Tord Olin

Muco-Pyocele of Sphenoidal Sinus or Posterior Ethmoidal Cells with Special Reference to the Apex Orbitae Syndrome

Almost 60 cases of mucocele of the sphenoidal and posterior ethmoidal sinuses have been described in the literature. Two new eases are added. The necessity for early diagnosis is emphasized if irreparable damage to one or both eyes is to be prevented. Rhinological examination was informative in one third of the cases. Ophthalmological examination may draw the attention to the apex orbitae. If the examiner is aware of the existence of such a condition, thorough radiological investigation including tomography will, as a rule, give a clear and confident diagnosis. Surgical therapy is best accomplished by endonasal drainage by a transmaxillary approach and not by craniotomy.

Stenosis of the Celiac Artery

The celiac axis is commonly involved by generalized atherosclerosis and other vascular diseases. Derrick, Pollard, and Moore (3) found its diameter narrowed in 44 per cent of 110 unselected autopsy cases. In 21 per cent of these cases, moreover, the narrowing was more than 50 per cent. In spite of this high incidence of severe celiac stenosis, surprisingly little note is made of celiac occlusive disease by authors writing about abdominal angina. Since the pancreaticoduodenal arcades connect major branches of the celiac and superior mesenteric arteries, an evaluation of both vessels, as well as of the inferior mesenteric artery, is necessary in the investigation of intestinal vascular insufficiency. Several authors point out that two of these three major aortic visceral branches must be narrowed before symptoms of the syndrome appear (8, 10). When such is the case, the perfusion pressure distal to the stenoses is quite low, providing flow adequate to preserve the life, but not the function, of the intestin...

A Pharmacoangiographic Method for Improving Nephrophleboqraphy

DENAL VEINS are normally observed during the venous phase of selective renal arteriography, but the contrast density is low because of dilution and excretion of the medium in the kidney. Cortical veins are never seen because they are concealed by the dense, contrastfilled parenchyma. Density in the venous phase has been improved in animals by using radiopaque agents which are not filtered by the kidney, such as Thorotrast (3) and emulsified oil (12), but because of their toxicity these agents cannot be employed in man. The most common method of demonstrating renal vein morphology is by catheterization of that vein, followed by retrograde injection of contrast medium against renal blood flow (5, 10). This flow quickly rinses out the medium and prevents adequate filling of the peripheral renal veins. Good filling of the peripheral renal veins has been obtained by injecting contrast material at high pressures between the balloons of a double-balloon catheter, which have been inflated on either side of the re...

COTTON FIBER EMBOLIZATION DURING ANGIOGRAPHY. A CLINICAL AND EXPERIMENTAL STUDY.

THE INJECTION of particulate foreign material into blood vessels during angiography obviously should be judiciouslyavoided. This report emphasizes one potential mechanism of accidental injection of foreign material. Case Reports CASE I: K. S., a 42-year-old man, entered the hospital for evaluation of hypertension. Intravenous pyelography showed a mass in the lower pole of the right kidney, and renal arteriography was performed. A PE 240 catheter was passed into the aorta through the right femoral artery by the Seldinger percutaneous technic. Abdominal aortography was performed twice with the injection of 30 ml of Renografin 764 during each procedure. The PE 240 catheter was then replaced with a radiopaque catheter (Kifa No.2, green) for selective renal arteriography. Ten milliliters of Renografin 60 was injected into the right main renal artery, and serial films were obtained. A lower pole right renal artery could not be catheterized, and 10 ml of Renografin 60 was injected in the aorta near the origin of...

Dye Dilution Technique with Nephroangiography for the Determination of Renal Blood Flow and Related Parameters

Urography and angiography have long held a well established position in the diagnosis of renal disease, although information such as of clearance and flow measurements is, however, often required. Renal blood flow may easily be measured by an indicator dilution technique in connection with angiography. The present investigation was undertaken to evaluate the determination of such flow by this method, used as a complement to urography and nephroangiography.

Development of portasystemic shunts after subcutaneous transposition of the spleen in the rat

Abstract Transposition of the spleen to the abdominal subcutaneous tissue in rats was performed, and the development of collaterals between the portal and systemic venous vessels was studied. The effects of different modifications in operative technic and of the time lapse after transposition on the development of these anastomoses were examined. The capacity of the collaterals was studied by determining survival after acute portal ligation, by recording portal pressure, and by performing angiography. The clinical significance of the method described is still to be demonstrated.

Neurotoxicity of roentgen contrast media. Study of the blood-brain barrier in the rabbit following selective injection of contrast media into the internal carotid artery.

The tOXICIty of modern contrast media injected intravenously is low. When such media are administered intra-arterially, however, toxicity is still a problem and this is cspeciaIly true for the central nervous system. Damage to the bloodbrain barrier following injection into the common carotid artery has been used as a parameter of the neurotoxicity of contrast media. BROMAN & OLSSON (1948) developed this method in the rabbit, trypan blue, which will not normally leak through the barrier, being used as an indicator to demonstrate the lesions. Similar studies have been made in other species, for example the dog (WHITELEATHER & DESAUSSURE 1956). Indicators other than trypan blue have also been used, for example sodium fluorescein (SMITH et call. 1951), l:n I human serum albumin (EDSTROM 1961) and :j~P-orthophosphate (GONSETTE & ANDRE-BALISAUX 1967). Another method of studying damage to the capillary endothelium of the brain has been microscopy following silver staining (MCCONNELL & MERSEREAU 1964). When the bloodbrain barrier is damaged, contrast medium leaks out into the brain parenchyma

Electromicturition in Male Dogs at Pelvic Nerve Stimulation: An Urethrocystographic Study

Electromicturition released by stimulation of the pelvic nerves has been studied in 23 male mongrels. This course has been followed by measurements of the bladder pressure and urethrocystography with filmchanger and cinefluorography respectively. In order to investigate the influence of various nerves, muscles and erectile tissue on micturition, the experiment was varied as follows. The pudendal nerves were severed or stimulated. The pelvic nerves were cut proximal to the electrodes. The bulbocavernous muscle was cut. Chordotomy was performed in some dogs immediately before the examination. Sympathectomy was made 2-6 weeks prior to the study. Finally, angiography of the pudendal artery was accomplished with and without stimulation of the pelvic nerves. Electrical stimulation of the pelvic nerves always gives rise to a contraction of the detrusor. Simultaneously an antidromic stimulation of the external sphincter appears, complicating the micturition, which is clearly demonstrated during the first phase of...

Arteriovenous Fistulae in Rabbit Kidney Studied by Dye-Dilution Technique and by Angiography

The effects of percutaneous punctures of kidneys of rabbits were studied by nephroangiography and by determination of renal blood flow using a dye-dilution technique. The punctures were made during the actual examination or up to 7 days earlier. At puncture small fistulae immediately were created, often only detectable by the dye-dilution technique. Slight arterial hypertension was registered in one rabbit with fistula, perhaps due to focal ischemia. Various vasoactive drugs were tested in order to increase the diagnostic accuracy at angiography and at the dye-dilution study. Only angiotensin proved to be of advantage. The combination of nephroangiography and blood flow determination using dye-dilution technique in man with fistulae, hemangiomas and tumours should be valuable, especially if angiotensin is employed.

Renal blood flow and function in the rabbit after surgical trauma. III. Effects of temporary occlusion of renal artery.

The renal artery was occluded in rabbits for varying lengths of time with the aid of a balloon catheter. Before and after the period of ischaemia, renal blood flow was measured by a dye-dilution technique and the glomerular and tubular functions were evaluated by measuring the extractions of labelled EDTA and Hippuran. Prolongation of the period of continuous ischaemia from 15 to 60 minutes resulted in a progressive increase in the postocclusive hyperaemia, but in a reduction of the renal function. Compared with 30 minutes of continuous occlusion, 30 minutes of intermittent occlusion caused only slight hyperaemia, but the same degree of reduction in renal function. One day after 30 minutes or 60 minutes of ischaemia, renal blood flow was within the range of the normal flow. After 30 minutes of occlusion, renal function was re-established 7 days later, whereas after 60 minutes of ischaemia, function was still severely impaired 7 days later. Fourteen days after 60 minutes of occlusion, renal function was 50% or less of the normal. Juxtamedullary shunting has not been demonstrated in the present investigation. Metabolic changes and cellular damage remain as possible explanations of the postocclusive changes in renal blood flow and function.