Biomedical subjects
Publications and source records attributed to W A Weidner.
Ten patients with metastatic disease to the liver were treated with difluoromethylornithine (DFMO) administered by continuous hepatic arterial infusion. Two of nine evaluable patients had an objective partial response. Stable disease was recorded in three patients. Ototoxicity was encountered in all patients who received a daily dose of DFMO equal to or greater than 1.0 g/m2.
Radionuclide blood flow studies were employed to evaluate the success or failure of preoperative Gelfoam embolization in two patients with intracranial meningiomas. In both cases, the initial radionuclide blood flow study showed tumor visualization during the arterial phase. Immediately following the embolization procedure, the radionuclide blood flow study showed no visualization of the meningioma during the arterial phase, indicating a successful embolization procedure in preparation for removal of the tumor in a relatively bloodless field.
This report describes the management of a woman with multiple pulmonary emboli secondary to a large right atrial clot which had formed around her permanent transvenous pacemaker. She continued to have pulmonary emboli despite adequate anticoagulation. Removal of the catheter and pacing required right atriotomy under cover of cardiopulmonary bypass. Additionally, eight English language case reports of symptomatic pericatheter thromboses are reviewed. In these cases, pericatheter clot resulted either in right-sided inlet obstruction or pulmonary emboli. The mortality rate was 75%. Although the cause for our patent's thromboembolic events is uncertain, congestive heart failure was a predisposing factor in 75% of the other reported cases. We suggest that pacemaker patients in congestive heart failure might benefit greatly from chronic anticoagulation.
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A young man developed severe epistaxis following trauma that resulted in a Le Fort III fracture of the maxilla. Anterior and posterior packs were placed but bleeding recurred, selective catheterization showed the false aneurysm, and autologous clot was used to embolize successfully the bleeding site.
Isotopic scanning of the liver to detect hepatic metastases is a commonly used clinical tool in assessing the extent of malignant disease and the proper mode of therapy. Opinions vary widely as to the efficacy of this test. To determine the accuracy of our scanning technique the clinical and laboratory data on 429 patients who had hepatic scans (technetium sulfur colloid) between February 1971 and May 1973 was reviewed. Of these patients, 125 had a confirmatory procedure (needle biopsy - 15, abdominal exploration - 69, autopsy - 41) done within 6 weeks of their scan. Nineteen patients who had negative scans were proven to have hepatic metastases. Fourteen patients had positive scans which could not be substantiated by one or more of the above confirming examinations. Thus the frequency of error was 25%. Regarding other tests - alkaline phosphatase and bilirubin - no better correlation could be made with respect to the presence or absence of metastases. From the data available on this small group of patients the liver scan is sufficiently inaccurate to preclude relying upon it for the selection of therapy in cancer patients. When the presence of hepatic metastases changes the type of therapy a confirmatory laparotomy or biopsy should be considered.
A non-invasive technique, utilizing scattered radiation, has been developed to monitor and measure the motion of the epicardial surface during fluoroscopy. A number of dogs were studied using a monitoring device which consists of an X-Ray beam collimator, collimated sodium iodide dectetors and their associated electronics. The detector signals are computer processed to obtain frequency fingerprints of epicardial motion that may, in the future, indicate the condition of the myocardium.