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Biomedical subjects

J F Walter

Publications and source records attributed to J F Walter.

52 records · Page 3Linked to original sources
PubMed1976

The treatment of acute traumatic rupture of the aorta: a 10-year experience.

Forty-three patients with aortic rupture secondardy to blunt trauma have been treated at the University of Micigan within the past 10 years with an overall salvage rate of 70%. The diagnosis should be suspected in anyone who has sustained a high speed decelerating injury, if the chest roentgenogram shows media-stinal widening, whether or not there is hypertension of the upper extremities; systolic murmur, or external evidence of chest injury. Aortography should be employed to confirm the diagnosis and to determine the site or sites of rupture. Repair of the lesion should be undertaken as soon as possible and takes priority in most instances over associated injuries. Repair in almost all cases can be accomplished safely and quickly using a bypass shunt without the aid of extracorporeal circulation.

Accidents, Traffic↗
PubMed1976

Newer angiographic observations in cholangiocarcinoma.

Three new angiographic features of cholangiocarcinoma are bile duct dilatation, venous obstruction and arterio-arterial collaterals. Differentiation of the lucencies of dilated bile ducts (cylindrical in shape) from those due to metastases (spherical) is discussed. Because of its high reliability and the difficulties of operative diagnosis, angiography can play an important diagnostic role in patients with suspected cholangiocarcinoma.

Adenoma, Bile Duct↗
PubMed1976

Arteriographic diagnosis of a gunshot injury to the ureter.

A gunshot wound to the ureter was diagnosed anigiographically. Such injuries are not common; however, they are frequent enough and the consequences of delayed diagnosis and secondary repair are serious enough that ureteric injury should be considered in all cases of abdominal trauma.

Adult↗
PubMed1976

Pharmacoangiographic manipulation of renal collateral blood flow.

Vasodilatory or vasoconstrictive renal pharmacoangiography was applied in investigating the significance of 50 renal artery stenoses. The technique involves comparison of selective magnification renal arteriograms before and after intra-arterial injection of epinephrine or acetylcholine, seeking changes in direction of flow in potential collateral routes. The drug injected depended upon the hemodynamic conditions during control arteriography. Final determination of significance depended on response to surgery in most patients, and renin levels in a few. Vasoconstrictive angiography was determinate in 18/26 (69%) of significant stenoses and correctly identified hemodynamic significance in each. Other angiographic signs of collateral circulation were present in seven of the other eight significant stenoses studied with the vasoconstrictive method. Vasodilatory pharmacoangiography was determinate in 20 arteries, and correctly evaluated each of nine significant and 11 insignificant lesions. Pharmacoangiography is a moderately sensitive and completely specific angiographic method for evaluating the hemodynamic significance of renal artery stenoses.

Angiography↗
PubMed1975

Hepatic cell adenomas, spontaneous liver rupture, and oral contraceptives.

During the past decade, an increasing number of hepatic cell adenomas have been reported. Sppntaneous rupture, a life-threatening complication of this rare tumor, has been noted more frequently. Eight patients with hepatic cell adenomas have been treated at our center. Three patients first developed symptoms from hemoperitoneum. Palpable tumors were discovered in three asymptomatic patients during routine examinations. Two patients had upper abdominal pain from intrahepatic hemorrhage. All patients were young women using oral contraceptive agents. Emergent hepatic lobectomy was performed in the three patients with rupture. The other five patients underwent selective angiographic studies, prior to elective liver resections. All survived operation and have done well since. The increased incidence of hepatic cell adenomas may be related to the use of oral contraceptive agents.

Adenoma↗
PubMed1975

Renal artery aneurysms. Significance of macroaneurysms exclusive of dissections and fibrodysplastic mural dilations.

Seventy-two patients (39 females and 33 males), 9 to 84 years in age, exhibited a total of 94 renal artery macroaneurysms. Solitary aneurysms affected 53 patients, and multiple aneurysms occurred in 19 patients. Arteriosclerotic changes, observed in nearly 30% of aneurysms, were considered secondary rather than primary processes in most instances. Renal artery fibrodysplasia was an associated finding among 27 patients. In 57 hypertensive patients, evidence supportive of renal artery aneurysms contributing to elevated blood pressure was meager. Two patients experienced frank aneurysmal rupture. Covert rupture into renal veins occurred twice. Aneurysmectomy was performed on 31 occasions. Nephrectomy, partial as well as total, was performed 17 times. No operative mortality occurred. Potential for rupture and an association with functionally important renal artery stenoses support surgical intervention in selected patients with renal artery macroaneurysms.

Adolescent↗
PubMed1975

Lymphangiographic findings in histoplasmosis.

The lymphangiographic findings of histoplasmosis in an 11-year-old girl are presented and correlated with the histopathology of a mediastinal lymph node. Nonconfluent lymphadenographic defects with discrete margins measuring 2-4 mm in diameter were seen, corresponding to the microscopic demonstration of nodal granulomas of the same size. This is quite different from the lymphadenographic pattern usually present in lymphoma but might be seen in certain stages of other granulomatosis diseases.

Child↗
PubMed1975

Histological-venographic correlates in portal hypertension.

Magnification hepatic wedge venography and manometry were evaluated in 40 patients with portal hypertension and in 6 normal individuals. Venography (alone or in combination with manometry) generally facilitated prediction of histology in cirrhosis, hepato-venular occlusive disease, periportal fibrosis, congenital hepatic fibrosis, and portal vein obstruction. The magnification wedge venograms demonstrated a number of histological features of cirrhosis that have not previously been described in vivo, including porto-hepatic vein shunts, micro- and macronodular regeneration, and obstructive changes which were more severe in hepatic than in portal veins.

Alcoholism↗