Biomedical subjects
R J Tuttle
Publications and source records attributed to R J Tuttle.
Angiography of angiomatous lymphoid hamartoma (Castleman tumor) and a suggested pathogenesis.
The histological nature and angiographic characteristics of two cases of Castleman tumor support the concept that these tumors are hamartomatous. On angiography, both tumors exhibited a dense and homogeneous blush in the later phase. In one, in the mediastinum, hypertrophied branches of the bronchial artery gave rise to multiple irregular vascular spaces within the tumor; in the other, in the retroperitoneum, hypertrophied branches of the lumbar artery gave rise to irregular vascular channels spaced throughout the tumor. Histologically, both lesions contained numerous lymphoid follicles which, in the central portion, contained capillary vessels with thick hyalinized walls and prominent endothelial cells. A pathogenesis of hamartoma formation is suggested based on a disturbance of the normal orderly replacement of somatic cells and tissues.
Angiographic diagnosis of aorto-inferior vena caval fistula.
Two cases of spontaneous aorto-caval fistula are reported. In the first, following laparotomy for an erroneous diagnosis of acute appendicitis, retrograde aortography was conclusive. In the second case, an attempted renal angiogram for acute renal failure and hematuria failed but a flush aortic injection showed the fistula.
Splenic cystic lymphangiomatosis: an unusual cause of massive splenomegaly.
Two unusual cases of massively enlarged spleens occupied by numerous lymphangiomatous cysts are described. Both angiography and pathology confirm the pathognomonic appearance.
The angiographic diagnosis of acute hemorrhagic renal cortical necrosis.
The authors report a case of acute renal failure resulting from acute cortical necrosis. A selective renal angiogram defined a very unusual, abrupt termination of vascularity at the interlobular and arcuate levels. Nephro-angiography is an important tool in the diagnosis of acute cortical necrosis in the initial phase of acute renal failure.
Meningioma of torcular simulating dural arteriovenous malformation.
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Diagnostic accuracy of cerebral angiography and computerized transaxial tomography.
Computer tomography (CT) of the brain has become widely accepted as an accurate method of studying a variety of intracranial diseases. In a prospective controlled study one group of radiologists interpreted cerebral angiograms and another interpreted CT studies undertaken in the same patients. The overall rates of diagnostic accuracy were similar (81 and 84% for angiography and CT, respectively), albeit less than reported in the literature, and thus support the contention that CT scanning should be available as the initial neuroradiologic examination whenever possible.
Prevention of venous thrombosis with small, subcutaneous doses of heparin.
The effect of low-dose heparin prophylaxis on venous thrombosis and bleeding after major elective surgery was studied in a prospective controlled study of 820 patients. The total incidence of venous thrombosis detected with leg-scanning using fibrinogen labeled with radioactive iodine (125I) was reduced from 16.0% in the control group to 4.2% in treated patients. More important, the incidence of popliteal or femoral vein thrombosis was reduced from 2.9% to 1.0%. Prophylaxis resulted in a slight increase in bleeding-minor wound hematoma, mean volume of blood transfused, and a post-operative hematocrit fall in treated patients. However, increased bleeding was clinically minor, and prophylaxis was well tolerated.
Quiz case. Chondromyxoid fibroma.
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The role of angiography in the management of intestinal carcinoid.
Carcinoid tumors of the intestine may present with bowel obstruction or with the carcinoid syndrome. Confirmation of the diagnosis by biochemical means is easy. Management is often surgical and a number of different procedures have been advocated, e.g. resection of the primary, hemicolectomy and lately, partial hepatectomy. The angiographic features of two cases are presented and discussed; the usefulness of the information so gleaned in the choice of management is stressed.