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Biomedical subjects

B Kramann

Publications and source records attributed to B Kramann.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Comparison of radiation exposure of patients caused by selected interventional and angiography procedures--initial results].

PURPOSE: To determine and judge patient doses caused by selected interventional and angiographic procedures using the "Multiskip" digital C-arm unit. MATERIALS AND METHODS: The dose-area product and the fluoroscopic time were measured for 71 percutaneous transluminal angioplasties (PTA), 33 PTA with stent implantation, and 37 embolizations; in addition, they were also measured for 285 digital subtraction angiographies (DSA). In the case of 13 PTA, 10 embolizations, and 33 DSA the number of radiographs was determined, and the dose-area product was divided into two parts, fluoroscopy and radiography, applying a computer programme. RESULTS: The median values of the dose-area product and the fluoroscopic time amounted to 36 Gy cm2 and 11.5 min for PTA, 131 Gy cm2 and 14.4 min for PTA with stent implantation, 197 Gy cm2 and 24.5 min for embolisation as well as 87 Gy cm2 and 3.7 min for DSA. For the relation between dose-area products caused by fluoroscopy and radiography and the number of radiographs, median values of 0.67 and 70 for PTA, 0.58 and 153 for embolisation as well as 1.35 and 135 for DSA were determined. CONCLUSIONS: To reduce the relatively high patient doses the modification of the C-arm unit is aspired to realize pulsed fluoroscopy and automatic filter selection. Also experimental investigations will be done related to additional filtration and reduction of the image intensifier input dose rate and dose per frame, respectively. Then, the effect of dose reduction caused by these measures will be confirmed in a comparable patient study.

Angiography↗
PubMed1999

[Urologic importance of interventional radiology techniques].

In radiology several therapeutical methods were developed and introduced into clinical routine in the last 10 to 15 years. In part these techniques are in competition with established surgical procedures although their main advantage is significantly less invasion. For the urologist diagnostic radiological procedures like selective blood sampling from renal or suprarenal vessels for hormone determination or CT-guided biopsy of retroperitoneal tumors are of special interest as well as procedures with therapeutic aims such as placement of drainage-tubes, percutaneous therapy of varicoceles and arterial endovascular interventions for hemorrhage or vascular wall stenosis. The role of these interventional techniques relevant for urology is described and critically discussed.

Angioplasty, Balloon↗
PubMed1998

[Percutaneous therapeutic embolization in therapy refractory, non-traumatic epistaxis].

UNLABELLED: The records of 24 patients with severe intractable non-traumatic epistaxis were reviewed to evaluate the efficacy of embolism therapy. MATERIAL AND METHOD: The histories of 17 patients with idiopathic epistaxis, 6 patients with Osler-Rendu-Weber disease and 1 patient with a high-flow angioma were analyzed. All patients were treated by means of percutaneous embolization of the maxillary artery and its branches. RESULTS: In 5/17 patients with idiopathic epistaxis repeat embolization was necessary in 5 cases, while permanent hemostasis was achieved in 16/17 patients with embolism alone. Five of the 6 patients with Osler-Rendu-Weber disease labelled stage III before treatment were managed successfully with repeated embolizations, while all cases were reduced to stage I disease. The high-flow angioma was successfully ablated after embolization combined with direct injection of thrombosing material and laser resection.

Adult↗
PubMed1998

[Seminal vesicle cysts associated with ipsilateral renal agenesis. Diagnosis, and long-term clinical course].

Congenital seminal vesicle cysts associated with ipsilateral renal agenesis or dysplasia are rare malformations. Even though they are more often diagnosed today due to the introduction of advanced, sectional imaging techniques as CT and MRI, no reliable data about the prevalence of this malformation are available. This study reports seven consecutive cases, with long-term follow-up in five cases (26-119 months, mean 52 months). All patients underwent sonography, excretory urography, CT and MRI. Only two of seven patients presented nonspecific symptoms of the lower urinary tract; five were asymptomatic. In all cases sonography revealed the cystic character of the retrovesical enlargement. The anatomy of the lower pelvis was most accurately shown on MRI, which depicted the ectopic insertion of the ureter into the seminal vesicle in five cases. Cysts demonstrated high signal intensities in T1- and T2-weighted spin-echo images. In five cases the CT density was over 40 HU. Whereas one patient (15 years) presented significant enlargement of the cysts 10 years after primary diagnosis with compression of the urinary bladder, four patients showed no changes of their malformation in the follow-up examinations. The present data therefore support the concept of treating only symptomatic patients.

Adolescent↗
PubMed1998

Dose reduction in thorax radiography in simulated neonates with additional filtration and digital luminescence radiography.

PURPOSE: To determine the minimum acceptable radiation dose for an adequate image quality in thorax a.p. radiographs of neonates using mobile X-ray equipment. MATERIAL AND METHODS: The influence of additional filtration (1.0 mm Al + 0.1 mm Cu) on image quality and radiation dose was determined for the speed class 400 screen-film system (SFS) and digital luminescence radiography (DLR) by making radiographs of a test phantom. Conventional and digital thorax a.p. radiographs of a rabbit were produced using various tube current-time products. The quality of the rabbit radiographs was judged by eight radiologists applying image quality criteria according to the German guidelines and the recommendations of the European Community. RESULTS: The added filter resulted in a dose reduction of 39% at 66 kV. DLR gave a further dose reduction of 25% in comparison to the speed class 400 SFS while maintaining adequate image quality, i.e. the radiographs were clinically acceptable with regard to quality criteria. CONCLUSION: The radiation dose resulting from thorax a.p. radiographs of neonates can be reduced by approximately 50% with the use of additional filtration and DLR.

Animals↗
PubMed1997

Use of preoperative vascular embolisation in spinal metastasis resection.

Preoperative selective embolisation was carried out on 17 patients with spinal metastases from various primary tumours. There was a significant reduction in the blood loss (2088 ml) and infusion volume requirement (3500 ml) and more favourable postoperative haemoglobin (Hb) development compared with the non-embolised but otherwise identical control group. The reduced intraoperative bleeding manifested itself in the form of greater clarity and a less complicated intraoperative course. Particularly with a dorsal approach, the reduced bleeding permitted more exact preparation and more extensive tumour resection. Preoperative embolisation is thus a valuable aid in spinal metastasis resection. Given suitable indications and exact positioning of the embolising material, no significant complications should arise. The method as a whole calls for close collaboration between interventional radiologists and spinal orthopaedists.

Blood Loss, Surgical↗
PubMed1997

[A new application of balloon catheter in TAE].

We report a new embolization method with cobra catheter and balloon catheter in TAE for aneurysms and arterioportal fistula. Embolization for one aneurysm and one arterioportal fistula was performed using a cobra catheter, and the target vessel was temporarily blocked using a balloon catheter during the intervention. 2 cases of aneurysms and arterioportal fistula were treated successfully without coils reflux. Application of both cobra catheter with balloon catheter in TAE is effective without complication.

Adult↗
PubMed1997

[Percutaneous embolization therapy in severe cervicofacial hemorrhages].

PURPOSE: To analyse the use of transcatheter embolisation. MATERIAL AND METHODS: We report on 43 patients treated by transcatheter embolisation for head and neck haemorrhage from 1987 to 1995. There were 13 patients with idiopathic intractable epistaxis, 6 with iatrogenic and three with traumatic bleeding, 7 patients with bleeding from vascular malformations, 12 patients with haemorrhage from tumours, one ruptured aneurysm of the inferior thyroid artery and one patient bleeding from a retrolingual dystrophic goitre. RESULTS: In 11/13 patients with idiopathic epistaxis, this could be stopped. In 8/9 of the traumatic and iatrogenic bleedings the haemorrhage was treated by embolisation alone. In two cases additional elective surgical interventions were necessary. In 6/7 patients with vascular malformations embolisation resulted in long-lasting periods free from bleeding. Palliative embolisation in bleeding tumours resulted in haemostasis in 10/12 patients. Bleeding was definitely stopped in a patient with aneurysm of the inferior thyroidal artery as well as in a patient with bleeding from a dystrophic goitre. We observed a total of three complications, two transitory neurological disturbances and one permanent amaurosis. CONCLUSION: Transcatheter embolisation is an effective tool in the treatment of life-threatening head and neck bleedings.

Acute Disease↗
PubMed1997

[MRI in testicular diagnosis: differentiation of seminoma, teratoma and inflammation using a statistical score].

PURPOSE: To differentiate scrotal pathology via MRI by means of a statistical score. METHODS: Between 1989 and 1995 MR images of 105 patients with scrotal pathology were rated retrospectively. In 69 cases linear discriminant analysis was used to differentiate seminoma, teratoma and inflammation. Six MRI attributes were found to be necessary and were weighted with a factor according to their importance. These factors were used to build a score. RESULTS: Criteria found to be important contained the distribution of the variate extensions of elements inside the pathological area and their maximal and minimal signal intensities. Furthermore, the contrast pattern of the pathological area and the visibility of healthy tissue in the pathological testicle was of importance. Seminoma was found to be homogeneous and well demarcated against healthy tissue. Teratoma was also well defined but characterised by inhomogeneous distribution of signal intensities. Inflammation showed diffuse signal increase of the pathological testicle, especially in T1-sequences. Using the score differentiation between tumors and inflammation succeeded in 94.2% between seminoma and teratoma in 89.7%. CONCLUSIONS: Compared to other studies using visual MR image analysis differentiation of scrotal diseases was improved by using a statistical score.

Adult↗
PubMed1997

[Congenital cysts of the seminal vesicles with ipsilateral kidney agenesis. Clinical aspects of 7 cases].

Seminal vesicle cysts with ureteral ectopy and ipsilateral renal agenesis or dysplasia are rare congenital malformations. This study reports 7 consecutive cases in a single center and, for the first time in the literature, reports long-term results on 5 cases. Patients were between the age of 15 and 57 years. The malformation was diagnosed in all cases with excretory urography, computed tomography, magnetic resonance imaging and cystoscopy. 5 patients were followed after diagnosis for 26 to 119 months (mean 52 months). Only 2 of 7 patients primarily presented with nonspecific lower urinary tract symptoms. One patient (15 years old) showed significant enlargement of the cysts with compression of the urinary bladder and signs of urinary incontinence 10 years after primary diagnosis. The other 4 patients had no changes of their malformation. In conclusion, seminal vesicle cysts with ipsilateral renal agenesis are now more frequently diagnosed because of the increasing use of sectional imaging procedures. They are mostly asymptomatic and their morphology does not change with time. These data support the concept of only treating symptomatic patients.

Adolescent↗
PubMed1996

[Comparative study on the long-term effect of permanent embolization of hepatic artery with Bletilla striata in patients with primary liver cancer].

From May, 1990 to Sept., 1993 106 cases of primary liver cancer were treated by temporary or permanent hepatic arterial embolization with Bletilla striata powders (permanent, 56 cases) or gelfoam powders (temporary, 50 cases) under controlled technical conditions, in term of degree of tumor necrosis, revascularization of tumor, and long-term effect, the results of Bletilla striata group were better as compared with those of gelfoam group. The 1, 2 and 3 year survival rates were 44.9%, 33.6% and 33.6% in Beltilla striata group while the rates were 48.9%, 31.1% and 16.0% in gelfoam group, suggesting that Bletilla striata is superior to gelfoam as an embolizing agent for hepatic carcinoma.

Antineoplastic Agents, Phytogenic↗
PubMed1996

[Arterioportal fistulas in the extra-hepatic circulation of the common hepatic artery. Diagnosis and radiologic interventional therapy].

Two cases of arterioportal fistulas and new possibilities in diagnosis and treatment are reported: A 62-year-old women was admitted to our hospital with abdominal pain. Color flow duplex sonography showed an arterioportal fistula between the proper hepatic artery and the ectatic portal vein that was confirmed by angiography, permitting percutaneous embolization as a definitive treatment. The pain disappeared immediately. A 36-year-old man underwent surgery due to a penetrating gastric ulcer. He was referred to us with an abdominal murmur. Color flow duplex sonography proved by spiral CT with 3D reconstruction and maximum intensity projection (angio-CT) revealed an arteriovenous fistula between the gastroduodenal artery and a mesenteric branch. Angiography confirmed the diagnosis and permitted definitive therapeutic embolization.

Adult↗