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Biomedical subjects

J Lammer

Publications and source records attributed to J Lammer.

At least 127 records · Page 7Linked to original sources
PubMed1986

Biliary drainage endoprostheses: experience with 201 placements.

Two hundred one biliary endoprostheses were inserted transhepatically with a two-step procedure in 162 patients. Teflon endoprostheses were inserted in the initial 95 patients and polyethylene in seven others. Because in vitro experiments and clinical experience have revealed a lower incrustation rate with Percuflex and polyurethane, endoprostheses made of these materials were used in the last 60 patients. The mortality rate directly related to the procedure was 3.7%, and postprocedural complications occurred in 9% of the patients. Delayed complications included cholangitis in 20%, obstruction in 6%, and dislocation in 3% of the cases. The mean survival time of all 162 patients was 20 weeks. It is concluded that endoprostheses offer effective palliative treatment of obstructive jaundice caused by malignancy.

Adult↗
PubMed1986

Intraarterial fibrinolysis: long-term results.

Intraarterial fibrinolytic therapy was performed in 136 patients suffering from arteriosclerotic thrombosis of the iliac and femoropopliteal arteries. The initial success rate was 78%. Despite anticoagulation therapy, early recurrent thrombosis was observed in 10% of the patients. The 2-year cumulative patency rate after recanalization was 81%. These results are competitive with those of reconstructive vascular surgery. Therefore, intraarterial fibrinolysis has become a viable alternative to surgery in treating segmental peripheral occlusions more than 4 cm in length that are less than 6-9 months in duration.

Adult↗
PubMed1986

Intraarterial fibrinolysis: in vitro and prospective clinical evaluation of three thrombolytic agents.

In order to investigate and compare the fibrinolytic activity of streptokinase, streptokinase-Glutamine-plasminogen, and urokinase for intraarterial fibrinolysis, as in vitro test and a prospective trial were performed. For the in vitro demonstration of lytic activity, fibrin plates with plasminogen and fibrin plates without plasminogen were incubated with streptokinase; with streptokinase-plasminogen in molar proportions of 1:1, 1:2, and 2:1, and with urokinase. In order to examine the in vivo activity of the different lytic solutions, 98 patients suffering from peripheral arterial occlusions were divided into three homogeneous groups for treatment with streptokinase, streptokinase-plasminogen, and urokinase. Although urokinase was superior to streptokinase on the fibrin plate with plasminogen, no difference was demonstrated in vivo between the two lytic agents. Streptokinase-plasminogen in a molar proportion of 1:2 showed significantly higher fibrinolytic activity than any other solution. Therefore, the fibrinolytic agent of choice for intrathrombotic injections seems to be a 1:2 solution of streptokinase with plasminogen or with the lytic enzyme plasmin itself.

Aged↗
PubMed1986

Biliary endoprostheses in tumors at the hepatic duct bifurcation.

In 51 patients with tumors at the hepatic duct bifurcation, endoprostheses were transhepatically inserted into the bile ducts. Patients with Bismuth-3-tumors (i.e. bilateral biliary obstruction) were treated by insertion of 2 or more endoprostheses. Long-term success presumed drainage of all obstructed ducts, because cholangitis has been a common problem secondary to undrained segments. Furthermore the debris and the high viscosity of infected bile increased the risk for obstruction of the endoprostheses, which was observed in 6%. The mean time of survival was 7 months with a maximum of 26 months. In our experience endoprostheses can be used successfully in unresectable Klatskin tumours, which increases the comfort for the patients in their last months of life.

Adult↗
PubMed1986

[Agenesis of the inferior vena cava].

A case of agenesia of 3 of the 4 segments the vena cava inferior is presented. The embryogenesis of the v. cava inferior is discussed in so far as is relevant for the malformation in this case. Exact diagnosis and classification can be made via intravenous and intraarterial DSA and computed tomography.

Adult↗
PubMed1985

[Indirect mesentericoportography with prostaglandin E1].

Indirect mesentericoportography was performed in 36 patients after administration of prostaglandin E1 and immediately before contrast medium injection. The results were compared with the findings in a control group of 20 patients receiving tolazoline as vasodilator. On comparing prostaglandin E1 with tolazoline no significant improvement in contrast enhancement of the superior mesenteric vein was obtained. On the other hand, prostaglandin E1 seemed to produce less side effects than tolazoline.

Adult↗
PubMed1985

[State of the art of digital subtraction angiography in diagnostic angiology].

Digital subtraction angiography (DSA) has become a widely accepted method which has decreased the risks of angiographic investigations. Intravenous DSA is the preferred method for screening investigations of carotid and renal arteries and in postsurgical control studies. Intraarterial DSA will be indicated if a detail information is required. The technical principles of time and energy subtraction will be explained, the different methods of contrast medium application will be discussed.

Angiography↗
PubMed1985

[Jugulotympanic paraganglioma].

A case is described of a jugulotympanic paraganglioma in a 64-year-old woman with extentions down the jugular vein to the clavicle and penetration of the cerebellar fossa. The symptoms, differential diagnosis, therapy and prognosis are discussed on the basis of this case report and compared with the literature. The importance of radiological investigation (e.g. selective angiography and computed tomography) in respect to diagnosis and determination of tumour size is emphasized. The diagnostic value of the immunohistochemical detection of neuron-specific enolase, a neuroendocrine cell marker and S-100 protein is stressed. The most favourable therapy, depending on tumour extension, seems to comprise preoperative embolisation, radical resection and postoperative radiotherapy.

Diagnosis, Differential↗
PubMed1985

Pseudotumorous pancreatitis.

Chronic pancreatitis can occasionally present as a focal, noncalcified mass, indistinguishable from carcinoma. Radiologic studies in 21 such patients were considered to show carcinoma in 16 and an islet cell tumor in 5 patients. Seventeen of the patients came to laparotomy when a palpable mass was found in each; 9 of the patients had a partial pancreatectomy, and multiple biopsy specimens were taken in 8 patients. Four patients did not come to surgery; in them the diagnosis was based on examination of percutaneous biopsy specimens and follow-up. In all patients the histologic diagnosis was chronic relapsing pancreatitis.

Adenoma, Islet Cell↗
PubMed1985

Complications of renal tumor embolization.

In 121 renal tumor embolizations with four different embolic agents (Gelfoam, Ivalon, ethanol, coils) the mean complication rate was 9.9%, with a mortality of 3.3%. Because of the large embolized tumor mass and the severely impaired health of patients, the complication rate in palliative embolizations was about four times as high as in preoperative procedures. Complications most commonly encountered were renal failure and unintentional embolization of nontarget organs.

Adult↗
PubMed1985

[Reduction of the rate of cerebral angiography complications by a standardized study method].

The complications from cerebral angiography encountered in 1034 patients between 1977 and 1982 are described. A standardised technique of cerebral transfemoral catheter angiography is outlined, which helps to reduce the number of complications. The role of the disease for which the examination is done, and the effect of the new contrast media on the risk of the examination, are discussed. Patients with a compromised blood-brain barrier and manifest reduction in cerebral blood flow run a greater risk than patients with other abnormalities. Low osmolar contrast media are better tolerated subjectively. Theoretically, their use would be expected to lead to a reduction in complications but, so far, it has not been possible to confirm this.

Adult↗
PubMed1985

[Percutaneous transhepatic bile duct endoprosthesis. Choice of material, technic, clinical results].

Eighty biliary endoprostheses were introduced by the transhepatic route in sixty patients with obstructive jaundice. Complication rate was 21% (no mortality). Average survival time is sixteen weeks (maximum 53 weeks). In most patients, a 12 F teflon endoprosthesis was introduced four to five days after the initial catheter drainage. Patients in poor condition had a primary implant of a 9 F endoprosthesis. A combined transhepatic/transoral implantation was carried out five times. Results have shown that implantation of a prosthesis is as effective as a surgical bypass operation for palliation of obstructive jaundice and that it is better than catheter drainage. In-vitro experiments have indicated that failure of a 12 F prosthesis due to encrustation may be expected in about 23 weeks. This is in line with the survival time of patients with carcinomas.

Adenoma, Bile Duct↗
PubMed1985

[Intracranial arteritis with circulating immune complexes].

Thirty-eight patients below the age of 50 years were investigated and in twelve, circulating immune complexes were found. Eight of these had angiographic evidence of an arteritis of the intracranial vessels. The causative factors, the role of the circulating immune complexes and the angiographic appearances in intracranial arteritis are discussed.

Adolescent↗
PubMed1985

Fibrinolysis in chronic arteriosclerotic occlusions: intrathrombotic injections of streptokinase. Work in progress.

Forty-seven patients with chronic arteriosclerotic occlusions of iliac and femoropopliteal arteries were treated by intrathrombotic fibrinolysis. The occlusions were 10-65 cm (mean, 22 cm) long and 6 weeks to 2 years (mean, 4.5 months) old. By means of consistent intrathrombotic injections of 2,500 units of streptokinase every 5 minutes, the thrombi were recanalized within 1-7 hours (mean, 2.5 hours). The primary recanalization rate was 75% (35/47), the patency rate after 2 weeks, 68%. In 29 patients (62%), a residual stenosis had to be dilated by balloon angioplasty. Because of the low total dose of streptokinase (mean, 70,000 units), the thrombin time was elevated up to twice the normal value in only one patient. Bleeding that required transfusions was observed in only two patients (4%). Advantages of intrathrombotic fibrinolysis include higher recanalization rate, lower total dose of streptokinase, fewer bleeding complications, and shorter therapy time than previously reported with other treatments.

Adult↗
PubMed1984

[High-dose methylprednisolone in the treatment of terminal cancer patients].

High-dose corticoid therapy was assessed in 36 patients with end-stage cancer of various different types. These patients were compared with a control group of patients with terminal cancer on a conventional palliative regimen without corticoid therapy. Euphoria, a decrease in the required dose of analgetic and psychopharmacological drugs and an anti-inflammatory effect in cases with peritumorous oedema were observed in 27 patients.

Breast Neoplasms↗
PubMed1984

Lymphatic metastases to the esophagus.

The authors present 4 cases of esophageal involvement by lymphatic spread of tumors originating in the stomach, distal esophagus, and thyroid. Double-contrast radiographs of the esophagus showed discontinuous submucosal extension and multiple polypoid masses.

Adult↗