Royal J. Bartrum

Percutaneous Aspiration Biopsy of the Pancreas under Ultrasonic Guidance

Fine-needle aspiration biopsy for cytologic diagnosis was performed on seven patients suspected of having pancreatic tumors. A 23-gauge biopsy needle was accurately placed in the suspicious lesion under ultrasonic guidance. Six patients had tumors; of these, five had a definite cytologic diagnosis, and the sixth was suspicious of tumor. There was no morbidity associated with the procedure in these patients. Although fine-needle biopsy is not expected to prolong life in patients with pancreatic tumors, it does eliminate the need for more complicated, expensive, uncomfortable and hazardous diagnostic procedures. In many cases exploratory surgery may be obviated.

Ultrasonic and Radiographic Cholecystography

To define the relative merits of radiographic and ultrasonic cholecystography, we studied 208 randomly selected patients with possible cholelithiasis. The patients underwent both procedures, and the results were interpreted in blind fashion. Two hundred patients had satisfactory confirmation of their diagnosis, by either a well visualized radiographic cholecystogram or operation or both. The overall accuracy of the ultrasonic examination was 93 per cent, with a false-negative rate of 11 and an indeterminate rate of 4 per cent. The indeterminate rate was 24 per cent for the single-dose oral cholecystogram and 8 per cent for the double-dose oral cholecystogram. Both ultrasonic cholecystography and radiographic cholecystography are useful to detect gallstones. Our findings support using single-dose oral cholecystography as the routine first examination. If the gallbladder is not satifactorily visualized, ultrasonic cholecystography can be performed immediately. In an emergency or for patients who might be pregnant, ultrasonic cholecystography is available as the initial examination.

A simple radioactive microsphere method for measuring regional flow and cardiac output.

The determination of regional blood flow and cardiac output with radioactively labeled microspheres and a reference arterial sample has been assessed in the rabbit. Paired determinations of cardiac output with the microsphere and indocyanine green dye dilution methods correlated well (F=236; p

Evaluation of renal transplants with ultrasound.

Ultrasound scanning is useful in evaluating renal transplants: it is atraumatic, independent of renal function, and well suited for analyzing such common complications as lymphocele, abscess, hydronephrosis, and hematoma. When there is uncertainty as to the nature of a paranephric mass, ultrasonically guided percutaneous aspiration is definitive. Ultrasound can also detect the acute increase in renal volume associated with rejection and may prove to be a valuable adjunct in the early diagnosis of this problem.

Ultrasonically Guided Percutaneous Aspiration Biopsy of the Pancreas

Percutaneous aspiration biopsy guided by ultrasound can obtain material for cytologic examination with more specificity and less trauma than currently used methods. The technique is described.

Collateral vessel formation: isolation of a transferable factor promoting a vascular response

SummaryCollateral vessel formation to the kidney was induced by renal artery stenosis or embolization in six dogs. Extracts from control and collateral-forming kidneys were assessed for their ability to promote a vascular response in the hamster cheekpouch. The highly significant response evoked by particulate and soluble fractions of cytoplasm from collateral-forming kidneys suggests a humoral element in collateral vessel formation.ZusammenfassungDie Nebengefäßbildung der Niere bei der renalen Arterienstenose oder bei Embolie wurde an 6 Hunden untersucht. Auszüge zur kontrollierten und gleichzeitigen Nierenbildung wurden wegen ihrer Fähigkeit, eine vaskuläre Reaktion in dem Backenbeutel des Hamsters anzuregen, angelegt. Die signifikant hohe Antwort sagte aus, daß bei teilweisem und löslichem Bruch des Zytoplasmas von den gleichseitig ausgebildeten Nieren ein humorales Element bei der Nierenbildung naheliegt.

Real-Time Ultrasound: Its Role in Abdominal Examinations

Until recently, real-time ultrasound has not had a central role in abdominal examinations due to the limited resolution of the scanners. However, a new generation of high-resolution real-time scanners has been introduced in the past year, and these machines are now being promoted as principal abdominal scanners. The authors have used a mechanical, phase-focused, annular array in conjunction with a conventional articulated-arm B-scanner for over a year in more than 2,000 examinations. Based on this experience, they present the argument that high-resolution real-time should be used as the standard technique for abdominal examination, and that it is not necessary to have a conventional articulated-arum scanner as backup.