Ultrasound guided pancreatic ductography

Thirteen patients underwent ultrasound guided percutaneous pancreatic ductography during a one year period. In nine cases the procedure was performed after failure of endoscopic retrograde pancreatography (ERP) and in four patients ERP was not attempted. Under ultrasound guidance a 22 gauge needle was inserted into the pancreatic duct through a vertical transgastric route. After aspiration of 10-15 ml of pancreatic juice, contrast medium was injected into the pancreatic duct. Opacification was successful in 12 (92%) patients. No significant complications were encountered. The usefulness of the procedure in our country is highlighted.     

Catheter for endoluminal bipolar electrocoagulation

An interventional catheter was designed that can induce controlled endoluminal tissue lesions by means of bipolar radio-frequency (RF) electrocoagulation under fluoroscopic guidance. The technique was used to obtain safe and reproducible percutaneous occlusion of the porcine cystic duct by reactive endoluminal scar formation. The new triple-lumen, 7-F, polyethylene catheter contains two insulated active wires and accommodates a 0.038-inch steerable guide wire, which facilitates insertion and placement of the active catheter tip under fluoroscopic control. The coagulation technique is relatively simple and requires only a small, portable bipolar RF generator and ammeter.     

Ultrasound-guided fine needle aspiration cytology of carcinoma involving the intra-abdominal oesophagus.

Ultrasound-guided fine needle aspiration cytology (FNAC) of carcinoma of the intra-abdominal oesophagus was attempted on 21 patients with a 21 G spinal needle using a percutaneous anterior epigastric approach. The results were compared with those of endoscopic biopsy and brush cytology. The ultrasound-guided FNAC had a positive yield in 20/21 (95.2%) compared with 18/21 (85.7%) for endoscopic biopsy and 18/21 (85.7%) for brush cytology (P greater than 0.59). The combination of US-guided FNAC with endoscopic biopsy and the brush cytology achieved a positive yield in 21/21 (100%) whereas combining endoscopic biopsy and brush cytology produced a positive yield of 19/21 (90.5%). Two patients developed temporary epigastric pain. We recommend US-guided FNAC as a safe and effective technique that can be used alone or as an adjunct to endoscopic procedures for the diagnosis of carcinoma of the intra-abdominal oesophagus.     

Acute renal vein thrombosis: successful treatment with intraarterial urokinase

When acute renal vein thrombosis is associated with renal failure, aggressive therapy to eliminate the venous obstruction is indicated. There are reports of successful treatment of this condition with thrombolytic agents administered systemically or directly into the renal vein. Renal arterial administration of urokinase was used successfully to treat acute renal vein thrombosis associated with renal failure in a 9 1/2-year-old child.     

Multinuclear MR imaging: a technique for combined anatomic and physiologic studies

With the use of specially designed multiple-tuned probes for magnetic resonance (MR) imaging, data collection schemes can be developed for obtaining images of different nuclei simultaneously. Both phantom and in vivo MR images of two nuclei (either hydrogen-1, phosphorus-31, lithium-7, or fluorine-19) were obtained in the time span necessary to collect the image of the less sensitive nuclei. This technique offers a means by which physiologic and anatomic information can be gathered in a highly efficient fashion.     

INVASIVE MICROWAVE HYPERTHERMIA FOR TREATMENT OF GLIOMA*

In this paper we report preliminary results of clinical trials in which 2 patients with gliomas of the brain were treated with a combination of sur gery and microwave hyperthermia using invasive techniques, with a follow-up of more than one year. The method of treatment is discussed and the equip. ment, consisting of a 2.45 GHZ microwave genera tor and the antenna system, is described.