Search PubMed⌕ Search

Biomedical subjects

K Klose

Publications and source records attributed to K Klose.

At least 19 recordsLinked to original sources

Methodological issues in evaluating a culture-based substance abuse treatment program in the Kuskokwim Delta, Alaska.

This paper presents a rationale for using videotape records in evaluation research. Although videotaping is commonly used in ethnographic and sociometric analysis, the evaluation literature does not show the application of these recording techniques to program evaluations. The authors outline a model for exploring the effectiveness of video in qualitative program evaluation.

Alaska↗

[A short infusion or a bolus injection of contrast medium in i.v. urography. Comparative density measurements in the kidney pelvic-caliceal system using sequential computed tomography].

The rate of contrast injection during i.v. urography may vary considerably (bolus injection or drip infusion). The effect of 5 rates of injection (6, 12, 18, 36 and 72 ml/min) on the contrast density in the renal collecting system was examined over a period of 30 minutes. Measurements showed an inter-individual difference of more than 200% in each group. The intra-individual variations for different rates of injection were very slight; individual concentration in the kidney for a given dose depends only slightly on the rate of injection. There is no statistically significant improvement in contrast values as a result of a bolus injection. The reduced incidence of side effects justifies the use of bolus injections but pressure injections are unnecessary from a diagnostic point view.

Adult↗

[A renal function analysis using computed tomography. CT clearance versus 131I-hippuran clearance].

The CT clearance in a number of urological patients (39 patients, 25 with normal renal function) was studied by means of an "area under curve" (AUC) method, using a region of interest. 31 patients were given meglumine ioxithalamate and 8 patients Iopamidol as a contrast medium. Both for total and partial function there was highly significant correlation with isotope clearance with good reproducibility. The difference in the pharmacokinetics of the contrast media affected the absolute clearance values.

Contrast Media↗

[Lymphographic findings in AIDS patients].

The lymphographic findings in 20 patients with AIDS-most in clinical stage IV-can be divided into four categories. In six there were no specific changes and in a further six the storage pattern was that of sinus histiocytosis. One patient showed transition to malignant lymphoma and another patient had atypical mycobacterial infection of the retroperitoneal lymph nodes. Six patients showed a lymphographic pattern of scarring. The results of this study show that lymphography is a sensitive method that can provide important additional information.

Acquired Immunodeficiency Syndrome↗

[The status of computerized tomography and conventional tomography in the assessment of endobronchial growth and extension of central bronchial cancer].

In comparison with endoscopy, computed tomography can produce excellent results with respect to the endobronchial spread of central bronchial carcinomas. Used for the same purpose, conventional tomography of the central bronchial system is greatly inferior. With respect to an evaluation of the endobronchial tumour growth configuration, computed tomography of the chest showed agreement with the endoscopic findings in only 56 per cent of all cases. This would seem to indicate that for the planning of palliative bronchological measures, such as, for example, laser therapy and afterloading treatment, prior endoscopic inspection is indispensable. By themselves, the results obtained with the imaging procedures described in this article are not adequate.

Bronchi↗

Intraabdominal abscesses--percutaneous catheter drainage versus operative treatment.

From 65 patients with 73 abscesses 38 were treated by operation and 27 by PCD. The mean duration of drainage was 6.8 days (OP) and 7.4 days (PCD) respectively. In the surgical group 2 patients needed reintervention and 1 died due to sepsis. In the PCD group 1 patient had to be operated on because of insufficient drainage and 1 died after perforation of the colon. With modern techniques of imaging (Ultrasound, CT) PCD is a useful tool in the therapeutic regimen of intraabdominal abscesses. PCD has to be considered as definitive treatment or preparation for surgical eradication. Above all indication to PCD depends on localization and cause of the abscess.

Abdomen↗

Peripheral competition in the control of sensory neuron numbers in Xenopus frogs reared with a single bilaterally innervated hindlimb.

Sensory neurons were counted in the hind-limb innervating spinal ganglia on both sides of juvenile Xenopus frogs which, as tadpoles, had had one hind limb bud amputated prior to innervation, and a channel made to allow innervation of the remaining limb bud from both sides. The total number of sensory neurons surviving on the two sides approximated the number on one side of normal frogs, the ipsilateral and contralateral numbers being negatively correlated. These effects differ markedly from the effects on motoneuron numbers, suggesting different control mechanisms of cell death in the two neuronal classes.

Animals↗

[Conventional x-ray study and computed tomography in the diagnosis of orbital fractures].

37 cases of skull fractures with involvement of the orbit were reviewed retrospectively. The value of plain films, tomography and computed tomography was analysed. Combined use of 28 degrees Caldwell and water views revealed 96% of all orbital floor fractures. Orbital emphysema in facial bone fractures nearly almost (in 14 of 15 cases) indicated involvement of the medial orbital wall. CT--performed on a biplane basis--showed best diagnostic accuracy in evaluating orbital fractures. Axial CT scans revealed only 70% of all orbital floor fractures. Because of that coronal scans are especially necessary for evaluating the orbital floor and the orbital roof. CT is necessary for evaluating the medial orbital wall since conventional radiology only shows 15% of all medial orbital wall fractures.

Adolescent↗

[Magnetic resonance tomography in the diagnosis of cervix cancer. Computed tomographic and histological correlations].

The value of magnetic resonance tomography in the diagnosis of carcinoma of the cervix was studied in a prospective series of 20 patients. The results were compared with those of computed tomography and with the clinical findings. The diagnosis depended on the postoperative histology. Gynaecological examination proved superior to imaging methods in determining the extent of local tumour spread. Tumour involvement of the regional lymphatic system was better demonstrated by MRT than by CT. Exact staging proved inadequate with both these methods and the new imaging methods have not produced any changes in operative planning or technique.

Adult↗

[Problem of pretherapeutic staging of cervical carcinoma. Studies of the diagnostic value of computerized tomography and magnetic resonance tomography in comparison with gynecologic palpation findings and pathologic-anatomic diagnosis].

In a prospective study of 20 cases, the importance of nuclear magnetic resonance as a diagnostic tool in cervix carcinoma was investigated. The results were compared with those of the Computer tomography as well as with those of the clinical examinations. The histology served as "Standard". In the evaluation of the local tumor invasion the gynecological examination appeared to be the most important. The involvement of regional lymph nodes was detected more accurately by the NMR as compared to CT. The exact clinical staging was not achieved by either method; thus these new diagnostic methods do not alter the planning and the technique of the operation.

Adult↗

[Computerized tomography of the thorax in intensive care patients].

Thoracic CT for patients in intensive care is cumbersome but provides important additional information in the presence of complicated lung changes. Total opacification of a lung field visualised on conventional portable films may be due to infiltration and/or fluid and/or collapse by using the clinical information in conjunction with densitometric measurements. CT may help in the differentiation of pulmonary oedema, particularly in the presence of ARDS and its complications. It is also possible to accurately localise abscesses and empyemas in the presence of extensive consolidation. This makes it possible to drain abscesses or empyemas, or pleural fluid in unusual situations, which has become loculated, or to aspirate a pneumothorax.

Adult↗

Is the bile duct diameter a reliable parameter to diagnose extrahepatic cholestasis? Relationship between bile duct diameter and bile duct pressure.

The common bile duct (CBD) pressure was determined in 57 patients before endoscopic retrograde cholangiography (ERC) and related to the diameter of the CBD and the common hepatic duct (CHD). We found that despite a weak overall positive correlation in the individual patient, CBD or CHD diameters do not correlate with CBD pressure. In patients without extrahepatic cholestasis and normal CBD pressure, both CBD and CHD diameters were measured in a wide range between 5 and 32 mm. Extrahepatic cholestasis due to distal CBD obstruction is reflected by a high CBD pressure, but cannot be identified reliably by measuring the CBD diameter which is found within the range of patients not obstructed. In cholecystectomized patients, CBD and CHD are significantly (p less than 0.005) wider than in non-cholecystectomized patients (8.8 +/- 1.0 vs. 13.3 +/- 1.2 and 9.2 +/- 0.9 vs. 14.2 +/- 1.2 mm, respectively). The CBD pressure, however, is nearly identical in both groups. It is concluded that the assessment of CBD and CHD diameter is not a reliable parameter for the diagnosis of extrahepatic cholestasis which--in certain cases--could be proved by endoscopic retrograde manometry.

Cholangiography↗

[Palliative bile duct irradiation].

Carcinoma of the common hepatic bile duct or common bile duct were treated by interstitial irradiation with gold seeds using the percutaneous transhepatic drainage partly boosted by external irradiation. The interstitial dose of 50 Gy was given in two applications and 40 Gy by linac. Twice histological examination showed wide tumor destruction of local irradiation, but also much more tumor extension than seen before by diagnostic investigation. Mostly the therapy is only palliative because of the infiltration of liver and lymph nodes.

Aged↗

Age and sex dependency of bile duct diameter and bile duct pressure--an ERC manometry study.

Using ERC-manometry diameters of the common bile duct (CBD) the common hepatic duct (CHD) as well as CBD pressure before and after opacification were determined in 35 non-cholecystectomized patients without extrahepatic cholestasis. We found a significant rise of both CBD and CHD diameters as well as CBD pressure recorded before the injection of contrast medium with increasing age. (p less than 0.005, less than 0.001 and less than 0.05 respectively). Following the opacification CBD pressure became elevated. Again this increase tended to be more pronounced in older patients although this association was lacking statistical significance. In the presence of comparable age female patients (n = 16) exhibited higher CBD and CHD diameters (n.s.) as well as CBD pressure values (p less than 0.05) than male patients (n = 19). We conclude that in the absence of extrahepatic cholestasis bile duct diameter as well as bile duct pressure rise significantly with increasing age. Furthermore women tend to have higher diameters and pressure values than men.

Adult↗

Computed tomography in xanthogranulomatous pyelonephritis.

Two cases of xanthogranulomatous pyelonephritis (XGP) examined preoperatively by computed tomography are reported. In one, preoperative diagnosis of an inflammatory abscess-forming disease was possible. Several features of computed tomography in XGP permit differentiation from renal carcinoma. Global renal enlargement, the presence of calculi, the spread of infiltration into the fatty capsule with thickening of Gerota's fascia, and the characteristic density differences between cortex and medulla as a result of reduced contrast medium concentrations in the pyramids are suspicious of this special form of interstitial nephritis.

Diagnosis, Differential↗