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Biomedical subjects

S Wallace

Publications and source records attributed to S Wallace.

At least 451 records · Page 25Linked to original sources
PubMed1977

Ether-dissolved ethiodol for lymphangiography: an experimental study.

In order to decrease administration time, the viscosity of Ethiodol was reduced by mixing it with ether; this mixture was evaluated in lymphangiography of dogs. The ether-Ethiodol solution was injected into a cannulated lymph vessel of one hind limb and compared to pure Ethiodol in the other. For the ether-Ethiodol solution, the time required for complete injection was 10-30 min in most cases compared to 60-105 min for Ethiodol alone. The radiographic appearance of the lymph vessels and nodes appeared similar on both sides, and follow-up lymphangiograms in two animals after 1 and 3 weeks showed no difference from the original study. Microscopic examination of the opacified lymph nodes on both sides revealed no histologic differences. The techniques has potential clinical application.

Animals↗
PubMed1977

Team approach to management of non-Hodgkin's lymphomas: past and present.

A detailed review of our results of radiotherapy for stage I and II non-Hodgkin's lymphomas has been presented as background for our current multidisciplinary approach which uses multiple-agent chemotherapy, radiotherapy, and immunotherapy for nodular and diffuse stage I, II, and III lymphomas of the poorly differnetiated lymphocytic, mixed, and histiocytic varieties. Optimum management is based on coordinated efforts of medicine, radiotherapy, pathology, diagnostic radiology, and surgery. In stage I, II, and III disease, routine staging procedures include lymphangiography, bilateral iliac crest needle biopsies of the bone marrow, and percutaneous needle biopsies of the liver. Staging laparotomy is considered essential to our present program for stage I, IE, II and IIE disease. In our opinion, staging laparotomy is not indicated in stage II or IIIE disease. Although very preliminary, results for these programs are encouraging. This paper presents the concept of team management and a specific plan for its implementation.

BCG Vaccine↗
PubMed1976

Decreased drug binding in serum from patients with chronic hepatic disease.

The binding of 3 drugs to serum proteins of patients with chronic hepatic disease has been studied by an ultrafilitration technique, and compared to that of normal subjects. The binding of phenylbutazone was reduced in all patients, salicylate in patients with inactive liver disease and sulphadiazine in patients whose disease was active. Analysis of binding data showed a real reduction in the capacity of albumin to bind the drugs in the majority of patients. Addition of bilirubin to normal plasma caused a reduction in sulphadiazine binding, but had no effect on the binding of salicylate or phenylbutazone. The possible causes of this reduction in binding are discussed.

Adult↗
PubMed1976

Interventional radiology.

Direct unencumbered visualization of areas of interest by image intensification combined with more invasive techniques of percutaneous puncture and angiography have extended the scope of the radiologist in the diagnosis and management of patients with neoplastic diseases. Percutaneous biopsies can be obtained more safely and with greater reliability from lesions of the lungs, skeleton, kidneys, liver, pancreas, and retroperitoneal lymph nodes. Intravascular therapy by arterial occlusion of the neoplasm has been employed to control hemorrhage, to decrease tumor mass, and preoperatively to facilitate surgical removal. The possibility of initiating an immune response to the ischemic neoplasm is also discussed.

Aged↗
PubMed1976

Radiologic features of adrenal metastases.

The incidence of adrenal metastasis is surprisingly high with certain types of malignant neoplasms such as carcinoma of the breast and lung, and melanoma. Since adrenal metastases are usually clinically silent, radiologic findings assume greater importance. The radiologic features found in 21 patients with proved adrenal metastases are presented.

Adolescent↗
PubMed1976

Intravascular occlusive therapy: use of interventional radiology in cancer patients.

Selective transcatheter intravascular occlusion in the treatment of cancer patients is a valuable extension of interventional diagnostic radiology. Intra-arterial embolization may be performed with various substances, including autologous clot, autologous subcutaneous tissue, Gelfoam, and stainless steel coil. Clinical applications in cancer patients include control of gastrointestinal and genitourinary hemorrhage, preoperative reduction of tumor vascularity, control of local symptoms, and therapeutic reduction of tumor bulk. The technique has been used for preoperative and palliative treatment of neoplasms of the head and neck, kidney, liver, spleen, and soft tissue and bone. Transcatheter intravascular occlusion should be performed only by radiologists experienced in angiographic techniques. Inadvertent occlusion of a normal vessel and thromboembolism are possible complications.

Angiography↗
PubMed1976

Lymphangiography as an aid in staging bladder carcinoma.

Eighty patients with histologically proven carcinoma of the urinary bladder had pedal lymphangiography as part of their assessment for metastatic disease. Results were correlated with surgical findings within three months of the lymphangiographic interpretation in 49 patients. There were no false-positive lymphangiograms, and only five (10%) false-negative readings were recorded. The finding of positive lymphangiograms in 9% of patients with stage B disease, 16% of patients with stage C disease, and 57% of patients with a fixation of the tumor to the pelvic or abdominal wall emphasizes the value of the procedure in limiting unnecessary surgical exploration.

Diagnostic Errors↗
PubMed1976

Factors affecting drug binding in plasma of elderly patients.

The binding of salicylate, sulphadiazine and phenylbutazone to plasma proteins has been studied in young and elderly subjects. Elderly patients had significantly reduced concentrations of plasma albumin, compared with subjects under 40 years of age. Sifnificant increases in free levels of all three drugs were found in elderly patients receiving multiple drug therapy, and a correlation obtained with the number of drugs being taken. It is suggested that because of their low albumin levels, elderly patients may be more susceptible to the effects of multiple drug therapy on drug binding. The clinical implications of these observations are discussed.

Adolescent↗
PubMed1976

Priscoline-augmented hepatic angiography.

Tolazoline hydrochloride (Priscoline) is a useful adjunct to hepatic angiography in the evaluation of space-occupying lesions. It was of definite value in 8 of 26 studies, either in facillitating the diagnosis or in evaluating the extent of disease. The mechanism of enhanced visualization is presumably related to its vasodilatory effect on the small blood vessels of the liver. Priscoline deserves further evaluation in the following situations: (a) a negative hepatic angiogram in the face of positive clinical findings or radionuclide images; (b) suspicious but not definitive findings on conventional hepatic angiography; and (c) assessment of the full extent of disease.

Adult↗
PubMed1976

Transcatheter occlusion of abdominal tumors.

Radiological and clinical experience with transcatheter intravascular occlusion of abdominal and pelvic tumors in 55 patients is presented. Major indications include control of hemorrhage, palliation of local tumor symptoms, and preoperative management of facilitate surgery. Methods of occlusion included embolization (clot, subcutaneous tissue, and Gelfoam), introduction of a stainless steel coil into larger vessels, and balloon catheters. Hemorrhage was controlled in 8 of 12 patients with bleeding gastrointestinal and pelvic tumors. Experience in 36 patients with hypernephroma is discussed. Initial observations are presented, including occlusion of the hepatic artery for dearterialization of primary and secondary neoplasms and of the splenic artery for hypersplenism.

Abdominal Neoplasms↗
PubMed1976

Azygography in the pre-treatment evaluation of oesophageal carcinoma.

Azygography is a useful technique for the pre-operative detection of unresectability of oesophageal malignancies. Invarison of the azygos vein by oesophageal carcinoma occurs because of the anatomic proximity of the thoracic oesophagus and the azygos vein. Azygography may be performed by either intraosseous injection of a rib or by direct retrograde catheterization. Complete obstruction of the azygos vein indicates that an oesophageal carcinoma is unresectable if no other intrathoracic disease is evident.

Angiography↗
PubMed1976

Therapeutic vascular occlusion utilizing steel coil technique: clinical applications.

The stainless steel coil has been utilized for permanent intravascular occlusion of the proximal portion of the renal, hepatic, splenic, and internal iliac vessels. This therapeutic approach has been successful in the management of renal arteriovenous fistulas, renal carcinomas, neoplasms of the liver, giant cell tumors of the sacrum, and in hypersplenism. The techniques involved and clinical uses are discussed.

Adult↗
PubMed1976

Radiologic features of gram-negative pneumonias in the neutropenic patient.

While gram-negative pneumonia is a frequent complication in immunosuppressed patients with malignant disease, the diagnosis is difficult to establish. Clinical and radiographic study of 195 episodes of pneumonia in 175 consecutive patients was undertaken. Chest radiographs were negative in 19% of the episodes, probably due to absence of alveolar inflammatory cell infiltrate. Radiographic patterns were classified as either alveolar or mixed alveolar and interstitial; no case of interstitial pattern alone was identified. A positive correlation was found between the neutrophil count and the presence of radiographic abnormalities. The different types of organisms could not be distinguished by the radiographic appearance. The importance of early diagnosis and prompt specific treatment is stressed.

Adolescent↗
PubMed1976

Hypercalcemia in patients with known malignent disease.

In 82 patients, a preoperative diagnosis of primary hyperparathyroidism has been established by means of transfemoral neck vein catheterization and measurement of serum immunoreactive parathyroid hormone (iPTH). Twenty-five of these patients have had cancer in other parts of the body but with no evidence of recurrence or metastasis. One patient had carcinoma of the colon with metastases, and four were members of families with multiple endocrine adenomatosis (MEA, Types I and II). In six other hypercalcemic patients, high levels of iPTH were found also in the effluent blood from cancer sites other than the parathyroid gland, secondary to ectopic hormone production or pseudohyperparathyroidism. In addition, a high serum level of iPTH was found in the superior vena cava of a seventh patient who had carcinoma of the breast but no clinical or radiological signs of recurrence or metastasis with the exception of an enlarged liver. This iPTH finding was interpreted as being, probably, the result of parathyroid adenoma in either the neck or the mediastinum. At the time of operation, a transcervical mediastinal search was made. Four normal cervical parathyroid glands were found; three were removed. Hypercalcemia persisted after operation, and the patient died. At postmortem examination, microscopic study revealed that the disease had metastasized to lungs and hilar lymph nodes. There was massive metastasis in the liver; the liver contained a large amount of iPTH. The results of these investigations suggest that (1) venous catheterization of the neck veins and the effluent blood from extraparathyroid tumors aid in identifying and localizing iPTH production; (2) primary benign hyperparathyroidism is not uncommon in patients with cancer, and its co-existence must be recognized; (3) high serum iPTH level in the superior vena cava may be found in patients with metastatic or primary cancer of the thoracic cavity; and (4) hyperparathyroidism may be the first hint of a familial multiple endocrine syndrome.

Adenoma↗
PubMed1976

Transcatheter embolization of the internal iliac artery in the management of neoplasms of the pelvis.

Six patients with neoplasms of the pelvis were treated with embolization of the internal iliac artery. The technique was used for the control of hemorrhage and pain and for preoperative devascularization. No complications or serious side-effects occurred. Embolization of the internal iliac artery often provides a therapeutic alternative, when a surgical procedure is not feasible.

Adult↗
PubMed1975

Percutaneous transfemoral renal artery occlusion in patients with renal carcinoma. Preliminary report.

Twenty-four patients have undergone percutaneous transfemoral selective renal artery occlusion as part of their management for renal carcinoma. Preoperative infarction was performed in 7 cases. This facilitated surgery by eliminating the major blood supply to the tumor and resulted in collapse of the large collateral veins and created edema within the perirenal tissue. In 17 patients with visceral metastases, tumor infarction was performed in lieu of nephrectomy for control of the primary lesion and in hopes of stimulating an autoimmune response. The current status of this procedure s discussed in light of its indications, complications, and preliminary results.

Acute Kidney Injury↗