Enhancing the Applicability and Effectiveness of Intraaortic Balloon Counterpulsation

Severe maneuvers designed to enhance the applicability and effectiveness of intraaortic balloon pulsation are presented. (1) Insertion of balloon catheter directly into the ascending aorta. The technique uses an indwelling silastic snare that allows direct insertion of a balloon catheter into the ascending aorta in the course of open heart operations without the necessity of returning the patient to the operating room and reopening the chest at the time of balloon catheter removal. (2) Elimination of electric artifacts in the course of intraaortic balloon assist. A method is presented that utilizes optical rather than electric signals to operate the intraaortic balloon pump and eliminates pacer interference as well as other electrical artifacts. (3) Enhancing assist effectiveness by balloon positioning. In a series of clinical observations, it was found that the effectiveness of balloon assist may be enhanced by as much as 75% by appropriate positioning. The previously held concept that placing the balloon in a subclavian location is optimal is challenged and it is recommended that the proper position of the balloon catheter be determined by using appropriate hemodynamic measurements in different locations. (4) Control of bleeding following removal of percutaneously inserted transfemoral balloon catheter. The technique utilizes a balloon catheter which is introduced into the puncture hole of the femoral artery after minimal surgical dissection and allows direct suturing of the bleeding source.     

Conjunctival biopsy in Sjögren''s syndrome: correlations between histological and immunohistochemical features

A primary tumour of the right atrium with morphological, ultrastructural and immunohistochemical features of a synovial sarcoma is described. This appeared to have arisen from a benign so-called mesothelioma of the atrio-ventricular node and had metastasized to the lungs. The histogenesis and relationship of these two tumours are discussed.     

Ultra-high-strip-density radiographic grids: a new antiscatter technique for mammography

We conducted a comprehensive study on the application of ultra-high-strip-density (UHSD) grids to mammography for the improvement of image contrast. These UHSD grids have strip densities of 70 to 100 lines/cm. After investigating the performance of mammographic grids with various design parameters through Monte Carlo simulation studies, we made prototypes of UHSD grids having lead strip thicknesses of 20 to 37 micron, aluminum interspacer thicknesses of 80 to 120 micron, and grid ratios of 2 to 6. The UHSD grids can be placed inside the cassette without a Bucky tray and thus will not increase geometric unsharpness. The measured physical characteristics and the phantom images obtained confirmed our findings in the simulation studies. A 40 to 90% increase in contrast was achieved at Bucky factors of 2 to 3.5; these results are comparable with those from conventional antiscatter grid techniques in mammography. The potential usefulness of the UHSD grids was demonstrated in a preliminary clinical comparison of mammograms.