripe. This stripe is therefore referred to as the "hypernephroma halo." Its identification on an excretory urogram is occasionally possible; in five patients it was recognized prior to angiography suggesting the lesion causing it is a hypernephroma.

Adenocarcinoma↗