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Biomedical subjects

R R Gray

Publications and source records attributed to R R Gray.

89 records · Page 5Linked to original sources
PubMed1982

Investigation of impotence by internal pudendal angiography: experience with 73 cases.

Angiography of the ileopudendal vascular tree was performed for the evaluation of impotence in 73 patients. This technique proved useful in identifying those cases caused by vascular lesions in major arteries and small penile vessels. Organic diseases cause a much higher proportion of impotence than in generally suspected, with vascular occlusions causing the greatest number of cases. Nocturnal penile tumescence (NPT) studies are the best screening procedure in the author's view. In this series, NPT was followed by angiography, which provided the definitive diagnosis.

Adult↗
PubMedDate not supplied

The sonography of renal columnar hypertrophy.

An enlarged Column of Bertin is a frequent cause of renal pseudotumor. In a retrospective study of the ultrasound findings in 11 patients with columnar hypertrophy, we have attempted to establish objective sonographic criteria of this entity. Columnar hypertrophy appears as a renal mass with the following characteristics: (1) indents the renal sinus laterally; (2) clearly defined from the renal sinus; (3) largest dimension of less than 3 cm; (4) continuous or contiguous with the renal cortex; and (5) Echogenicity close to that of the cortex. Two minor criteria are also presented, and the present appropriate use of the criteria is suggested.

Diagnosis, Differential↗
PubMedDate not supplied

Ureteral stenting in urosepsis: a cautionary note.

Double-J internal ureteral stents have become a popular, comfortable method of urinary drainage in patients with ureteral obstruction. We describe a case of sepsis leading to rapid death following insertion of a stent. The indications for stent insertion and the potential complications are presented. Special reference is made to the danger of inadvertently creating a conduit for ascending urosepsis.

Humans↗
PubMedDate not supplied

Percutaneous deflation of a gastric balloon: technical note.

Gastric balloons have been used extensively as an adjunct to diet and behavioral modification in the treatment of exogenous obesity. Small bowel obstruction occurred in a 42-year-old female after her balloon migrated through the pyloric channel. The authors describe a simple method for percutaneous deflation which permitted the balloon to pass through the gastrointestinal tract thus relieving the obstruction.

Adult↗
PubMedDate not supplied

Computed tomographic diagnosis of pulmonary sequestration.

Two cases of pulmonary sequestration demonstrated by CT scans of the chest are described. In one, CT demonstrated the anomalous artery. This finding may obviate the need for angiography when surgery is not contemplated.

Adult↗
PubMedDate not supplied

Severity of disease score as a predictor of mortality after caval filter insertion.

PURPOSE: To estimate 30-day mortality after vena caval filter insertion and assess the usefulness of a severity of disease score in predicting postprocedure 30-day survival. PATIENTS AND METHODS: Records of 40 consecutive patients undergoing inferior vena caval filter insertion over a 2 1/2-year period were retrospectively reviewed. A severity of illness score for each patient was calculated based on the weighting system described for the APACHE (Acute Physiology and Chronic Health Evaluation) II system. In addition, 30-day postprocedure survival was determined. RESULTS: Seven patients died within 30 days of the procedure (18%). The use of a severity of disease score of greater than 15 as a predictor of postprocedure 30-day mortality had a sensitivity of 50%, specificity of 97%, positive predictive value of 75%, a negative predictive value of 91.4%, and accuracy of 90%. CONCLUSIONS: The 30-day mortality after caval filter insertion is significant. A severity of disease score is a useful predictor of patients likely to survive following caval filter insertion. On this basis it may be possible to establish criteria for more beneficial use of vena caval filters.

APACHE↗
PubMedDate not supplied

US-guided puncture of the internal jugular vein: complications and anatomic considerations.

PURPOSE: To examine success and complication rates for ultrasound (US)-guided cannulation of the internal jugular vein (IJV) in comparison with blind techniques and to present the variations in anatomy of the IJV. MATERIALS AND METHODS: Data were prospectively collected for 869 cases of sonographically guided cannulation of the IJV. In all cases, the side of the puncture, procedural success or failure, and any immediate complications were recorded. In 764 (88%) cases, the number of passes required and whether a single- or double-wall puncture was used were recorded. In 690 (79%) cases, IJV diameter and depth were recorded, while its relationship to the common carotid artery (CCA) was noted in 659 (76%) cases. RESULTS: Cannulation was successful in 868 (99.9%) cases. Complications occurred in 20 (2.3%) cases. Eighty-seven percent of cannulations were achieved with one pass and 83% with a single-wall puncture. Success at first pass was significantly correlated with right-sided puncture and the diameter of the IJV. In 5.5% of cases, the IJV lay medial to the CCA, making successful cannulation with use of the landmark technique unlikely. CONCLUSIONS: US-guided cannulation of the IJV is superior to blind techniques, increasing the success rate and incidence of first pass cannulation and reducing the incidence of complications.

Adolescent↗
PubMedDate not supplied

Abdominal plexiform neurofibromatosis simulating pseudomyxoma peritonei on computed tomography.

We present and discuss an unusual case of extensive abdominal plexiform neurofibromatosis that simulated pseudomyxoma peritonei on CT. Multiple low density subdiaphragmatic masses caused scalloped liver margins and thickening of the mantle, which displaced bowel loops centrally, suggesting the diagnosis of pseudomyxoma peritonei. However, open biopsy revealed plexiform neurofibromatosis.

Abdominal Neoplasms↗
PubMedDate not supplied

Vasoactive intestinal polypeptides induce guinea-pig ileum contraction by causing release of endogenous acetylcholine.

Two vasoactive intestinal polypeptide (VIP) analogues were observed to induce a concentration-dependent contraction of guinea-pig ileum, which was blocked by atropine but not by tubocurarine. The analogue from guinea-pig, VIP [VIP(gp)], was the most potent inducer of ileum contraction, followed by human-porcine-rat VIP [VIP(hpr)], which differs from VIP(gp) by 4 nonpolar amino acid substitutions. VIP(1-15), composed of only the first 15 of the 28 amino acids of VIP(hpr), was without effect. The relative potency of VIP(gp), VIP(hpr), and acetylcholine was 50 to 100 times more potent in inducing contraction in ileums of which the acetylcholinesterase was inactivated by paraoxon than in the controls. The VIP analogues which induced contraction of ileum also induced secretion of endogenous acetylcholine. The secreted acetylcholine was quantified by high-performance liquid chromatography using electrochemical detection and an immobilized-enzyme column consisting of choline oxidase and acetylcholinesterase. The induction of ileum contraction by VIP(gp), from 10nM to 1 microM VIP, was correlated with the amounts of ACh secreted from ileum. VIP(hpr) induced less acetylcholine secretion than VIP(gp), and was also less potent in causing ileum contraction. VIP(1-15), even at 10 microM, caused neither acetylcholine release nor ileum contraction.

Acetylcholine↗