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Biomedical subjects

J J Bookstein

Publications and source records attributed to J J Bookstein.

At least 109 records · Page 6Linked to original sources
PubMed1977

Advantage of intraarterial over intravenous vasopressin infusion in gastrointestinal hemorrhage.

Recent laboratory data have suggested equivalent therapeutic value of selective intraarterial or peripheral intravenous infusions of vasopressin in the control of gastrointestinal bleeding. However, recent experience in two clinical cases continues to support a therapeutic advantage of the selective intraarterial route and casts doubt on the applicability of the laboratory results to man. Until further data is accumulated, it is premature to discard the presumed therapeutic advantage of the selective intraarterial infusion of vasopressin.

Adult↗
PubMed1977

Angiographic aspects of experimental nonocclusive intestinal ischemic injury.

An experiment was designed to fulfill the following aims: (1) to develop a model of nonocclusive intestinal ischemic injury compatible with survival for several days; (2) to determine the accuracy of angiography in diagnosing the presence and extent of intestinal ischemic injury; and (3) to determine the therapeutic and diagnostic value of intraarterial papaverine infusion. Experimental shock models were developed in the dog, and efficacy of the hypovolemic and normovolemic models was confirmed by gross and histologic evidence of intestinal injury in surviving dogs. No reliable angiographic signs of intestinal mucosal injury could be elicited. Angiographic abnormalities associated with the experiment were attributable to the shock itself and disappeared with the relief of shock. Infusion of papaverine into the superior mesenteric artery within 2 hr of the onset of shock prevented or ameliorated intestinal injury.

Angiography↗
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

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↗
PubMed1976

Adrenal imaging with 131I-19-iodocholesterol in the diagnostic evaluation of patients with aldosteronism.

The results of adrenal scintiscans, venograms and venous aldosterone levels are compared with the histologic findings in 33 patients submitted to operations for primary aldosteronism. Standard and suppression scintiscans were performed 2-14 days following intravenous administration of 2mCi of 131I-19-iodocholesterol. The adrenal lesions were histologically classified into four categories: 25 patients had adenomas, 6 had macronodular hyperplasia, 1 had microscopic hyperplasia and 1 had an adenocarcinoma. Asymmetrical uptake between the two adrenals seen on standard scintiscans did not differentiate between a tumor or asymmetrical hyperplasia, unless the tumor was greater than 2 cm in diameter. During suppression scintiscans, unilateral uptake visible within five days of tracer injection was consistent with adenoma. Patients with nodular hyperplasia demonstrated early uptake in both adrenal glands during suppression scintiscans, while the patient with microscopic hyperplasia did not. The type of adrenal lesion was correctly identified in 20/26 (77%) of patients by suppression scintiscans; 21/28 (75% of patients by venograms and 12/16 (75%) of patients who had adrenal venous aldosterone measurements attempted. The majority of surgically correctible lesions could be identified on suppression adrenal scintiscans. Adrenal vein catheterization can be reserved for those patients in whom the results of suppression scintiscans are inconsistent with the clinical degree of aldosteronism.

Adenoma↗
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

Angiography in Acute Pancreatic Transection.

Angiographic observations are described in 2 patients with acute traumatic transection of the pancreas. Abnormalities were subtle, and, in retrospect, suggestive of transection in only one case. Although angiographic abnormalities any imply acute pancreatic transection, absence of specific features does not exclude the diagnosis.

Adult↗
PubMed1975

Arteriography of renal transplants.

Arteriograms were reviewed in 60 cases of renal transplant dysfunction and correlated with the final diagnosis. Angiographic refinements included selective injections, 2-4X direct magnification, and flow-dependent injection rates. Angiography permitted recognition of common causes of post-transplantation dysfunction, including acute vasomotor nephropathy (AVN), acute refection (AR), chronic rejection, and obstruction of the ureter, renal artery, or renal vein. In 28 patients with AVN or AR who had technically adequate cortical microangiograms, classification was correct in 57%, indeterminate in 36%, and erroneous in 7%. In addition to its diagnostic value, angiography provides some prognostic information in AR, permitting prediction of functional return when the pattern suggests AVN and lack of return when cortical necrosis is indicated.

Acute Disease↗
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↗
PubMed1975

Pharmacoangiographic evaluation of the hemodynamic significance of coronary artery stenoses.

Acute stenoses of varying degree were produced in the circumflex arteries of 5 calves, and chronic stenoses which reduced blood flow by about 50% were effected in the left anterior descending coronary arteries of 14 dogs. Selective vasodilators or amyl nitrite increased blood flow more than 100% in nonstenotic arteries, but less in stenotic ones. Increased transstenotic blood flow was associated with an increased pressure gradient and increased frequency of collateral circulation. Collateral circulation was sometimes recognizable when the pre- and postvasodilatory angiograms were compared but not when the angiograms were examined individually. The altered flow patterns demonstrated by comparative studies may be a very sensitive index of collateral circulation.

Adenosine↗
PubMed1975

Renal artery dissection: a complication of catheter arteriography.

Renal artery dissection is a rare complication of catheter arteriography. Predisposing factors include atherosclerosis and fibromuscular dysplasia. Optimum management requires aortographic documentation of the extent of vascular obstruction. Dissections causing incomplete obstruction of blood flow can be treated with systemic anticoagulation to prevent downstream thrombosis and should be followed with serial isotope blood flow studies and LDH measurements. Dissection causing complete vascular obstruction usually requires immediate surgery, although spontaneous reestablishment of flow may occur. The 3 patients discussed illustrate a spectrum of findings, including the acute development of renovascular hypertension.

Adult↗
PubMed1975

Angiographic features of peripancreatic malignant lymphoma.

Angiographic features are described in 5 patients with peripancreatic lymphomas who initially presented with clinical features of primary pancreatic disease. Each patient demonstrated a large hypovascular mass with considerable displacement of pancreatic and peripancreatic arteries and associated compression of adjacent veins. Smooth arterial encasement was present in 2 cases. Signs of mass out of proportion to signs of invasion mitigated against the diagnosis of carcinoma in each case. Other differential diagnostic considerations are pancreatic pseudocyst and cystadenoma.

Aged↗
PubMed1975

Control of renal hemorrhage by selective arterial embolization.

An attempt was made to control renal hemorrhage by selective embolization of the renal artery in 7 patients. In 2 patients the bleeding site was single, but in 2 others, several sites of arterial extravasation were present. Two patients had arteriovenous fistulas, and 1 had an unsalvageable, macerated kidney. Six of the 7 patients (86 per cent) were treated successfully. Nephrectomy was avoided in 5. No patient developed hypertension during the follow-up of 4 months to 2 years. Our results in these patients indicate that selective arterial embolization should have an important place in the management of patients with renal trauma.

Adolescent↗
PubMed1975

[The value of roentgen examination in reno-vascular hypertension (author's transl)].

Renal arteriography plays a definitive role in diagnosis and evaluation of renal artery stenosis. Because of its high reliability and low risk, arteriography is more frequently being performed on the basis of clinical indications without reliance on screening tests. Arteriography will indicate the presence of stenosis, its cause, and the presence or absence of hemodynamic significance, and it is useful in evaluating the post-operative patient. Renal vein renin determinations are sometimes needed in evaluating the hemodynamic significance of the lesion. Arteriography may also reveal juxtaglomerular cell tumors, chronic renal inflammatory disease, or other diseases of renal parenchyma which could cause hypertension.

Adolescent↗