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Biomedical subjects

K Amplatz

Publications and source records attributed to K Amplatz.

At least 217 records · Page 12Linked to original sources

Transvenous embolization of internal spermatic veins: nonoperative approach to treatment of varicocele.

Eleven men, shown on routine spermatic venography to have bilateral varicocele, underwent transjugular bilateral embolization of the internal spermatic veins with stainless steel coils or Ivalon plugs. Embolization of the left spermatic vein was successful in 9; in the other 2 it was not attempted because of aberrant drainage of the vein. Embolization of right spermatic vein was successful in 8 patients. There were three complications, none of which was serious. These preliminary results suggest that both internal spermatic veins can be occluded consistently by the transjugular approach. However, it has not yet been established that fertility is improved by detecting and correcting varicocele on the right side.

Embolization, Therapeutic↗

Varicocele and male subfertility.

Unilateral and bilateral subclinical varicocele was found by internal spermatic venography in 10 of 30 men with stress-pattern semen and normal endocrine profiles. Seven of the 10 had no clinical evidence of varicocele. Right-sided varicocele may be almost as common as varicocele on the left and may be responsible for much of the bilateral effect of clinical left-sided varicocele. Transjugular venography has a low morbidity rate and can be used to clarify the relation between subclinical varicocele and infertility. The technique also permits nonsurgical treatment of varicocele.

Adult↗

Comparison of various quantization methods of segmental ventricular wall motion in ischemic heart disease.

Numerous methods of measuring regional myocardial wall motion are in use. A critical comparison is needed to assess the strengths, weaknesses, accuracy, and precision of these methods. This paper reports the evaluation of five methods using computer-assisted interactive graphics. Fifty cines were selected: 16 from normal subjects, and 34 from patients with proven cardiovascular diseases. Tracings were made of the opacified left ventricle in end systole and diastole and digitized. All fifty cines were analyzed by five methods using computer-implemented graphic techniques. The results included a display of the silhouettes, which were translated and rotated according to various methods. In addition, the percent contraction for eleven myocardial regions was tabulated and displayed. The sixteen cines from normal subjects were used to derive a range of "house" normal values for region contraction patterns with which the measurements from the 34 abnormal patients were compared. The five methods were evaluated by comparing results from the computer-aided analysis with the visual assessment of two experienced radiologists. One method was found, the results from which agreed with the radiologists' visual impression for every case. This computer-aided method was quantitative and reproducible. Consequently, it can give information which supplements the visual impression.

Coronary Angiography↗

Syphilitic aneurysms of the innominate artery.

Syphilitic aortitis can cause formation of fusiform or saccular aneurysms of the ascending aorta or transverse arch. The authors report 3 cases in which a saccular aneurysm developed at the origin of the innominate artery and was seen as a mediastinal mass on the chest radiograph.

Adult↗

Radiographic scanning in barium examinations of the gastrointestinal tract.

The possibility of using radiographic scanning for gastrointestinal studies was evaluated experimentally. Two tubular barium-filled phantoms containing simulated ulcers and polyps were placed in a 25-cm water container, and radiographs made with the conventional technique and scanographic technique were compared. Images obtained with the radiographic scanner were superior in contrast and sharpness. Two-millimeter polyps could be easily detected in the larger phantom. Due to improved latitude the larger phantom could be adequately penetrated without overexposing the smaller phantom. This was not possible with the standard technique. Best results were obtained with a heavily filtered 140-kVp beam. Radiographic scanning has great promise in barium examinations of the gastrointestinal tract.

Barium Sulfate↗

Embolization of the spermatic vein for treatment of infertility: a new approach.

A new transjugular technique for spermatic venography and nonsurgical transcatheter occlusion of incompetent spermatic veins is described. With this technique, the left spermatic vein was easily catheterized in 28 of 30 patients examined, and in 21 patients the vein could be occluded. Right spermatic vein catheterization was attempted in 25 patients. Right-sided spermatic vein occlusion was successful in 17 of 24 patients. The vein could not be selectively entered only twice. Bilateral incompetence of the spermatic veins in men with primary sterility is the rule rather than the exception. Valvular incompetence does not necessarily produce a clinically detectable varicocele. Bilateral venography is indicated in all men with abnormal spermiograms.

Adult↗

Transvenous angioplasty of experimental branch pulmonary artery stenosis in newborn lambs.

A dilatable form of bilateral branch pulmonary artery stenosis was created in 27 newborn lambs. Nine lambs were long-term survivors and were dilated with modified Grüntzig balloon dilation catheters. They were allowed to recover for 6-9 weeks, during which time there was no significant change in the mean systolic gradients across the narrowed sites. Thirteen arteries underwent dilation. Dilation was associated with a decrease in the systolic gradient in all cases (from 34.9 mm Hg to 8.1 mm Hg) and an increase in the diameter of the narrowed site (from 4.6 to 7.6 mm) as estimated by angiography. Flows and flow distribution were measured in four lambs before and after unilateral dilation using 15-mu radiolabeled microspheres; in each case, the fraction of total flow to the dilated lung rose after dilation (19.2 to 45.4%), as did the total flow to the dilated lung (30.0 to 69.2 ml/kg-min). Four lambs were catheterized every 2-4 weeks for an average of 16 weeks after dilation; the average gradient in these lambs remained below 10 mm Hg despite considerable growth (from 9.6 to 25.9 kg). Gross pathologic examination showed an intact vascular adventitia in all cases; there were multiple linear tears in the intima in recently (less than 7 days) dilated cases, but complete intimal healing had occurred by 2 months after dilation. No significant morbidity could be attributed to the dilation procedure. These results indicate that clinical trials are warranted.

Angioplasty, Balloon↗

The three types of criss-cross heart: a simple rotational anomaly.

Criss-cross heart is an angiographically confusing malformation where apparent crossing but not mixing of contrast medium is seen at atrioventricular level. The malformation can be understood by a clockwise or counter-clockwise ventricular rotation. In the normal heart or one with complete transposition ventricular rotation is clockwise. With corrected transposition rotation occurs in a counter-clockwise fashion. One case of criss-cross heart with associated corrected transposition and two criss-cross hearts occurring with complete transposition are reported.

Heart↗

Isolation of a subclavian artery.

Eight patients with isolation of a subclavian artery are described. Isolation of subclavian artery is defined as a loss of continuity between the subclavian artery and aorta but with persistent connection to the homolateral pulmonary artery through a ductus arteriosus. The connecting ductus arteriosus may or may not be patent. As the pulmonary vascular resistance is usually lower than the systemic resistance, the isolated subclavian artery is perfused by subclavian steal, and if the connecting ductus arteriosus is patent, flow occurs from the subclavian artery into the pulmonary artery. In this material and in all reported cases, isolation of subclavian artery has always been associated with other anomalies of the aortic arch, such as right aortic arch or bilateral ductus. Its frequent association with intracardiac defects, usually the tetralogy of Fallot, makes its recognition clinically important. Thoracic aortography with delayed filming is the only procedure that allows consistent diagnosis of this rare anomaly during life.

Child, Preschool↗