Compound angulation for the angiographic evaluation of renal artery stenosis

The increasing role of percutaneous transluminal angioplasty in the therapy of renal artery stenosis has, in turn, emphasized the need to optimize imaging of the entire length of the main renal artery and its major branches. The usual angiographic positioning techniques for anteroposterior and oblique views may not be adequate to define the precise location and extent of a stenosis. The authors combine oblique projections with sagittal angulation of the x-ray tube to augment the standard imaging methods for selective renal arteriography.

Anatomic variations of the coronary arteries supplying the anterolateral aspect of the left ventricle: possible explanation for the "Unexplained" anterior aneurysm

Coronary arteriograms of 418 adult patients were studied to ascertain the frequency of variations in blood supply of the anterolateral free wall of the left ventricle; 92.6% had from one to three ramus medianus or diagonal branches supplying this area. Complete absence of any ramus medianus or diagonal branches was exceedingly rare (only 0.5% in this series), and when this occurs the angiographer should suspect complete occlusion of one or more such branches immediately at their origins. Failure to detect ostial occlusion of a ramus medianus or diagonal branch may be a cause of significant misinterpretation of coronary arteriograms.

Small-intestine involvement in Waldenstrom's macroglobulinemia. Case report and review of the literature

A patient presented with a three-year history of diarrhea and was found to have a monoclonal gammopathy (IgM lambda) and a malabsorption syndrome with dilatation of the small bowel. Small-intestinal biopsy revealed a homogeneous eosinophilic granular material between the epithelial cells. On electron microscopy this material was shown to consist of an electron-opaque background mixed wit radiolucent lipid sheres. Immunofluorescent studies showed the accellular material to consist entirely of IgM-reactive material. The patient's course and a review of the literature is presented.