Some varieties of Papaver somniferum L. with changed morphinane alkaloid content.
Explore the source record for details and available documents.
Morphinans↗
Biomedical subjects
U Nyman
Publications and source records attributed to U Nyman.
Breeding oil poppy (Papaver somniferum) for low content of morphine.
Explore the source record for details and available documents.
Chromatography, Gas↗
Aneurysms of the pancreaticoduodenal artery associated with occlusion of the celiac artery.
Aneurysms of the pancreaticoduodenal artery are rare and may be associated with celiac artery stenosis or occlusion. Twenty-eight patients are reported in the literature. The diagnostic findings and therapeutic alternatives of four additional patients form the basis of this report. One patient with ruptured pancreaticoduodenal aneurysm was successfully treated by transcatheter embolization, and one patient was treated surgically; both patients had an uneventful recovery. In the remaining two patients, the aneurysms were left untreated. One patient died 1 year later of an unrelated cause, and the other patient is symptom-free after 2 years.
Aged↗
Endovascular treatment of chronic mesenteric ischemia: report of five cases.
PURPOSE: To evaluate the midterm results of percutaneous transluminal angioplasty (PTA) and stent placement in stenotic and occluded mesentesic arteries in five consecutive patients with chronic mesenteric ischemia. METHODS: Five patients with 70%-100% obliterations of all mesenteric vessels resulting in chronic mesenteric ischemia (n = 4) and as a prophylactic measure prior to abdominal aortic aneurysm repair (n = 1) underwent PTA of celiac and/or superior mesenteric artery (SMA) stenoses (n = 2), primary stenting of ostial celiac occlusions (n = 2), and secondary stenting of a SMA occlusion (n = 1; recoil after initial PTA). All patients underwent duplex ultrasonography (US) (n = 3) and/or angiography (n = 5) during a median follow-up of 21 months (range 8-42 months). RESULTS: Clinical success was obtained in all five patients. Asymptomatic significant late restenoses (n = 3) were successfully treated with repeat PTA (n = 2) and stenting of an SMA occlusion (n = 1; celiac stent restenosis). Recurrent pain in one patient was interpreted as secondary to postsurgical abdominal adhesions. Two puncture-site complications occurred requiring local surgical treatment. CONCLUSIONS: Endovascular techniques may be attempted prior to surgery in cases of stenotic or short occlusive lesions in patients with chronic mesenteric ischemia. Surgery may still be preferred in patients with long occlusions and a low operative risk.
Adult↗
Chronic aortic dissection: stenting of aortic true lumen obliteration with late dynamic variations of both lumens.
Percutaneous endovascular techniques were used to treat an arteriovenous fistula (AVF) associated with pancreatic transplantation. A pancreatic transplant superior mesenteric artery-to-superior mesenteric-vein AVF was successfully embolized while flow to the pancreas transplant was preserved. The embolization was aided by the use of Guglielmi detachable coils and a detachable balloon. No complications were encountered. At 23 months follow-up, the patient is doing well with no recurrence.
Aged↗
Primary stenting in infrarenal aortic occlusive disease.
PURPOSE: To evaluate the results of primary stenting in aortic occlusive disease. METHODS: Thirty patients underwent primary stenting of focal concentric (n = 2) and complex aortic stenoses (n = 19), and aortic or aorto-iliac occlusions (n = 9). Sixteen patients underwent endovascular outflow procedures, three of whom also had distal open surgical reconstructions. Median follow-up was 16 months (range 1-60 months). RESULTS: Guidewire crossing of two aorto-biiliac occlusions failed, resulting in a 93% (28/30) technical success. Major complications included one access hematoma, one myocardial infarction, one death (recurrent thromboembolism) in a patient with widespread malignancy, and one fatal hemorrhage during thrombolysis of distal emboli from a recanalized occluded iliac artery. One patient did not improve his symptoms, resulting in a 1-month clinical success of 83% (25/30). Following restenting the 26 stented survivors changed their clinical limb status to +3 (n = 17) and +2 (n = 9). During follow-up one symptomatic aortic restenosis occurred and was successfully restented. CONCLUSIONS: Primary stenting of complex aortic stenoses and short occlusions is an attractive alternative to conventional surgery. Larger studies with longer follow-up and stratification of lesion morphology are warranted to define its role relative to balloon angioplasty. Stenting of aorto-biiliac occlusions is feasible but its role relative to bypass grafting remains to be defined.
Adult↗
Hepatic laceration from wedged venography performed before transjugular intrahepatic portosystemic shunt placement.
Transjugular intrahepatic portosystemic shunt (TIPS) placement is an increasingly used, nonoperative technique for treating variceal bleeding and refractory ascites secondary to portal hypertension. Since the first clinical TIPS case in 1989, the procedure has undergone significant technical refinement to improve the safety and efficacy of shunt placement. A major technical challenge of TIPS creation is passage of the transjugular needle from the hepatic vein into the portal vein. Perforation of the liver capsule from an errant needle pass can lead to massive intraperitoneal bleeding. To minimize the number of needle passes required to enter the portal vein, investigators have devised a variety of techniques to visualize the portal vein anatomy including direct transhepatic catheterization of the portal vein, superior mesenteric artery (SMA) angiography, real-time ultrasound (US) guidance and refluxing contrast medium into the portal vein with wedged hepatic venography. While these technical improvements have made TIPS a safe and attractive alternative to conventional surgical shunts, the procedure remains technically challenging and lethal hemorrhagic complications can occur when the liver capsule is perforated during the course of the procedure. To our knowledge, there are no reported major complications directly related to the wedged hepatic venogram prior to TIPS. We describe an unusual series of severe liver injuries from wedged hepatic venography during attempts to localize the portal vein.
Adult↗
Angiographic evaluation of scintigraphic abnormalities in screening for pulmonary embolism after total hip replacement.
Among 240 consecutive patients subjected to total hip replacement, 206 underwent perfusion scintigraphy in screening for pulmonary embolism 10 to 14 days after surgery. All patients with perfusion abnormalities (n = 77) also underwent ventilation scintigraphy with a dry 99Tcm microaerosol. The scintigraphic abnormalities were classified according to a detailed coding system and in 50 patients pulmonary angiography was performed within 24 hours for correlation. Emboli were diagnosed in 19 patients at angiography. All patients with ventilated segmental (n = 6) or larger (n = 5) perfusion defects or multiple subsegmental defects larger than half a segment (n = 2) had emboli. Two of 8 patients with abnormally ventilated subsegmental perfusion defects larger than half a segment had emboli. Four of 21 patients with wedge-shaped subsegmental perfusion defects smaller than half a segment or defects with a rounded border towards the hilum and a peripheral extension equal to or less than that of a segment had emboli. In one of them the site of the emboli correlated to the site of the perfusion defect but occurred in normally perfused areas in the remaining 3. Ventilation scintigraphy was of no value in this group of patients. No emboli were found in patients who had areas with decreased but not totally lost perfusion (n = 8). No emboli were diagnosed in 27 lungs with a normal perfusion.
Adult↗
Post-operative lesions of the common bile-duct. A cholangiographic investigation.
Cholangiograms were reviewed of 190 patients with gall-bladder disease, who were consecutively operated upon with common bile-duct exploration during a 2.5-year period. Nine patients were excluded for various reasons. In 86 patients endoscopy of the duodenum was also performed after surgery. In 181 patients post-operative cholangiography revealed the following lesions, not found at the pre-explorative examinations: Fistula to the duodenum in 27, ulcers or sinus tracts in 11, ectasia and/or irregularities in another 11. In 17 patients retained calculi were found. The clinical significance of the iatrogenic lesions is probably low, but they must be recognized as such in order not to be radiologically misinterpreted.
Adult↗
Computed tomography of pelvic lipomatosis. Report of a case.
Pelvic lipomatosis is a non-malignant condition of unknown etiology characterized by an overgrowth of non-encapsulated fatty tissue in the perirectal and perivesical spaces of the pelvis. The symptoms are generally vague and the condition is often diagnosed accidentally. It may cause obstruction of the ureters, inferior vena cava and pelvic veins and may be associated with cystitis glandularis. The typical conventional radiographic findings, though not pathognomonic, are a high-positioned and pear-shaped bladder, tubular narrowing of the rectum and distal sigmoid colon and reduced attenuation of the pelvic soft tissues. Computed tomography demonstrates a non-encapsulated fatty mass surrounding the pelvic organs symmetrically and with an attenuation similar to that of subcutaneous fat. The fatty tissue may contain strands with a higher attenuation than that of fat. The findings at computed tomography seem to be pathognomonic for this condition and eliminate the need for routine surgical biopsies.
Adult↗
Teletransmission of radiographic images. Preliminary report.
A digital system for transmission of images over telephone lines using a 256 X 256 X 6 bits matrix provided for communication between a county hospital and a university hospital is presented. During a three-month period radiologic diagnostic problems encountered in 62 patients (computed tomography in 46 and conventional radiography in 16) were referred by transmitting selected images from each examination. Transmission of computed tomograms was performed without significant degradation of image quality and there was no loss of diagnostic information. Deterioration of image quality was noticed when conventional films especially those of the chest, were digitized and transmitted, though in no instance were they non-diagnostic. The consultations gave valuable information to the transmitting radiologist in approximately 50 per cent of the cases. Review by the consulted radiologists of all original films in each of the examinations 6 months later did not improve the diagnostic results. Thus, a few carefully selected images, digitized and transmitted over telephone lines, may be sufficient for adequate consultation.
Electronics, Medical↗
Vascular enhancement during incremental body computed tomography. A simple and reliable technique.
An initial manual bolus injection of contrast medium to an amount of 15 g iodine immediately followed by a manual infusion of 25 to 35 g iodine during 3 to 5 minutes will provide proper enhancement of vascular structures (110-150 HU) at incremental body computed tomography during that time and for some minutes after the end of the infusion. This technique applied in more than 1,000 examinations proved it to be reliable, simple and fast. A computed tomograph allowing 3 scans per minute permits an adequate and even level of vascular enhancement of the entire neck, mediastinum, abdomen or pelvis when continuous or more sparse slices of about 10 mm thickness are used. When the images are reconstructed without delay and presented on a monitor in the scanning suite, it is possible to individually optimize the rate of infusion and thereby also minimize the amount of contrast medium. A prerequisite for a proper vascular enhancement is a high rate of infusion initially.
Adult↗
Abdominal computed tomography in macroglobulinemia (Waldenström's disease). Report of a case.
The findings at abdominal computed tomography (CT) in a patient with primary macroglobulinemia (Waldenström's disease) are reported. CT was of special value in monitoring the extent of the disease in the abdomen and the response to treatment. At the first examination the patient had changes in both the reticuloendothelial system and the small bowel. The prompt disappearance on treatment of the small bowel changes proves that these changes were due to a high plasma viscosity syndrome. The slow response on the liver, spleen and lymph nodes suggests lymphomatous engagement. Although the primary method to diagnose Waldenström's disease is through laboratory tests, CT is of use in monitoring the abdominal involvement, especially the response to treatment.
Aged↗
Addition of local anesthetics to contrast media. I. Effects on patient discomfort and hemodynamics in aortofemoral angiography.
Effects of equiosmolar solutions (osmolality 1.35 mol/kg) of the ratio 1.5 contrast medium metrizoate (250 mg I/ml) containing either the local anesthetic mepivacaine or saline were evaluated on subjective discomfort, aortic blood pressure and heart rate in 17 patients referred for aortofemoral angiography due to intermittent claudication. Each patient was injected with 30 ml (15 ml/s) of each solution in random double-blind order. Each patient was then injected with 45 ml (12 ml/s) of the ratio 3 medium ioxaglate (320 mg I/ml, osmolality 0.58 ml/kg). Ioxaglate caused significantly less total discomfort, pain, heat, vocal reactions, involuntary movements and hemodynamic effects than metrizoate-mepivacaine and metrizoate-saline. The effects of the two metrizoate solutions did not differ significantly. Previous contradictory reports on the effects of anesthetics in contrast media were reviewed with regard to experimental design, different osmolality of the test and control solutions, premedication, and pH dependence of local anesthetics. Ratio 3 media are recommended because they produce a more reliable relief of patient discomfort and fewer hemodynamic changes than the addition of local anesthetics to ratio 1.5 media.
Adult↗
Computed tomography in renal replacement lipomatosis.
Replacement lipomatosis of the kidney is the result of severe atrophy or destruction of the renal parenchyma often caused by calculous disease with secondary marked proliferation of renal sinus, renal hilus, and perirenal fatty tissue. The diagnosis is difficult to establish with conventional radiographic methods. Though ultrasonography may show highly suggestive findings, computed tomography seems to be the most accurate method in demonstrating the distinctive features of replacement lipomatosis, i.e. a rim of the destroyed renal parenchyma adjacent to a lipomatous mass with attenuation values similar to those of normal fat and calculi. This entity should readily be differentiated from fat-containing tumors in the kidney or its vicinity by computed tomography. When surgery is contemplated CT may also be of value to determine the extension of the fibrous fatty tissue relative to adjacent organs and possible abscess formation.
Aged↗
Addition of local anesthetics to contrast media. II. Increase of acute mortality in mice with intravenous contrast administration.
The acute intravenous toxicity (i.v. LD50) of solutions of the ratio 1.5 contrast media metrizoate or diatrizoate and the ratio 3.0 contrast medium metrizamide was determined in mice with and without the addition of local anesthetics to the solutions. The two local anesthetics mepivacaine or lidocaine were added to final concentrations up to 2.0 mg/ml of the contrast medium solutions. This corresponds to clinically used concentrations. All additions of local anesthetics to the solutions increased the mortalities caused by the contrast medium solutions. Addition of local anesthetics to a final concentration of 2 mg/ml approximately doubled the acute intravenous toxicity of the contrast media. The ratio 3 contrast media produce less hypertonic solutions than the ratio 1.5 contrast media and should be preferred for angiography because they cause less pain and do not require the addition of local anesthetics which increase the acute toxicity of the solutions.
Anesthetics, Local↗
Cytostatic infusion into bronchial arteries in bronchogenic carcinoma.
Explore the source record for details and available documents.
Adenocarcinoma↗