Biomedical subjects
Publications and source records attributed to M Kunnen.
In a patient with weight loss and a systolic epigastric murmur, aortography demonstrated positional celiac axis occlusion. Color Doppler imaging of the celiac axis showed occlusion in the supine position, but patency was documented during deep inspiration and with the patient in the upright position. This report documents a rare example of extreme celiac axis compression with position-dependent celiac patency.
The performance characteristics of a 50 microns niobium filter and a copper filter of equivalent thickness (0.15 mm) were compared for postero-anterior chest X-ray examination. Radiographs of 20 patients obtained using an automatic exposure control device showed no significant differences in image quality and exposure setting between the filters. Radiation dose distributions measured in a Rando phantom revealed a higher reduction in the patient dose with the niobium filter. The reduction in the effective dose equivalent, produced by the addition of the niobium and copper filters to the standard filter of 2.5 mm aluminium, of 17% and 10%, was relatively small compared with the reductions in the entrance surface dose of 31% and 26%. Our study confirms that drastic alterations in the patient dose by the addition of a dose reduction filter to the usual filtration cannot be expected.
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The typical pathological finding in the pancreas of patients with the Shwachman-Diamond syndrome is fatty infiltration. In this report it is emphasized that this lipomatosis can be demonstrated by non-invasive techniques, using abdominal ultrasound and CT-scan.
Retrospective analysis of 100 patients treated for varicocele-associated infertility by means of transcatheter embolization with 2-isobutyl-cyano acrylate (Bucrylate, Ethicon Inc., Somerville, NJ) reveals that the age of the man and the duration of infertility do not influence the probability of pregnancy after treatment. Patients treated for subclinical varicoceles had the same probability of success as patients with larger varicoceles. The following factors were found to have predictive power as far as the posttreatment success rate is concerned: the coincidence of other disease interfering with the fertility of the man or woman, serum follicle-stimulating hormone concentration, total testicular volume, and pretreatment semen quality. Depending on the latter factors, the probability of conception varies between 8% and 80%. It seems possible to define certain subgroups of varicocele patients with poor, moderate, or good fertility prognosis.
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The results of CT scan are discussed with special reference to the value of density measurements in several cases of mediastinal cyst lesions. Although in some cysts with watery content, the CT attenuation values can be indicative, in most other lesions with heterogeneous structure and viscid fluid content, attenuation values in CT scan cannot be considered conclusive for diagnosis.
Rapid sequence scintigraphy was used to study testicular arterial perfusion and venous stasis in 53 patients with varicocele-associated infertility, 17 with idiopathic testicular failure and 9 treated for varicocele. Arterial blood supply to the diseased testicle was decreased in 63 per cent of the patients with subclinical or low grade varicocele compared to 18 per cent with idiopathic testicular failure. In the majority of cases the disturbance of perfusion disappeared immediately after interruption of retrograde blood flow in the internal spermatic vein by transcatheter embolization, whereas persistently impaired perfusion was found in a few cases with no improvement of semen quality after treatment. Venous stasis was found in only 18 per cent of the patients with low grade varicocele compared to 88 per cent with large varicoceles. It is suggested that impaired arterial blood supply rather than venous stasis is the pathogenic factor in epididymo-testicular dysfunction associated with low grade varicocele.
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