Biomedical subjects
Publications and source records attributed to W Dock.
Diseases of the gastrointestinal tract accompanied by a thickened bowel wall have become more accessible to ultrasonic detection during the last years. In most of the cases, however, the sonographic pattern has no characteristic feature for any disease. In this paper we present the rare case of a phlegmon of the colon and discuss its differential diagnosis.
Pulmonary sequestration is an extremely rare malformation and most reported series are therefore small. For this reason an attempt has been made to review our own cases and those reported in the literature in order to describe the radiological appearances and to distinguish between the intralobar and extralobar types. 85% of pulmonary sequestrations are localised in the lower zones, with a distinct preference for the left side. 28% of intralobar sequestrations have a homogeneous appearance, 33% are inhomogeneous and 39% are cystic; 77% of extralobar sequestrations are homogeneous and 23% are cystic. Extralobar sequestrations never showed an inhomogeneous appearance. There was a difference in the manifestations of the two forms: 75% of intralobar and 59% of extralobar sequestrations were symptomatic. Distinction between the two types of sequestration could not be based on their arterial supply nor on their venous drainage.
A prospective study of the results of fibrinolytic therapy in 87 patients was carried out with particular reference to the type of fibrinolytic agent. The primary success rate using urokinase was 78%, which was markedly greater than the 44% success rate when using streptokinase. An attempt was also made to evaluate the effect of other factors, such as the extent and duration of the occlusion. Long term results, as might have been expected, were directly related to the primary success rate. If fibrinolytic therapy resulted in fairly normal vasculature, the long-term results were satisfactory in 79%, whereas unsatisfactory reconstruction of the vascular bed produced a satisfactory long-term result in only 30%.
The accuracy of genital urography in the diagnosis of intersex and for the demonstration of the internal genitalia has been studied in 16 patients. It was found that the radiological appearances agreed in all cases with the surgical findings. Individual malformations of the genitals have been considered with reference to the classification of Shopfner and Prader and the advantages and disadvantages of various examination techniques are discussed.
The aim of this study was to determine the accuracy of colour-coded Doppler sonography (CDS) and its advantages as compared with angiography and pulsed Doppler sonography. For this purpose, the arteries in the pelvis, thigh and knee of 42 patients were examined by CDS, the gold standard being angiography. In ten patients, pulsed Doppler sonography was performed as well and the length of the examination compared with that of CDS. It was shown that CDS is valuable in the investigation of peripheral vessels and that it can replace angiography after femoro-popliteal bypass operations or PTA. Compared with pulsed Doppler sonography, CDS has the advantage of being much quicker.
Percutaneous removal of centrally located, embolized, intravascular foreign bodies is essential. A technique was developed to shift fixed foreign bodies into a position where they may be grasped and eventually removed with a snare or Dormia basket. It involves insertion by bilateral femoral vein puncture of a curved-end catheter and a second catheter attached to a Dormia basket set. A wire passed through the first catheter is grasped with the Dormia basket, and the foreign body is mobilized by means of traction on both catheter systems.
Sixteen cases of centrally embolized foreign bodies are reported (eight catheter fragments, two guide wires, four pacemaker electrodes, one ventriculo-atrial shunt, one Port-A-Cath catheter). In all patients only the Dormia basket was used. Foreign body extraction was successful in all patients except one, in which removal of a pacemaker electrode from the myocardium failed. Technical aspects as well as complications of percutaneous foreign body extraction are discussed.
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In this study, we successfully performed local thrombolysis in 6 patients with peripheral arterial occlusions by using a novel high-molecular-weight urokinase. Mean duration of recanalization was 12.8 hours, mean fibrinogen consumption was relatively low (42%), reptilase time was relatively long (mean increase by 47%). These findings would suggest that the substance is highly effective, though systemic adverse reactions are mild.
A complication of inexpert handling of the Olbert catheter system is presented. The balloon was inflated while the clamp at the proximal end of the catheter was closed. This resulted in kinking of the distal end of the catheter within the balloon. Difficulty in catheter removal resulted but was overcome by an improvised coaxial sheath technique.
We tried to find out the validity of 16 wellknown signs indicating an acute traumatic aortic rupture on plain chest radiographs of 22 patients. Angiographically 11 of all patients had a tear at the aortic isthmus. It turned out that 7 of the 16 signs (widened mediastinum, loss of the aortic knob contour, opacification in the aortopulmonary window, bulging of the vascular pedicle predominantly to the left, left apical cap, depression of the left main stem bronchus and displacement of the right paraspinous interface) are of great diagnostic value.
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In this case report the cystic form of meconium peritonitis is presented. The aetiology and differential diagnosis of this rare entity are discussed.
Based on the data of 15 patients the typical radiological signs of pulmonary arteriovenous fistulas, their differential diagnostic implications, clinical signs and symptoms and management are reviewed. In addition, lung function parameters of 9 patients are presented. The critical role of pulmonary angiography and sequential dynamic CT for the diagnosis is stressed, particularly in those cases in which conventional chest radiographs and tomographies fail to show characteristics abnormalities. Since pulmonary arteriovenous fistulas tend to increase in size and cause complications, they should be subjected to intermediate treatment, even if they are of no haemodynamic relevance.