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Biomedical subjects

S L Kaufman

Publications and source records attributed to S L Kaufman.

At least 109 records · Page 6Linked to original sources
PubMed1976

Management of postoperative renal hemorrhage by transcatheter embolization.

A patient with uncontrollable postoperative renal hemorrhage was successfully treated by sub-selective injection of autologous clot into the renal artery. Followup arteriography 10 days later revealed persistent occlusion of the bleeding vessel with recanalization of all other vessels. This method is an effective alternative to an operation in cases of renal hemorrhage of diverse etiology not responsive to conservative management.

Blood Coagulation↗
PubMed1976

Evidence for a colon chalone.

The molecular weight fractions of 10,000-50,000 daltons prepared from "used" medium obtained during cultivation of human colon carcinoma cells (SW-48) in vitro inhibited the proliferation and DNA synthesis of these cells. Fractions exceeding 50,000 daltons were not inhibitory; those less than 10,000 daltons were cytotoxic. The inhibitory fraction did not affect either proliferation of human fibroblasts or transformation of human lymphocytes in vitro. Similar fractions from the colon mucosa of other species inhibited the proliferation of SW-48 cells, whereas extracts of dog jejunum or lung did not. This mitotic inhibition was completely reversible and could be destroyed by preincubation with trypsin. Therefore, colon cells appear to contain a cell- (but not species) specific, endogenous mitotic inhibitor or chalone.

Animals↗
PubMed1976

Vasopressin control of massive hemorrhage in chronic ulcerative colitis.

A case of a massive colonic hemorrhage in nontoxic, quiescent ulcerative colitis is described. The source of active colonic bleeding was primarily defined with selective superior mesenteric arteriography and was completely controlled with transcatheter vasopressin infusion. A suubsequent elective segmental distal transverse and descending colectomy revealed chronic ulcerative colitis; localized marked inflammatory giant pseudopolyp formation near the splenic flexure was responsible for the bleeding.

Aged↗
PubMedDate not supplied

Digital subtraction spinal cord angiography in patients undergoing thoracic aneurysm surgery.

Thoraco-abdominal aortic replacement can be associated with a high incidence of paraplegia. Because the major source of blood supply to the thoraco-abdominal spinal cord is through the anterior spinal artery of Adamkiewicz, reimplantation of intercostal and lumbar arteries could reduce the risk of this operation. We used intraarterial digital subtraction angiography (DSA) for preoperative localization of the anterior spinal artery in 12 patients. This vessel was successfully located in 9 patients, with DSA providing good quality images in all patients. Preoperative knowledge of the origin of this vessel was helpful in the planning of the operation in all patients, but its efficacy as a routine procedure was not established.

Adult↗
PubMedDate not supplied

Urokinase thrombolysis using a multiple side hole multilumen infusion catheter.

A multilumen, multiple side hole infusion catheter was used for urokinase thrombolysis in 13 patients with thromboembolic occlusions of peripheral arteries and grafts. Balloon angioplasty was performed following urokinase infusion in 6 patients and atherectomy in 1 patient. There was one hemorrhagic complication. The major advantage of the multiple sidehole infusion catheter was the elimination of the need to reposition the catheter during the infusion and the reduction of the time burden on the angiographic facility. The success rate for the thrombolysis (77%) was comparable to results recorded in the literature. The total duration of infusion was not reduced compared to other series.

Adolescent↗
PubMedDate not supplied

Bleeding following endoscopic sphincterotomy: angiographic management by transcatheter embolization.

Transcatheter embolization is a well-established and effective method for the control of bleeding from the upper gastrointestinal tract and often represents the preferred alternative to more invasive surgical management. The applications of this technique for the management of bleeding following endoscopic sphincterotomy have not been reported previously. Of five patients referred for arteriography with life-threatening postsphincterotomy bleeding, active bleeding from branches of the gastroduodenal artery was demonstrated in four. Embolization of this vessel with Gelfoam controlled the bleeding in all three patients in whom it was attempted. Arterial stenosis and spasm precluded such treatment in one patient. The fifth patient was not bleeding at the time of arteriography. There were no complications from these procedures. Our experience shows that postsphincterotomy bleeding can be safely and effectively controlled by transcatheter embolization, thereby avoiding surgery which is associated with significant morbidity and mortality in this setting.

Adult↗
PubMedDate not supplied

Calculation of actuarial life tables with use of a microcomputer spreadsheet program.

PURPOSE: To simplify the calculation of the life-table method of survival analysis. MATERIALS AND METHODS: A template was developed for use with a popular microcomputer spreadsheet program to perform life-table survival calculations and to perform statistical comparisons between the survivals of groups of patients with use of the log-rank test. RESULTS: The template successfully performed life-table and log-rank calculations when compared with two standard, accepted statistical computing programs. CONCLUSION: The template can be used to quickly perform life-table calculations that can be used in the long-term follow-up of patients undergoing interventional radiologic procedures.

Female↗
PubMedDate not supplied

Hemodynamic effects of superior mesenteric arterial and intravenous vasopressin infusions in patients with portal hypertension.

Administration of vasopressin (0.4 units/minute) via the superior mesenteric artery (SMA) resulted in a mean 25% reduction in corrected hepatic venous wedge pressure (CHWP) in 9 stable non-bleeding patients with cirrhosis and portal hypertension. There was wide variation of response in individual patients with two of nine showing no decrease in CHWP to vasopressin. Selective intra-arterial infusion did not protect against the systemic effects of vasopressin and resulted in significant elevations in blood pressure (21%) and systemic vascular resistance (39%). A slight decrease in cardiac output (11%) was also observed. In 6 of these patients, vasopressin (0.4 units/minute) was also given intravenously. The resultant decreases in CHWP were similar to those observed with SMA administration.

Alcoholism↗
PubMedDate not supplied

Transcatheter embolization with microfibrillar collagen in swine.

Transcatheter embolization of the gastrosplenic and renal arteries was performed in 7 domestic swine with suspensions of microfibrillar collagen (MFC), a recently developed topical hemostatic agent. Embolized vessels remained occluded 2 days following embolization. Recanalization occurred by 14 days, although some occlusion in distal vessel persisted at 3 months. Pathologically a marked granulomatous arteritis was noted at 14 days which resolved by 3 months. Gastric ulcers or infarcts were present in two animals. The severe vasculitis and gastric pathology observed with MFC in this study would seem to preclude its use as a general embolic agent. It may be useful, however, in the preoperative embolization of neoplasms, especially in pediatric patients since its physical characteristics allow it to be easily injected through small diameter catheters.

Animals↗
PubMedDate not supplied

Metrizamide, the ideal radiopaque filling material for detachable silicone balloon embolization.

Porcine visceral and extremity arteries were embolized with detachable silastic balloons; 10 balloons were filled with isoosmolar metrizamide, five were filled with 30% meglumine-sodium diatrizoate and five were filled with 3:1 mixtures of blood and 76% meglumine-sodium diatrizoate. Follow-up radiographs were obtained weekly for 2 weeks, at 4 weeks and at 5 months. At 3 months, arteriography was performed. All balloons occluded the vessel completely upon detachment. Balloons filled with metrizamide did not change their volume or radiopacity during the entire observation period and all remained inflated. The balloons filled with diatrizoate salts enlarged by osmotic growth during the first two weeks and there was a decrease in opacity. Thereafter, one balloon filled with 30% diatrizoate salt solution and one filled with blood-76% diatrizoate deflated. In the former, the embolized artery remained occluded, while in the latter, the vessel reopened and the balloon was found incorporated into the vessel wall at the site of detachment. It is concluded that isoosmolar metrizamide is an ideal filler for detachable silastic balloons since it does not lead to changes in volume or radiopacity and also guarantees long-term vascular occlusion.

Angiography↗
PubMedDate not supplied

Therapeutic embolization with detachable silicone balloons: long-term effects in swine.

Twenty-one embolizations were performed in 12 swine using a detachable silicone balloon-catheter system. In 11 embolizations, balloons were filled with 60% meglumine sodium diatrizoate (R-60); 30% meglumine sodium diatrizoate (R-30) was used in 10 embolizations. Serial radiographs were obtained to determine the duration of balloon inflation. Repeat angiography and autopsy examinations were performed three to six months following embolization. Eighty percent of balloons filled with R-30 were still inflated after 10 days, as opposed to 27% of the balloons filled with R-60. Balloons which remained inflated for more than 10 days caused permanent occlusion of the embolized arteries. The vessels were occluded precisely at the point at which the balloons were initially attached. Pathologically, the occluded vessels exhibited organized thrombi with minimal inflammation. Detachable balloons appear to be an effective, safe method of performing selective vascular occlusion in many circulatory systems. Careful control of the volume and osmolarity of the contrast medium used to inflate the balloons produces permanent arterial occlusion.

Angiography↗
PubMedDate not supplied

Hemodynamic effects of vasodilators across iliac stenoses in dogs.

Blood flow and pressure gradients were measured in dogs across externally applied iliac artery stenoses following 3 minutes of reactive hyperemia and injection of tolazoline (0.4 mg/kg), papaverine (0.04 mg/kg), and prostaglandin E1 (0.033 micrograms/kg) into the iliac artery. Stenoses of borderline and definite hemodynamic significance at rest were produced. The gradients produced with all four modalities of vasodilatation following borderline stenosis were significantly greater than those produced with each modality before the induction of stenosis. The peak effects of all modes of vasodilatation occurred within 30 seconds, although the effects of prostaglandin E1 were continued the longest. Our results indicate that pharmacologic or reactive hyperemia can help assess the significance of borderline iliac stenoses in patients with intermittent claudication.

Animals↗