Collateral pathways in inferior vena caval obstruction in children, including the cavo-portal route.
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Biomedical subjects
Publications and source records attributed to R L Gordon.
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A 12-year-old patient presented following inadvertent intraarterial injection of benzathine penicillin. Complications manifested as an incomplete cauda equina lesion with ischaemia and necrosis over the buttock in the distribution of the injected artery. Angiography confirmed damage to the superior gluteal artery while histology revealed severe ischaemic damage without evidence of an allergic process. Spasm of the injected vessel with retrograde flow and occlusion by particulate matter can explain the clinical manifestations. The prognosis for these complications is poor and the best approach lies in prevention.
The role of the double-contrast enema examination (DCE) in the detection of rectal carcinoma was evaluated and compared to the proctoscopic examination. Records of 90 consecutive patients with a diagnosis of rectal carcinoma were reviewed. Sixty-six patients had a preoperative DCE. The correct diagnosis was either made or suggested in 91% of these patients. The proctoscopic examination was diagnostic in 86%. The causes of radiologic and proctoscopic error were evaluated. Findings confirm that the DCE is an accurate method for the diagnosis of rectal carcinoma. Careful examination of the rectum should be incorporated in all radiologic studies of the colon since a normal proctoscopic examination does not exclude the possibility of rectal carcinoma.
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A simple method for replacing biliary drainage or nephrostomy catheters that have fallen out is described. The original catheter tract is used.
Simple renal cysts and reported in 9 children. Two children presented with hematuria following trauma and the cyst was demonstrated on the initial excretory urogram. The other 7 had cysts found on excretory urograms in be course of evaluation of various urologic complaints. The diagnostic approach used was identical to that advocated for adults, namely, percutaneous needle puncture once a solid renal mass has been excluded by an appropriate screening procedure such as ultrasonography. These cysts are benign lesions similar to cysts in adults and are probably more common than the few reported cases would suggest.
Coronary veins in seven of eight patients with bleeding esophageal varices were successfully catheterized and embolized with Gelfoam followed by multiple steel coils. Bleeding immediately ceased in all seven, but recurred within 1 month in six. One had not rebled on 3 month follow-up. Therefore, steel coils do not prevent recurrent bleeding any more effectively than other embolic materials used for this purpose.
DNA molecules of seven T7 mutants with overlapping deletions in the early region were cleaved by restriction enzymes HindII, HpaI and II, and HaeIII. The differences in the cleavage patterns after electrophoresis have been used to generate a cleavage map of the restriction sites of this enzyme. It covers the first 9% of the T7 DNA molecule. Cleavage points for HindII are at 0.60, 1.33, 1.59, 1.76, 5.26, 6.27, 7.4 and 8.38%; for HpaI and II at 1.36, 1.62, 4.46, 6.29, 6.62, 7.56, and 8.76%, for HaeIII at 3.85, 6.98, 7.88 and 8.26%. Some fragments have been located in the region containing the early promoters, others carry the complete sequences of gene 0.3.
The investigation of the non-jaundiced patient by percutaneous transhepatic cholangiography (PTC) and the indications for this examination are presented. Diagnostic examinations were obtained in all 15 patients studied despite the absence of jaundice at the time of examination. Complications were minimal. The value of this method particularly after previous biliary surgery is emphasized. It is suggested that PTC may be of great value, and safely used in non-jaundiced patients.
A patient with simultaneous metachronous carcinoma and polyps of the large bowel is presented. The importance of carcinoma as a predisposing cause to perforation during barium enema is stressed. In view of the considerable incidence of recurrent large bowel tumors, careful routine follow-up studies should be undertaken and extreme caution exercised during the barium enema.
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A rapid procedure involving DNA-cellulose chromatography followed either by sedimentation in a high-salt glycerol gradient or by gel filtration is described for the complete purification of Escherichia coli DNA-dependent RNA polymerase.
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