[Comparison between antazoline and verapamil in the treatment of paroxysmal supraventricular tachycardia].
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Biomedical subjects
Publications and source records attributed to J F Pedersen.
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An ultrasonic multitransducer scanner has been developed. It works in combination with a conventional echocardiograph and is capable of instant dynamic cross-sectional imaging of the heart. A 10 cm wide area is scanned by 50 parallel sound beams, spaced 2 mm apart, at a frame rate of 36 per second. The equipment is described and preliminary clinical experience is reported. The scanner has been used for routine heart examinations and for obstetrical and abdominal scanning as well.
A technique for percutaneous puncture guided by real-time scanning is described. By means of a special puncture adaptor fastened to one end of a multitransducer, a needle can be guided in the plane of scanning in an adjustable angle to the transducer front. By this technique, the puncture target as well as the needle can be monitored on the real-time image during the entire puncture procedure. The technique has been used for amniocentesis, fine needle biopsy of a renal mass, renal cyst puncture, and pericardiocentesis.
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Twenty-seven consecutive patients with endocrinological disease necessitating adrenal surgery underwent blind preoperative investigation with ultrasound, renal aortography, and adrenocortical scintigraphy for an adrenal lesion. Nine patients had pituitary-dependent Cushing's syndrome, five had pituitary-independent Cushing's syndrome, four had an adrenocortical androgenic excess, and nine had a preoperative diagnosis of phaeochromocytoma. The predictive value of preoperative ultrasound was 100% for a positive finding and 79% for a negative result. Preoperative aortography had a predictive value of 83% for a positive finding and 64% for a negative result; and the predictive value of adrenocortical scintigraphy was 100% for a positive finding and 85% for a negative finding. In localising biochemically suspected adrenal lesions ultrasound should be the first choice, since it is rapid, noninvasive, cheap, and reasonably accurate. Adrenocortical scintigraphy has a similar diagnostic value, especially in Cushing's syndrome, but it is time consuming. Nevertheless, it may be preferable for diagnosing small glucocorticoid-secreting adenomas. Aortography should be reserved for cases with inconclusive diagnoses and suspected extra-adrenal phaeochromocytomas.
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Ultrasonically-guided percutaneous nephrostomy using the Seldinger technique was attempted on 24 kidneys in 19 patients with obstructive hydronephrosis. Seventeen of the procedures were successful, 4 failed, and in 3 the catheter slipped out of the renal pelvis 1-48 hours after insertion. The procedure is simple and independent of renal function. Postrenal uremia can be relieved, infected hydronephrosis drained prior to elective surgery, and urinary parameters assessed. Injection of contrast material can define pathological anatomy in those cases where excretory urography and retrograde pyelography are unsatisfactory. No significant complications were encountered.
Fifteen pancreatic cysts have been successfully punctured percutaneously under the guidance of ultrasonic B scanning. The procedure may be used for verification of ultrasonic diagnosis, for definitive therapy, for decompression in the case of threatening rupture and for allowance of time for maturation of the cyst membrane before surgical intervention.
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An ultrasonic method to diagnose acute testicular torsion is presented. With the doppler principle the presence of absence of intratesticular arterial pulsation can be demonstrated. In 5 patients with acute testicular torsion and 10 patients with epididymitis a correct ultrasonic diagnosis was made. In long-standing torsions some arterial pulsation may be present.
In 14 patients with an indwelling catheter, 48 different determinations of bladder volume were made using 5 different ultrasonic methods. The simplest procedure, the largest sagittal diameter of the bladder in the median plane, gave only a rough estimate of the bladder volume. The product of bladder depth, height, and width, as determined from transverse and sagittal scans, showed the best correlation to the true bladder volume (r equals 0.90). Computerized reconstruction of multiple serial cross sections proved less accurate than the much simpler depth, height, width product. None of the methods for quantitation of small volumes was good, but qualitative determination of small volumes was accurate.
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