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Biomedical subjects

J J Bookstein

Publications and source records attributed to J J Bookstein.

At least 91 records · Page 5Linked to original sources
PubMed1980

Diagnosis of pulmonary embolism: experimental evaluation of the accuracy of scintigraphically guided pulmonary arteriography.

Technically refined angiograms and scintigrams were extremely sensitive in demonstrating experimental canine thromboemboli, both immediately after embolization and during the entire course of embolic lysis. Technical refinements included subselective, scintigraphically guided, magnification arteriography and eight-view perfusion scintigraphy. During thromboembolic lysis, excellent angiographic-scintigraphic correlation persisted. For every postembolic perfusion defect, the embolic basis could be demonstrated angiographically. Thus, apparent disparities between angiographic and scintigraphic evidence of embolism can no longer be attributed to lysis. Studies using nonresorbable Ivalon emboli indicated that localized spasm may play an important role in the perfusion defects that develop within a half hour after embolization, and that this spasm subsides considerably within 24 hours.

Angiography↗
PubMed1979

Control of hemorrhage from a common carotid arterial-cutaneous fistula by temporary implantation of a balloon catheter.

Hemorrhage from an infected carotid arterial-cutaneous fistula was treated by occlusion of the common carotid artery with a 6-French (Swan-Ganz) balloon catheter. After nine months, there was no recurrence of bleeding or neurological sequelae. Temporary balloon occlusion to induce thrombosis of a major artery is an alternative to transcatheter embolization of small particulate material and larger foreign bodies.

Adult↗
PubMed1979

Angiography of intussusception of the small bowel.

Angiography demonstrated intussusception in a patient with recurrent unexplained gastrointestinal hemorrhage after outside barium studies had been interpreted as normal. Magnification arteriography provided an unusually clear depiction of the anatomic derangement of intussusception.

Adult↗
PubMed1978

Preoperative localization of virilizing tumors by selective venous sampling.

Two postmenopausal patients with virilization had preoperative localization of ovarian tumors by selective blood sampling from both ovarian and adrenal veins and assay of hormone levels. In the first patient, the peripheral concentrations of testosterone (T), androstenedione, and estrone were 936, 1,508 and 73 pg. per milliliter, respectively, levels which are above the ranges found in normal postmenopausal women. The catheterization study showed an increase in the left ovarian vein of all hormones except cortisol. It was predicted that a tumor was present in the left ovary. At operation a 7 by 4 mm. lipid cell tumour was found. In the peripheral blood of the second patient, the T level (4,518 pg. per milliliter) was markedly elevated and the estradiol concentration (73 pg. per milliliter) was increased. At retrograde catheterization the concentration of T in the right ovarian vein was markedly elevated at 120,400 pg. per milliliter. At operation a hilus cell tumor of the right ovary was found. These two cases represent the third and fourth consecutive androgen-secreting tumors from this institution that have been localized by selective ovarian and adrenal vein catheterization and sampling.

Adrenal Glands↗
PubMed1978

Therapeutic angiography. Its value to the surgical patient.

Standard angiographic techniques formerly used exclusively as diagnostic modalities have been modified to serve as definitive or adjunctive therapeutic measured. The techniques include transcatheter embolization; infusion of vasoactive drugs, chemotherapeutic agents and radioactive particles; tamponade of bleeding arteries and balloon catheters; extraction of vascular foreign bodies and retained biliary tract stones and transluminal arterial dilation. These techniques have been proved effective and safe when used judiciously.

Adult↗
PubMed1978

Rectal bleeding secondary to fecal disimpaction: angiographic diagnosis and treatment.

Two cases of bleeding caused by manual disimpaction of fecal material are presented. Angiography played a critical role in the diagnosis and treatment. One case was managed with balloon tamponade, and the other was successfully treated by selective intra-arterial vasopressin infusion, after prior intravenous infusion had been ineffective. A history of fecal disimpaction should suggest the possibility of low rectal bleeding which can be diagnosed and treated angiographically.

Adult↗
PubMed1978

Transcatheter embolization for lower gastrointestinal bleeding.

Transcatheter embolization was performed in 7 patients with lower gastrointestinal bleeding. Hemorrhage was controlled in each of the 5 actively and massively bleeding patients but recurred after several months in 2 patients who had bled intermittently from vascular dysplasias. The authors recommend preoperative angiographic localization of the bleeding site in almost all cases of major lower gastrointestinal bleeding. When the cause and bleeding site have been identified, it seems reasonable to exploit the therapeutic potential of the angiographic catheter already in place: indeed, surgery may be obviated. If embolism fails or ischemic sequelae develop, partial colectomy can still be performed. Further long-term follow-up will be necessary before the role of transcatheter embolization can be definitively assessed.

Aged↗
PubMed1977

Cooperative study of radiologic aspects of renovascular hypertension. Bilateral renovascular disease.

Abnormal urographic features were present in 60.7% of 250 patients with bilateral diseases. The urogram was relatively insensitive in the minority of patients whose lesions were of approximately equivalent severity bilaterally. In bilateral renovascular disease, the urogram demonstrated some surgical prognostic value that was not evident in unilateral renovascular disease. Furthermore, in patients with bilateral disease, the urogram was helpful in deciding between unilateral or bilateral operation.

Arteriosclerosis↗
PubMed1977

Therapeutic embolization for intractable chronic bleeding.

Intractable, chronic vaginal and/or vesicle bleeding complicating pelvic cancers in five women was treated by transcatheter embolization of the hypogastric artery or its branches. Bleeding was presumed to be from hypervascular granulation tissue formed in response to irradiation in two patients and from tumor tissue in three. The embolic materials were Gelfoam and Oxycel reinforced autologous clots. Bleeding was stopped or reduced in volume by at least 90% in each patient. This form of therapy was useful even though bleeding site was not demonstrated angiographically.

Chronic Disease↗
PubMed1977

Transcatheter embolization for treatment of diverticular hemorrhage.

Two patients underwent transcatheter embolization for control of massive diverticular hemorrhage after vasopressin infusion had failed to control the bleeding. The role of angiography in the management of diverticular bleeding is discussed. If surgery is being considered, angiography should be utilized to localize the bleeding site and to permit limited colonic resection. Transcatheter embolization is proposed as an alternative to operative intervention.

Aged↗
PubMed1977

Sodium nitroprusside in the treatment of ergotism.

Severe peripheral vasoconstriction of the legs due to hypersensitivity to small doses of ergotamine tartrate developed in a patient with migraine headaches. The vasospasm was successfully treated with continuous intra-arterial and intravenous infusion of sodium nitroprusside. The contribution of angiography in the diagnosis and treatment of ergotism is stressed.

Adult↗
PubMed1977

Angiography of massive hemorrhage secondary to pancreatic diseases.

Twenty patients with massive abdominal hemorrhage related to chronic pancreatitis, pancreatic neoplasms and arteriovenous malformations were studied angiographically. Abdominal hemorrhage drained most frequently into the gastrointestinal tract, but also flowed through cutaneous drain sites and fistulas, intraperitoneally, into pseudocysts and once into a large pancreatic tumor. The most common angiographic observation in pancreatitis was pseudoaneurysm formation. Both patients with arteriovenous malformation had dilated, racemose feeding arteries and early dense filling of the draining veins. Three patients had pancreatic carcinoma and documented bleeding from gastroesophageal varices related to portal or splenic vein occlusion by the tumor. Five patients were treated by vasopressin infusion, balloon tamponade, or therapeutic embolization.

Adult↗
PubMed1977

The role of bronchial arteriography and therapeutic embolization in hemoptysis.

A case is presented which demonstrates the value of bronchial arteriographic studies in localizing and treating hemoptysis. The patient was bleeding from an old post-tuberculous bulla and for several reasons was not a candidate for surgery. Bronchial arteriographic studies demonstrated both hypervascularity in the region of the cavity and also a mycotic aneurysm of a bronchial artery. After therapeutic embolization with gelatin (Gelfoam), the hypervascularity and aneurysm were no longer opacified. Active bleeding abruptly ceased and, except for a single mild recurrence, has not recurred during the three months since therapeutic embolization. The major theoretic risk of bronchial arteriographic study and therapeutic embolization is spinal injury. It is believed that permanent injury can almost be avoided, providing proper technique is used.

Bronchial Arteries↗