Minimising side effects in lumbar radiculography

An attempt was made to reduce the side effects associated with the use of Metrizamide in lumbar radiculography by the removal of the contrast medium on completion of the examination. Almost complete removal was achieved in 103 patients and of these 73% had no symptoms after examination, while 8% had severe symptoms. Eleven of 14 patients in whom removal was not attempted or was not successful had significant symptoms after examination. It is concluded that aspiration of Metrizamide will reduce the incidence and severity of the side effects associated with the use of this contrast medium.

Glucagon as a hypotonic agent in cholangiography

The effects of Glucagon on 35 cholangiographic studies was examined. Relief of spasm at the choledochoduodenal sphincter resulted in consistently improved demonstration of this area. Diminished spasm-induced pain was also recorded. The use of intravenous Glucagon is recommended for cholangiographic studies where there is total biliary obstruction, or where there is unsatisfactory demonstration of the choledocho-duodenal area.

Percutaneous needle biopsy in the management of solitary lesions of bone

Needle biopsies were performed in 12 patients with solitary bone lesions, employing a simple 18 gauge cutting needle. Material sufficient for reliable diagnosis was obtained from eight of our 12 cases, thereby avoiding exploratory surgery. It is concluded that percutaneous needle biopsy of bone is a safe and simple procedure of value in the management of solitary lesions of bone.

Angiographic evaluation of gastrointestinal haemorrhage complicating pancreatic disease

Seven patients with gastro-oesophageal varices due to splenic or portal vein obstruction from a diseased pancreas have been seen at the Mater Hospital during the past three years. Four of these patients had episodes of acute and massive gastrointestinal bleeding and this paper emphasises the role of angiography in the management of this complication. In three instances the bleeding was the result of the varices, but in one patient with carcinoma of the head of the pancreas the bleeding was shown to result from invasion of the tumour into the duodenum.

The use of prostaglandin F2-alpha in selective pancreatic and left gastric angiography

Prostaglandin F2-Alpha has been used in 10 superselective angiographic studies of the pancreas and 10 left gastric studies. Injection of Prostaglandin into the dorsal pancreatic or gastroduodenal artery increased opacification of small pancreatic vessels and better demonstrated the angiographic changes in three cases of carcinoma of the pancreas. Injection of the drug into the left gastric artery increased opacification of the left gastric vein, allowed identification of the direction of flow of the contrast medium and enhanced demonstration of gastro-oesophageal varices. It is concluded that Prostaglandin improves the quality of pancreatic and left gastric angiographic studies.

The use of prostaglandin F2 alpha in selective hepatic angiography

Comparison has been made between slow infusion hepatic angiographic studies obtained before and after the intra-arterial injection of prostaglandin F2 alpha. The prostaglandin injection resulted in increased caliber of the hepatic arteries, increased opacification of the parenchyma of the liver and improved visualization of the wall of the gallbladder. Poorly vascularized metastatic lesions were better shown on the prostaglandin studies, and carcinoma of the gallbladder was diagnosed in two instances. The demonstration of highly vascularized metastatic tumor was enhanced on the prostaglandin studies, but further improved after the injection of angiotensin.

Cross-modal induction of changes in sensory thresholds

Two experiments are reported in which subliminal stimulation of one modality with emotional material impairs detection performance in a different modality. In the first experiment the visual awareness threshold for neutral material was raised by simultaneous auditory presentation of emotional words. This result supports the hypothesis that threshold changes induced by emotional stimulation are mediated centrally. In the second experiment a similar effect was obtained when the experimental roles of the two modalities were reversed. An analysis of the effect in terms of the parameters of Signal Detectability Theory indicates that it is mediated by a lowering of the sensitivity of the detection mechanism. This may be caused either by attenuation of incoming signals, or by an increase in the level of “noise” against which the signal is received.