Implantation of the Talent endograft device is a safe and effective alternative to open surgery for exclusion of abdominal aortic aneurysm. In comparison with first-generation grafts, the device showed superior durability for as long as 5 to 7 years after implantation. Even if prototypes of the Talent device were implanted in this study, the graft was also successfully used in most patients, even in those with adverse anatomy. Because improvements of the endograft have been made to address connecting bar breaks, a lower incidence of graft limb occlusion can be expected in the future.
Percutaneous transluminal angioplasty of aortoiliac and femoropopliteal atherosclerotic lesions can provide long-lasting hemodynamic improvement. High-dose aspirin is commonly prescribed as reocclusion prophylaxis, but low doses would be preferable because of fewer adverse effects. We performed a double-blind, randomized, controlled clinical trial in patients with peripheral vascular disease with lesions appropriate for angioplasty. We compared the efficacy and side effects of two doses of aspirin (50 mg vs. 900 mg daily) during a period of 12 months after angioplasty. A total of 359 patients were evaluated: 175 were randomly assigned to treatment with 900 mg aspirin daily and 184 to 50 mg aspirin daily. Thirty-nine patients developed restenosis at the angioplasty site; the cumulative percentage of event-free survival after 1 year (patency rate) was 85% in 900 mg group and 84% in 50 mg group. An equivalence test showed the two groups equivalent with respect to restenosis rates (P = 0.0003 for an equivalence region of < 10% difference. Nine patients (5%) in the 900 mg group had serious gastrointestinal side effects (peptic ulcer, 8; erosive gastritis requiring transfusion, 1) compared to two ( peptic ulcer) in the 50 mg group (P = 0.03). The results of our study show that a dose of 50 mg aspirin a day is as effective as 900 mg for the prevention of restenoses after lower limb angioplasty, and that severe gastrointestinal side effects are less frequent.
The use of thyroid protection collars is an effective preventive measure against exceeding occupational organ dose limits, and a thyroid shield also considerably reduces the effective dose. Therefore, thyroid protection collars should be a required component of anti-X protection.
In 32 cases pancreatic cysts were diagnosed by endoscopic pancreatocholangiography (ERPC) all confirmed by subsequent surgery. From the X-ray findings, we can enumerate the following symptoms as being typical of or at least suspicious for pancreatic cysts: I. Direct filling of cyst cavity. 2. Filling defect in the pancreatic branches and parenchyma. 3. Obstruction of the main pancreatic duct as a strict or as a tapering type abruption. 4. Displacement and compressions of the common bile duct. Pancreatic cysts were located in the head region in 17 cases and in 15 cases in the tail region. Single cysts are seen more often than multiple cysts. If a pancreatic cyst is diagnosed or suspected by ERPC, surgery is indicated. The time of operation depends on the X-ray findings. Filled cysts without discharge into the main duct must be operated on immediately, at least within 10 hours of ERPC, due to the danger of purulent infection.Key-Words: Endoscopic pancreatocholangiography (ERPC), pancreatic cysts, X-ray findings in the pancreatic duct system, X-ray findings in the common bile duct, localization of the cysts.Until recently, pancreatic cysts could be diagnosed only by indirect methods prior to surgery. X-ray of stomach and duodenum, including hypotonic duodenography, and Endoscopy 6 (1974) 77-83 Röntgenbefunde bei Pankreaszysten dwelt endoskopische Pankreatocholangiographie Bei 32 Patienten wurden Pankreaszysten durch die Methode der retrograden Pankreatocholangiographie (ERPC) diagnostiziert und nachfolgend operativ bestatigt. Nach den Röntgenbefunden sind die folgenden Zeichen typisch oder weitgehend verdachtig auf das Vorliegen von Pankreaszysten: 1. Direkte Auffilllung eines zystischen Hohlraumes. 2. Fiillungsdefekt in den Seitengangen und im Parenchym des Pankreas. 3. Abbruch des Pankreashauptganges, entweder scharf oder allmahlich verdammernd. Verlagerung und Einengung des Ductus choledochus. In 17 Fallen waren die Pankreaszysten in der Kopfund in 15 Fallen in der Schwanzregion lokalisiert. Einzelzysten waren häufiger als multiple Zysten. Wenn mittels ERPC eine Pankreaszyste nachgewiesen wird oder der dringende Verdacht besteht, ist ein chirurgisches Vorgehen angezeigt. Der Zeitpunkt der Operation hangt dabei vom röntgenologischen Bild ab. Gefüllte Zysten ohne freien Abfluß in den Ductus Wirsungianus sollten wegen der Gefahr einer Superinfektion umgehend, spatestens aber innerhalb von 10 Stunden nach durchgeführter ERPC operiert werden. intravenous cholangiography displacements, compression, obstructions and impressions may indicate a pancreatic cyst. Also, selective angiography of the arteria coeliaca and the
Various radiological methods for estimating lung volume depend on anatomical correlation with the volume of the thorax. It is not possible to derive general factors for correcting these methods and the accuracy and reliability can be improved only by introducing individual corrections. It must also be remembered that radiometric calculations of gas volume and lung capacity depend on the assumption that there is a fixed relationship between these. This, however, is untrue for a whole series of patho-physiological circumstances. Because of these problems, we describe our own radiometric method.
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