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Contrast Study (contrast + study)
Selected AbstractsORIGINAL INVESTIGATIONS: Potential Faces of Patent Foramen Ovale (PFO PFO)ECHOCARDIOGRAPHY, Issue 8 2010F.R.C.P., Tasneem Z Naqvi M.D. Background: Patent foramen ovale (PFO) is diagnosed on echocardiography by saline contrast study with or without color Doppler evidence of shunting. PFO is benign except when it causes embolic events. Methods and Results: In this report, we describe unique additional manifestations related to the diagnosis and presentation of PFO. These include demonstration of PFO during the release phase of "sigh" on the ventilator in the operating room, use of a separate venipuncture to allow preparation of blood-saline-air mixture after multiple failed saline bubble injections, resting and stress hypoxemia related to left to right shunting across a PFO in the absence of pulmonary hypertension, presentation of quadriperesis secondary to an embolic event from a PFO and development of a thrombus on the left atrial aspect of PFO in a patient with atrial fibrillation, and on the right atrial aspect of PFO in a patient who had undergone repair of a flail mitral valve. Finally, in one patient with end-stage renal disease, aortic valve endocarditis and periaortic abscess, PFO acted as a vent valve relieving right atrial pressure following development of aortoatrial fistula. Conclusion: PFO diagnosis can be elusive if appropriate techniques are not used during saline contrast administration. PFO can present as hypoxemia in the absence of pulmonary hypertension, can be a rare cause of quadriperesis, and can be associated with thrombus formation on either side of interatrial septum. Finally, PFO presence can be lifesaving in those with sudden increase in right atrial pressure such as with aortoatrial fistula. (Echocardiography 2010;27:897-907) [source] Characteristics of Exercise-Induced Intrapulmonary Arteriovenous Fistula in Patients with Unexplained Exertional DyspneaECHOCARDIOGRAPHY, Issue 8 2010Stephanie J. Kelly B.S. Dynamic appearance of intrapulmonary arteriovenous fistula (AVF) during exercise may be associated with unexplained exertional dyspnea (UED) and can be diagnosed with an agitated saline contrast study during exercise echocardiography. However, the occurrence of AVF during exercise in patients with UED has not been well described. Thus, the frequency of exercise-induced intrapulmonary AVF in the outpatients with UED was retrospectively analyzed. Thirty-nine outpatients (age: 53 ± 12, 33 female) with UED underwent symptom-limited supine bicycle exercise echocardiography. Ten patients (26%) developed exercise-induced intrapulmonary AVF. Patients with and without AVF showed the similar peak exercise heart rate, systolic blood pressure, and rate-pressure product. The patients with AVF demonstrated a small but significant decrease in arterial oxygen saturation with exercise as compare to baseline (95.6 ± 2.8% at peak, vs. 97.5 ± 2.5% at baseline, P < 0.05 with a paired Student t -test). Our study suggests that exercise-induced intrapulmonary AVF is relatively common in the outpatients with UED and associated with mild exercise desaturation; however, the mechanism of desaturation could not be determined by this study. Further investigation to characterize and determine the clinical significance of AVF is warranted. (Echocardiography 2010;27:908-913) [source] Management of cor triatriatum dexter by balloon dilatation in three dogsJOURNAL OF SMALL ANIMAL PRACTICE, Issue 1 2004M. Stafford Johnson Two dogs, one immature and one adult, were presented with a history of progressive ascites. In a third, immature dog, increasing exercise intolerance had been noted. Echocardiography demonstrated a partition in the right atrium (cor triatriatum dexter) and echocontrast studies documented normal flow from the cranial vena cava into the right atrium and ventricle. A saphenous vein contrast study demonstrated flow from the caudal vena cava into an accessory right atrial chamber (sinus venarum). The sinus venarum communicated with the true right atrium via a small defect in the atrial membrane in one dog, and additionally with the left atrium via a right-to- left shunting foramen ovale in the other dogs. All defects were visualised on angiographic studies by selective catheterisation of the caudal vena cava via the femoral vein. Balloon dilatation of the defect was then performed using a small followed by a larger balloon angioplasty catheter to enlarge the defect in the atrial membrane. Clinical signs improved within days and were sustained in the long term in all cases. [source] Multi-scale analysis of soil erosion dynamics in Kwazulu-Natal, South AfricaLAND DEGRADATION AND DEVELOPMENT, Issue 3 2005M. P. W. Sonneveld Abstract For a case study area in the Okhombe catchment in the province of KwaZulu-Natal, South Africa, a multi-scale analysis of soil erosion dynamics was performed. At sub-catchment level, the dynamics of erosional features were investigated by means of aerial photographs. At site level, the changes in soil physical and chemical properties were investigated by means of a fence-line contrast study. Attention was paid to both surface and subsurface erosion phenomena. The number of erosional features in the study area in 2000 was not substantially different from the number of features in 1945. At sub-catchment level, an increase in the number of gullies was observed from 1975 to 2000 but this followed a substantial inactivation of most erosional features from 1962 to 1975. Increases in erosional activity in 1962 compared to 1945 were mainly related to abandoned cultivated fields. At site level, a significant decrease in soil C/N ratio was observed within the fenced site within three years. For the same site, total carbon, saturated hydraulic conductivity and bulk density were not significantly different for the topsoil inside the fenced area compared with outside. Subsurface erosion phenomena mainly occur in the communal grazing areas and are mostly related to transitions between permeable and less permeable layers. The complex relationships between soil erosion, land use change and climate might further be understood by involving local people in the development, monitoring and evaluation of alternative types of land use, which is also likely to facilitate future steps in controlled grazing management. Copyright © 2005 John Wiley & Sons, Ltd. [source] TEMS: an alternative method for the repair of benign recto-vaginal fistulaeCOLORECTAL DISEASE, Issue 6 2008R. J. Darwood Abstract Indications, The repair of high recto-vaginal fistula can be challenging since access may be limited via the endo-anal approach yet the alternative trans-abdominal route carries significant morbidity. We report the use of TEMS to repair a recto-vaginal fistula following anterior resection and pelvic radiotherapy. Method, The patient was placed prone and a 25cm rectoscope was inserted. A proximally based mucosal advancement flap was raised to repair the fistula. The patient was discharged 2 days later and a contrast study confirmed closure of the fistula. Comparison with other techniques, TEMS allows excellent visualisation of a rectovaginal fistula compared to standard endo-anal or trans-vaginal techniques. The morbidity is lower than the trans-abdominal route. Comments, TEMS is a useful technique for the repair of benign recto-vaginal fistula and has distinct advantages over conventional techniques. [source] Management of diverticular fistulae to the female genital tractCOLORECTAL DISEASE, Issue 5 2007F. Hjern Abstract Objective, Fistulae to the female genital tract are an infrequent but severe complication of diverticular disease. The purpose of this study was to evaluate treatment and outcome in patients with diverticular colo-genital fistulae. Method, Sixty women treated for diverticular fistulae (DF) to the female genital tract during 1992,2004 were identified. Clinic and operative charts were reviewed. Mean age was 70 years and mean follow-up time after surgery was 1 year. Results, Most common presenting symptoms were vaginal discharge of faeces or gas (95% of patients) and abdominal pain (43%). About 75% of patients had undergone a hysterectomy. Forty-six patients underwent at least one radiological contrast study and the fistula was demonstrated in 35 (76%) patients. Fifty-seven patients had surgery, and findings included colo-vaginal fistulae (n = 47), colo-uterine fistulae (n = 2) and multiple fistulae involving vagina and other organs (n = 8). A sigmoid resection and primary anastomosis was performed in 51 and a Hartmann procedure with colostomy in six patients. Sixteen (28%) patients experienced morbidity after surgery, including anastomotic dehiscence (n = 4) and ureteric injury (n = 3). There was no mortality. Conclusion, Diverticular fistulae to the female genital tract usually occur in elderly patients with a prior hysterectomy. Radiological contrast studies demonstrate the fistulous tract in most cases. Sigmoid resection and primary anastomosis results in a satisfactory outcome in the majority of patients. [source] | ||||||||||