Hydatidiform mole with large ovarian cysts and venous thrombosis: a case report.

A 24-year-old gravida 1 with benign molar pregnancy, which was evacuated after 12 weeks of amenorrhea, developed ovarian cysts that reached the costal margin. Afterwards, she developed thrombosis, which occluded the superior vena cava as well as the right axillary vein. Treatment with streptokinase, followed by heparin and warfarin sodium, apparently resulted in a clinically complete cure. The ovarian cysts regressed spontaneously, and regular menstrual cycles recurred.

A controlled clinical trial of streptokinase and heparin in the treatment of major pulmonary embolism.

Treatment with streptokinase or heparin was allocated randomly to 20 patients with major pulmonary embolism verified by angiography. In addition, 4 patients treated with streptokinase and 1 patient treated with heparin were included in the trial prior to the start of treatment. Streptokinase of heparin was given for 72 hours and pulmonary angiography was repeated. The angiographic evidence of thrombolysis was significantly greater (p less than 0.01) in the 14 patients treated with streptokinase than in the 11 treated with heparin. In the heparin group, 1 patient died from massive embolism 15 hours after the start of treatment. In another patient who died 4 weeks later from cerebral glibolastoma, persistent massive embolism contributed to the fatal outcome. In the streptokinase group, 1 patient with a metastatic pulmonary carcinoma died 3 weeks after the start of treatment from gangrene of both legs following thrombotic occlusion of the inferior vena cava. Bleeding was more common after treatment with streptokinase than with heparin, but was not a serious problem in any patient. It is concluded that patients with life-threatening pulmonary embolism should be offered the benefits of streptokinase.

Vectorcardiographic changes at selective coronary angiography. Comparison of two contrast media.

Vectorcardiography revealed typical changes following routine selective coronary angiography using Urografin 60% and Isopaque Coronar; the response was dose-dependent. The two contrast media compare well with one another, no statistical difference being recorded, indicating that there is no difference in myocardial toxicity.

The diagnosis of colitis by colonoscopy with biopsy and X-ray examination. A blind comparative study.

The examinations were performed in 40 outpatients, of whom 21 were women. From the rectal and colonic mucosa 185 biopsies were obtained. The X-ray examination was performed within one week from the colonoscopy, using a conventional barium enema. A complete agreement between the colonoscopic diagnosis and that of the directed biopsy was found in 33 cases (80 per cent), and minor disagreements in 3 cases. A complete agreement between the colonoscopic and X-ray diagnoses was obtained in 22 patients (55 per cent), and minor disagreements in 16 cases, most of whom showed "unspecific" non-ulcerative colitis. In 3 cases with ulcerative colitis a normal colon was found by X-ray. A higher percentage of cases showed decreased haustration by X-ray examination than by colonoscopy, whereas a fairly equal percentage of ulceration was detected by the two methods. Erosions, mucus covering, oedema, vascular injection, and bleedings were not detected by X-ray examination.

Selective coronary arteriography.

A series of 414 selective coronary arteriographies in 322 patients has been done at Ullevål Hospital from May 1971 to Jan. 1974. Judkins technique was used in all cases. The indications for arteriography, the diagnoses as regards the coronary arteries, the therapeutic consequences,and the complications of selective coronary arteriography are described.

Aortocoronary vein bypass in patients with angina pectoris.

In the 3-year period from May 1971 to April 1974, 90 patients had aortocoronary bypass for angina pectoris at Ulleval Hospital. One patient died shortly after the operation (operative mortality 1.1%). There were no further deaths in the observation period. Clinical improvement was seen in 93% of the patients, early shunt patency in 92%. The study suggests that patients with isolated affection of the right coronary artery should not have bypass, because these patients 1) had less severe symptoms, 2) had better preserved left ventricular function, and 3) seemed to have a smaller chance of benefiting from the operation than the other patients. Multiple shunts gave good clinical results and carried no higher surgical risk than did single shunts. Good clinical results were seen also in patients with occluded shunts provided they had at least one patent shunt too. Graft occlusion occurred early and was associated with low graft flow as measured intraoperatively. Graft occlusion was not usually followed by demonstrable myocardial necrosis. In view of the small operative risk and the high score of symptom relief it is concluded that all patients with angina pectoris that does not readily respond to medical treatment, should be considered for aortocoronary bypass.