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Biomedical subjects

S D Braun

Publications and source records attributed to S D Braun.

53 records · Page 3Linked to original sources
PubMed1985

Intravenous digital subtraction angiography in the preoperative evaluation of renal masses.

Intravenous digital subtraction angiography (DSA) was performed in 23 patients with renal masses to document tumor extension into the main renal vein or inferior vena cava. The DSA findings were compared with computed tomographic as well as surgical and pathologic findings. Additional data regarding the number of renal arteries present and the relative vascularity of the tumor were also gathered. DSA documented 17 true-negative renal veins, three true-positive renal veins, and one false-negative renal vein. Two patients could not hold their breath long enough to evaluate the renal vein. In 17 of 19 cases, single renal arteries to the affected kidney were correctly identified. In three patients, two renal arteries to the involved kidney were correctly identified. The renal masses were avascular in two patients, hypovascular in five, moderately vascular in eight, and hypervascular in seven. In one case the mass was out of the field of view, and vascularity was not evaluated. In these patients, DSA was an accurate and relatively noninvasive method to assist in the preoperative evaluation of renal masses.

Adenocarcinoma↗
PubMed1985

Nitrous oxide: effective analgesic for vascular and interventional procedures.

During a 2 year period nitrous oxide was used as a sole or supplementary analgesic during 173 vascular or interventional procedures including peripheral angiography and endourologic and endobiliary procedures. The decision to administer nitrous oxide to a given patient was a matter of physician preference. Patients with bowel obstruction, pneumothorax, or chronic obstructive pulmonary disease were excluded from this method of analgesia. The nitrous oxide was administered by a radiology nurse under the supervision of an attending radiologist. Nitrous oxide was used without premedication for 39 procedures and with premedication (usually meperidine 1 mg/kg, promethazine 0.3 mg/kg, or atropine 0.01 mg/kg) in 134 procedures. In 74% of nonpremedicated individuals analgesia was adequate with nitrous oxide alone; 26% required supplemental intravenous medication. In 61% of premedicated individuals pain relief was adequate with nitrous oxide; 39% required supplemental intravenous medication. Complications, including nausea, vomiting, and agitation, occurred in eight patients, but were minor and easily reversed by decreasing the concentration of nitrous oxide. Nasally administered nitrous oxide is a safe, easily used, and effective analgesic.

Analgesics↗
PubMed1984

Percutaneous transluminal angioplasty in diabetic patients: an effective treatment modality.

Percutaneous transluminal angioplasty (PTA) was performed for nonhealing ulcers, severe claudication, or rest pain in 10 patients with diabetes mellitus. Twenty-two atherosclerotic lesions were dilated in 15 extremities, including 16 iliofemoral arteries and 6 superficial femoral arteries. The procedure was technically successful in all patients and 8 of 9 (89%) with clinical follow-up showed improvement clinically after the procedure. Diabetes is not a contraindication to PTA; rather this modality can be used effectively to control and treat peripheral vascular insufficiency in diabetic patients.

Aged↗
PubMed1984

CT differentiation of thoracic aortic aneurysms from pulmonary masses adjacent to the mediastinum.

Paramediastinal masses adjacent to the aorta require a diagnostic evaluation to differentiate between tumor and aneurysm. It has been suggested that neoplasm may enhance sufficiently to be confused with a vascular structure or that a clot filled aneurysm may simulate a neoplasm by not filling with contrast medium. Five patients, two with thoracic aneurysms, two with malignancy, and one with a malignancy and an aortic dissection, are presented in whom bolus injection computed tomography (CT) was able to distinguish between aneurysm and mass. The CT examination also accurately visualized the point of communication of the aneurysm with the aorta, defined the relationship of the aneurysm to vital mediastinal structures for planning surgical resection, and helped plan the approach for percutaneous transthoracic needle aspiration when tumor was suspected. Bolus injection CT represents a rational alternative to aortography for mediastinal paraaortic masses.

Adult↗
PubMed1984

CT assistance for fluoroscopically guided transthoracic needle aspiration biopsy.

Five cases are presented that illustrate the utility of obtaining limited CT prior to fluoroscopically guided biopsy in patients who have lung or mediastinal lesions that cannot be adequately localized by chest radiography. Each case describes a unique setting in which the CT images facilitate accurate and safe biopsy needle placement. The rare requirement for biopsy using CT alone, which can be considerably more time consuming, is emphasized.

Adult↗
PubMed1984

Intraarterial digital subtraction angiography in hypertensive azotemic patients.

Ten intraarterial digital subtraction angiography studies in nine azotemic patients were reviewed to assess the technical adequacy and the effect of contrast load on renal function. All studies were of diagnostic quality. In only two of 10 studies was there a mild transient deterioration in the degree of renal insufficiency. Intraarterial digital subtraction angiography is a reliable method that can be used to evaluate the renal arteries, even in the presence of azotemia.

Aged↗
PubMed1984

Ventilation-perfusion scanning and pulmonary angiography: correlation in clinical high-probability pulmonary embolism.

During a 3-year period, 173 clinically selected patients underwent pulmonary angiography to confirm or exclude acute pulmonary embolism. All patients had undergone ventilation-perfusion (V/Q) scanning (167 patients) or perfusion scanning alone (six) before angiography. Angiography was done because the results of the V/Q scanning did not satisfy the clinician's needs for certainty. The results of the V/Q and studies were compared to determine the relative accuracy of V/Q scanning in this clinical setting. Pulmonary embolism was found in seven (15%) of 47 patients with low-probability scans, 11 (32%) of 34 patients with intermediate-probability scans, 22 (39%) of 57 patients with indeterminate scans, and 23 (66%) of 35 patients with high-probability scans. In this clinically selected population, low-probability scans were more accurate in excluding pulmonary embolism than were high-probability scans in establishing that diagnosis.

Humans↗
PubMed1983

Closed-system venography in the evaluation of angiodysplastic lesions of the extremities.

Closed-system venography is a minimally invasive, well tolerated method for diagnosing and delineating extremity angiodysplastic lesions. This method involves passive filling of the vascular tree after compressive exsanguination of an extremity and extrinsic occlusion of its arterial supply and venous drainage, thereby creating a static, closed system. Closed-system venography was done in 17 patients, where it correctly identified 11 of 12 surgically confirmed vascular abnormalities. There were no false-positive examinations. Whereas ateriography remains the examination of choice in studying arteriovenous malformations, closed-system venography has demonstrated a superior ability to diagnose and define lesions of capillary and venous origin.

Adolescent↗
PubMedDate not supplied

Urinary tract injury in patients with blunt chest trauma: the value of postaortographic abdominal radiographs.

Patients who require thoracic aortography for blunt decelerating chest trauma often sustain injury to other organ systems due to the magnitude and mechanism of injury. Hospital records and radiographs of 117 consecutive, injured patients studied with thoracic aortography were evaluated to assess the accuracy, value, and limitations of postaortographic abdominal plain radiography for detection of major genitourinary injury. In summary, major urinary tract injury occurred with a frequency of 6%, enough to justify a rapid, low cost, noninvasive screening procedure. Postaortographic plain films of the abdomen were found to be an accurate (95%) screen for detection of major urinary tract injury. The sensitivity for detection of patients with renal injury was 100%. The ability to correctly predict patients who may be safely observed (no significant renal injury) was 100%. One limitation of this technique was the poor diagnostic quality found in 15% of the abdominal radiographs, most commonly caused by excessive superimposed bowel gas. Postaortographic pelvic radiographs were believed to be valuable for detection, but not exclusion, of bladder rupture.

Adult↗
PubMedDate not supplied

Pulmonary embolism.

Pulmonary embolism is a common medical problem whose incidence is likely to increase in our aging population. Although it is life-threatening, effective therapy exists. The treatment is not, however, without significant complications. Thus, accurate diagnosis is important. Unfortunately, the clinical manifestations of pulmonary embolism are nonspecific. Furthermore, in many patients the symptoms of an acute embolism are superimposed on underlying chronic heart or lung disease. Thus, a high index of suspicion is needed to identify pulmonary emboli. Laboratory parameters, including arterial oxygen tensions and electrocardiography, are as nonspecific as the clinical signs. They may be more useful in excluding another process than in diagnosing pulmonary embolism. The first radiologic examination is the chest radiograph, but the clinical symptoms are frequently out of proportion to the findings on the chest films. Classic manifestations of pulmonary embolism on the chest radiograph include a wedge-shaped peripheral opacity and a segmental or lobar diminution in vascularity with prominent central arteries. However, these findings are not commonly seen and, even when present, are not specific. Even less specific findings include cardiomegaly, pulmonary infiltrate, elevation of a hemidiaphragm, and pleural effusion. Many patients with pulmonary embolism may have a normal chest radiograph. The chest radiograph is essential, however, for two purposes. First, it may identify another cause of the patient's symptoms, such as a rib fracture, dissecting aortic aneurysm, or pneumothorax. Second, a chest radiograph is essential to interpretation of the radionuclide V/Q scan. The perfusion scan accurately reflects the perfusion of the lung. However, a perfusion defect may result from a variety of etiologies. Any process such as vascular stenosis or compression by tumor may restrict blood flow. In addition, areas of the lung that are not well ventilated will be poorly perfused. Thus, a ventilation scan and a chest radiograph are essential to optimal interpretation of the perfusion scan. Ventilation/perfusion scans are interpreted as degrees of probability of pulmonary embolism. Emboli are not present in patients with a normal V/Q scan. An embolus is unlikely (10%-15%) among patients with a low-probability V/Q scan. However, small emboli that are nonocclusive may be present, and pulmonary arteriography may be used to further evaluate patients with a high clinical suspicion of pulmonary embolus.(ABSTRACT TRUNCATED AT 400 WORDS)

Angiography↗
PubMedDate not supplied

Biliary cytodiagnosis. Bile sampling for cytology.

The records of 121 patients who presented for PTC and biliary drainage within a five-year period were reviewed. Fifty-eight bile samples had been obtained from 38 of these patients for cytologic analysis. Malignancy was detected in 14 of 32 patients with carcinoma (sensitivity 44%). Repeat sampling was positive in four of nine patients whose initial specimen contained no tumor cells. Bile duct carcinoma, pancreatic carcinoma, and metastatic disease were all detected. An approach to biliary cytodiagnosis is offered that, it is hoped, will further minimize future false negative results.

Bile↗
PubMedDate not supplied

Encapsulation of proteins and peptides in milkfat: encapsulation efficiency and temperature and freezing stabilities.

Encapsulation of aqueous protein solution was most efficient when the butter and protein solution emulsion was at 58 degrees C before dispersion into water, although encapsulation efficiencies were high between 46 and 66 degrees C. Capsules could be produced with no emulsifiers and an emulsion temperature of 66 degrees C but no capsules were formed when emulsion temperature was lowered to 38 degrees C. Capsules with encapsulated beta-casein peptides and with proteose peptone had similar low-temperature stabilities with a loss of about 10 per cent of the peptides after 24 h at 4 degrees C. However, capsules with beta-casein peptides were slightly more stable above 26 degrees C. Little diffusion of the haemoglobin from capsules occurred at less than 20 degrees C but above 32 degrees C capsules destabilized and the haemoglobin diffused out of the capsules. Capsules were stable after freezing at -90 degrees C and -18 degrees C and could be thawed and redispersed; a 15-25 per cent loss of capsules was observed during freezing. Concentrating capsules by removing all or one-half of the dispersion fluid did not increase stability to freezing.

Animals↗