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Biomedical subjects

B Kramann

Publications and source records attributed to B Kramann.

At least 19 recordsLinked to original sources
PubMed1992

[Intra-arterial calcium provocation for the preoperative diagnosis of the location of an occult insulinoma].

Blood-sugar levels below 40 mg/dl were measured during syncope in two female patients (aged 59 and 73 years). Suspected organic hyperinsulinism was confirmed by a fasting test. Ultrasound examination and computed tomography failed to demonstrate an insulinoma. Coeliacomesentericography was then undertaken together with a selective intra-arterial calcium provocation test of the pancreas (0.4 or 0.5 mmol calcium in physiological saline was injected into the pancreas-supplying arteries--proximal and distal splenic, superior mesenteric and gastroduodenal). The insulin level was determined in simultaneously obtained hepatic venous blood. In case 1, the insulin level rose tenfold after calcium injection into the proximal splenic artery, indicating a process in the body of the pancreas. In case 2, a steep rise in insulin occurred after injection into the truncus coeliacus and the proximal and distal splenic artery, suggesting an insulinoma in the tail of the pancreas. The site of the insulinoma was confirmed in both cases at surgery. The adenoma was enucleated in case 1, removed by partial resection of the tail of the pancreas in case 2.--These observations show that occult insulinomas can be localized preoperatively by intraarterial calcium injection with measurement of insulin concentration in simultaneously obtained hepatic venous blood.

Aged↗
PubMed1992

[The diagnosis of bone marrow lesions in the MR tomogram in children with diseases of the hematopoietic system with special reference to post-therapy changes].

119 MR-examinations of both tibiae, knees and the lower part of both femur were performed in 41 children suffering from bone marrow disease (27 ALL, 4 AML, 3 NHL, 1 agranulocytosis, 6 anaemia). T1- and T2-spin-echo sequences and a T2-gradient-echo sequence were used. Bone marrow changes in leukaemia were diffuse before therapy and patchy after therapy. Due to their different signal in T2-weighted images, differentiation of the post-therapeutic patchy findings into infiltrations, fibrosis, necrosis and siderosis seems to be possible. In future, MRI will be the method of choice for screening and controlling bone marrow disease if the examination time is shortened by using only a T1-spin-echo sequence and a T2-gradient-echo sequence.

Adolescent↗
PubMed1992

[MR tomography of the lower limbs of children with diseases of the hematopoietic system].

In 41 children with disorders of the hematopoetic system 119 MR examinations of both tibiae and knees were performed (T1 and T2 spin-echo sequences and a T2 gradient-echo sequence). Before therapy bone marrow changes in leukemia were diffuse, and patchy during and after therapy. Signals in T2-weighted images were different for infiltrations, fibrosis, necrosis and siderosis. In 3 children suspected of suffering from osteomyelitis, Ewing-sarcoma or coxitis, MR examination was the first to show the correct diagnosis. Therefore in children indications for MR tomography should be handled more generously to win time for therapy. Using only a T1 spin-echo sequence and a T2 gradient-echo sequence screening of more than one region is capable of controlling bone marrow diseases.

Acute Disease↗
PubMed1992

[Radioimmunoscintigraphy and magnetic resonance tomography in the diagnosis of urinary bladder cancer].

Magnetic resonance tomography is a method which is sufficiently precise to demonstrate morphological changes for tumor staging of carcinoma of the urinary bladder. The stage of the tumor was correct in 68 resp. 86% of the patients. The RIS shows organ and lymph node metastases and has the capability to differentiating between scar and tumor after transurethral resection. The local spread, especially the infiltration depth of the tumor, is not visible. In 90% of the patients a primary tumor was detected, only in 5 cases a false-negative and in 2 cases a false-positive finding was made.

Adult↗
PubMed1990

[The multicentric glioblastoma multiforme].

The authors report on two cases of multicentric glioblastoma multiforme, one of them being a trilocular glioblastoma, whereas in the second case a second focus developed contralaterally. Both patients received whole skull radiation of 40 Gy. The patient who suffered from the primarily unilocal tumour was given a tumour boost. The article reports on the imaging via CT and MR.

Brain Neoplasms↗
PubMed1990

[Early and late results of PTA in relation to the patient's age].

506 cases of percutaneous transluminal angioplasty performed between 1983 and 1988 in the iliac, femoropopliteal and crural segments were analyzed with special consideration of the patients' age. The early results were significantly worse only in the age group over 70. The late results were evaluated by the life table method. Relapses within the first 6 months occurred in 13.8% of the patients over 60 and in 8.2% of the younger age group (under 60). After 12 months, however, no significant difference was observed between the two age groups. The rate of complications (overall value 7.9%) was twice as high in the geriatric age group than among the younger patients. Type and extent of the occlusion, clinical stage and run-off conditions determine the early and late results.

Age Factors↗
PubMed1989

[Diagnosis of postpartum complications using CT and MRT].

Severe puerperal infections, iliacal and ovarian vein thrombosis are post-partum complications which are potentially life-threatening. They require prompt medical treatment. CT and MR enable diagnosis by noninvasive methods.

Female↗
PubMed1989

[The significance of vascular surgery treatment of complications following percutaneous transluminal angioplasty of the lower extremities].

In 147 patients suffering from arterial occlusive disease of the lower extremities 162 PTAs of the iliac, femoral and popliteal arteries were performed. Thirteen complications occurred in 12 patients, while surgical intervention was necessary in seven cases (4.3%). Hematoma at the site of the arterial puncture were the most frequent complications, requiring acute surgical intervention (n = 3). In two patients, acute vascular occlusion after PTA required bypass operation and thrombendarteriectomy, respectively. In one patient, presenting with an iliac stenosis, PTA was performed using a transaxillar approach and was complicated by an axillar hematoma due to the ruptur of the arteria subscapularis. Furthermore, one patient with an extended hematoma of the abdominal wall required surgical intervention. The results presented indicate that PTA of the lower extremities for treatment of arterial occlusive disease is a procedure with low risk. Complications, which require acute operative therapy, can be treated mostly successful by small surgical interventions.

Angioplasty, Balloon↗
PubMed1987

[Use of streptokinase and urokinase in deep venous thrombosis and pulmonary embolism: indications and clinical experience].

The efficacy of fibrinolysis in DVT is dependent upon the age and organization of the thrombus as well as its localization. In consequence, selective evaluation prior to determining the indication for thrombolytic therapy is just as important for therapeutic success as choosing the appropriate fibrinolytic agent. To improve the results of fibrinolysis a team of angiologists, hemostaseologists, radiologists and surgeons are cooperating in a special "thromboembolic care unit". Phlebographic criteria were defined which allow differentiation of fibrinolytic indications depending upon the site of the thrombus. Selection of the fibrinolytic agent and careful monitoring of the thrombolysis should ensure a maximum therapeutic effect with a minimum of bleeding complications. The duration of thrombolysis was established through phlebographic verification and functional tests with venous occlusion plethysmography. The cause and results of 108 cases of thrombolysis shall be presented.

Humans↗
PubMed1987

[Gallbladder perforation on the computed tomogram].

Seven cases of perforated gallbladder disclosed by computed tomography are reported. In all cases the symptoms were obvious. As clinical signs and ultrasound do not always give reliable results, computer tomography plays an important rôle in the diagnosis of gallbladder perforation.

Acute Disease↗
PubMed1987

Rupture of the spleen by penetration of pancreatic pseudocysts.

2 patients with known chronic recurrent pancreatitis and proven pancreatic pseudocysts in the tail of the pancreas developed a pseudocystic invasion of the spleen followed by tryptic erosion of it. This complication, previously seldom reported, occurred twice in one year, the diagnosis being achieved by CT.

Adult↗
PubMed1986

[Premedication with H1- and H2-receptor antagonists for intravenous urography using contrast media].

Intravenous urography using Telebrix was performed on 500 patients. Two hundred patients (group I) received no pre-medication; 300 patients (group II) were premedicated with H1 and H2 receptor antagonists. All patients were examined for signs of contrast reactions, blood pressure, pulse rate and plasma histamine levels. These were measured before and three minutes after the administration of the antihistamine substances and/or the contrast medium, and also at the end of the examination. Following the administration of H1 and H2 receptor antagonists, a slight, transient and insignificant rise in plasma histamine could be demonstrated. Both groups showed a significant rise in plasma histamine levels after the injection of the contrast medium. Although the pre-medicated group contained a higher percentage of high risk patients, there were significantly fewer patients with contrast reactions. Pre-medication with H1 and H2 receptor antagonists in high risk patients is therefore advisable.

Adult↗
PubMed1985

[Successful treatment of superior mesenteric artery thrombosis with local high-dose urokinase therapy].

A 56 year old man presented with increasing abdominal pain. He suffered from arterial occlusive disease with occlusion of the right A. iliaca communis. Angiography revealed partial thrombotic occlusion of the superior mesenteric artery. Urokinase (UK) at a dose of 150 IU/kg X minutes and heparin (1,000 U/h) was infused through the 7F angiographic catheter for 180 minutes. After 70 min of treatment, angiography showed improvement, and after 120 min the thrombus was nearly completely lysed. A stenosis of approximately 50% was still present after 180 min. Two hours after treatment the patient was pain free without analgesics. Laboratory studies showed systemic fibrinogenolysis, but fibrinogen was still within the upper normal range. Only slight systemic fibrinolytic activity (less than 5 IU UK/ml) could be determined. However, alpha 2-antiplasmin was depleted. The catheter was drawn 15 h after thrombolysis without bleeding. While under concurrent heparin and phenprocoumon therapy, the patient developed an infected gluteal hematoma as a result of i.m. injections prior to this treatment. A repeat angiography approximately one month after thrombolysis revealed further improvement and patency. The patient is well and free of abdominal angina and under oral anticoagulant therapy.

Drug Therapy, Combination↗
PubMed1979

Transvenous xeroarteriography: noninvasive method for demonstrating peripheral arteries.

Xeroradiography allows visualization of peripheral arteries after intravenous injection of relatively low quantities of contrast medium. By means of a special changer, several exposures are chosen according to standardized programs. Determination of the arrival time of the contrast medium after its passage through the heart and the lungs is not necessary. The method has proved effective in demonstration of localized vascular lesions and evaluation of postoperative status and soft tissue tumors. Transvenous examinations of 237 patients are reported.

Adult↗