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Biomedical subjects

M Appleberg

Publications and source records attributed to M Appleberg.

At least 55 records · Page 3Linked to original sources
PubMed1982

Radiological diagnosis of carotid ulceration.

The standard radiological reports of 50 carotid angiograms were reviewed with regard to the presence of ulceration at the carotid bifurcation. The angiograms were then specifically re-examined retrospectively by a radiologist and the presence or absence of ulceration commented on. The macroscopic features of the carotid endarterectomy specimens of the same patients undergoing carotid endarterectomy were then examined by an independent observer. The results of these three examinations were then compared. There were 28 ulcers in 23 of the 50 specimens with 12 large ulcers (greater than three mm diameter) and 16 small ulcers (less than three mm). In the diagnosis of ulcers, the initial radiological report showed a sensitivity of 32% and a specificity of 97.2%, with an accuracy of 79%, whilst on the retrospective search for ulcers the sensitivity rose to 67.8% whilst the specificity fell to 55.5%, with an accuracy of 59%. The factors affecting the accuracy of the detection of carotid ulcers by angiography are discussed. Angiography in its present form has limitations in diagnosing carotid ulceration.

Carotid Arteries↗
PubMed1982

Cystic adventitial disease of the popliteal artery: a report of two cases and a review of the literature.

Cystic adventitial disease is a rare condition affecting the wall of certain major arteries. The case histories of two patients presenting to the Royal North Shore Hospital are reviewed. Both patients were young men who presented with unilateral incapacitating calf claudication of sudden onset. Lower limb arteriography on each affected leg revealed a peculiar irregularity of the popliteal artery. Each patient had the popliteal artery explored and similar findings were revealed viz: an extensive cyclic lesion occupying the adventitial layer of the popliteal artery. The cysts were found to contain mucoid material. It was not necessary to enter the arterial lumen in either case. As far as can be established both patients have remained asymptomatic after the simple procedure of evacuating mucoid material from the cysts.

Adult↗
PubMed1982

The limitations of B-mode imaging of the carotid bifurcation: a comparison with three flow-dependent non-invasive tests.

Three hundred and four carotid arteries in 152 patients presenting with cerebral symptoms or asymptomatic carotid bruits were scanned with a real time B-mode scanner. These patients were also submitted to three other non-invasive screening modalities of Oculoplethysmography (OPG), Periorbital Doppler (POD) and Carotid Phonoangiography (CPA). Contrast angiography was performed on 57 patients (114 arteries). Lesions greater than 50% luminal reduction were considered haemodynamically significant. B-mode identified these lesions with a sensitivity of 75.5% and a specificity of 80.3%. Combined with OPG the sensitivity reached 96.2% but with a reduction of the specificity to 73.8%. In defining the need for angiography, no individual with a potentially surgically correctable lesion was incorrectly refused angiography. The limitations of real time B-mode scanning of the carotid bifurcation are enumerated.

Carotid Artery Diseases↗
PubMed1982

Real-time intraoperative angiosonography after carotid endarterectomy.

Real-time intraoperative angiosonography is a readily available and simple means of obtaining high-resolution imaging of the carotid vessels after endarterectomy. In an experience of 60 intraoperative scans, nine abnormalities (15%) were detected, or which 4 lesions were hemodynamically significant. Three of these abnormalities were in the external carotid artery, and one was in the common carotid artery. The detection of these defects, which usually were not obvious during palpation or inspection, enabled immediate reexploration and correction of the fault to be undertaken. The considerable advantages of the intraoperative method of scanning over the transcutaneous technique and operative angiography are discussed. Immediate intraoperative angiosonography is recommended for routine use after carotid endarterectomy.

Carotid Arteries↗
PubMed1982

A comparison of two techniques for the detection of the vasculogenic component of impotence.

Eighty-six patients have been evaluated in the vascular laboratory with regard to vasculogenic impotence. Doppler ultrasound and a new method, photoplethysmography, have been used alone and in combination, compared and correlated with the results of psychiatric therapy. Doppler ultrasound and the photoplethysmographic techniques give almost identical results apart from the zero reading on the Doppler recordings which correlates poorly with the results of psychotherapy and photoplethysmographic findings. The photoplethysmographic technique is quicker, more esthetically acceptable and is, therefore, the method of choice for the assessment of the vasculogenic component of impotence.

Blood Pressure↗
PubMed1980

Ruptured abdominal aortic aneurysm: long-term survival after operation.

The long-term follow-up of 65 patients surviving surgery for ruptured abdominal aortic aneurysms is presented. Fifty-six per cent of these patients were alive at the time of review, having survived for a mean period of 36 months. The majority were enjoying a quality of life similar to that experienced before operation. Preexisting ischaemic heart disease did not alter the long-term prognosis. Cumulative survival curves for this group of survivors approximated both the survival curve for the average matched Australian population and similar curves constructed for patients operated upon electively for abdominal aortic aneurysms.

Adult↗
PubMed1977

Graduated internal dilatation in the treatment of fibromuscular dysplasia of the internal carotid artery.

A patient with transient ischaemic attacks due to fibromuscular dysplasia of the internal carotid artery is presented. Standard methods of vascular reconstruction may not be possible as the disease often involves the distal half or two-thirds of the extracranial internal carotid artery. For this reason the technique of graduated internal dilatation first described by Morris et al. was employed and showed satisfactory results on short-term follow-up.

Adult↗
PubMed1976

The value of the postoperative temperature chart as an aid to the diagnosis of deep vein thrombosis.

Forty consecutive patients with an abnormal postoperative pyrexia were investigated for deep vein thrombosis (DVT). All 80 lower limbs were examined by means of Parks 801 or 806 Doppler ultrasound apparatus. Doppler findings were confirmed by ascending peripheral venography or by the 125I-fibrinogen uptake method, or by both methods, in all cases. DVT was present in 9 limbs (11%). In 89% of the limbs DVT was excluded. An abnormal postoperative pyrexial response, as defined in this text, is thus a poor sign of DVT. It should, however, not be ignored, as it was indicative of venous thrombosis in 15% of the patients in this study. Confirmation of DVT should be obtained wherever possible by ascending peripheral venography, Doppler ultrasound, or some other available method. The use of anticoagulants should be restricted to those patients in whom the diagnosis has been confirmed.

Fever↗
PubMed1976

The diagnosis of deep vein thrombosis in the lower limbs by means of the transcutaneous Doppler ultrasound method.

The transcutaneous ultrasonic flow velocity meter was employed in 120 limbs in which the presence of deep vein thrombosis was suspected. In 115 of these limbs confirmation of the ultrasound findings was obtained by venography or 125I-fibrinogen scanning, or both. The overall accuracy rate of the ultrasonic method was 90%, with a 3% false positive and a 7% false negative incidence. It is concluded that the transcutaneous ultrasound technique provides a reliable, rapidly available, non-invasive method to confirm the diagnosis of deep vein thrombosis.

False Negative Reactions↗
PubMed1976

The need for objective diagnosis of deep vein thrombosis.

In a series of 81 limbs in which the clinical diagnosis of deep vein thrombosis was suspected, objective confirmation could be obtained in only 24 or 30%. Of the patients who presented with signs and symptoms of deep vein thrombosis confined to the calf, the diagnosis was confirmed in only 37%. In view of the attendant morbidity and mortality associated with anticoagulation therapy, it is suggested that in all patients in whom the clinical diagnosis of deep vein thrombosis is made, objective confirmation should be obtained by one or more of the currently available methods, before the initiation of long-term anticoagulation therapy.

Fibrinogen↗
PubMed1976

Graft sepsis.

Explore the source record for details and available documents.

Blood Vessel Prosthesis↗
PubMed1975

Congenital atresia of the external iliac artery.

A patient with congenital atresia of the external iliac artery is presented. Successful revascularisation was acheived by means of an ileofemoral reversed long saphenous vein graft. The embryology of this malformation is discussed.

Adult↗
PubMed1975

Evaluation of aorto-iliac disease with Doppler ultrasound and isotope clearance techniques.

The clearance of 99mTc from the hamstring muscle compartment of patients with aorto-iliac or iliac disease was examined with the patients at rest and after exercise. The values were compared with those obtained in a group of controls and another group with superficial femoral, or femoropopliteal arterial occlusion. A statistically significant difference in the rate of 99mTc clearance was found in patients with proximal vascular disease.

Ankle↗