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Biomedical subjects

B M Cramer

Publications and source records attributed to B M Cramer.

31 records · Page 2Linked to original sources
PubMed1983

[Clinical experiences with arterial embolization of kidney tumors with ethanol].

Based on 584 compiled cases of renal tumour embolization the materials used, the results and complications, are analyzed. The most serious complication proved to be the displacement and dislocation of particles from the embolization. Personal experience with 102 of our patients confirmed these results. In our clinics we have carried out tumour embolization in 20 patients using 95% alcohol since 1980. The first results are presented. The particular advantages of embolization using ethanol are: 1. The high risk of dispersal of particles from an embolization is eliminated. 2. It leads not only to destruction of the vascular system but also of the peripheral tissues as well to an extent rarely seen with the majority of other embolization materials. Attention must also be drawn to the comparatively safe and simple usage of ethanol during embolization.

Animals↗
PubMed1982

[CT diagnosis of recurrent subluxation of the shoulder (author's transl)].

CT provides a clear, unobstructed and reproducible view of the shoulder joint. This permits, unlike conventional methods, for the first time a complete view of the anatomy and of the factors which predispose to a recurrent subluxation of the shoulder. In addition it is possible to see bone lesions resulting from the subluxation.

Chronic Disease↗
PubMed1981

[Computerized tomography in adrenal diseases with excessive production of hormones].

In 41 patients with adrenal diseases and hormonal excess (pheochromocytoma n = 9, Cushing's syndrome n = 6, primary aldosteronism n = 26) computer tomography was performed for localization and classification of the adrenal lesion(s). In all patients diagnosis was confirmed by surgery. In all patients with pheochromocytoma a tumor was detected. 8 patients had unilateral adrenal pheochromocytoma, whereas in one female patient the pheochromocytoma was multilocular. 4 of the 6 patients with hypothalamic-pituitary Cushing's syndrome had enlargement of the adrenals. In the 26 patients with primary aldosteronism, computed tomography showed normal adrenal glands in 2 of the 17 patients with unilateral adenoma (with a diameter of 8 mm in both of the 2 patients) and in 6 of the 9 patients with bilateral hyperplasia. In the remaining patients adenoma or hyperplasia was detected. The results document that in patients with pheochromocytoma, with Cushing's syndrome, and in those with primary aldosteronism, computed tomography is a simple and valid method for localization and classification of the adrenal lesion(s). In primary aldosteronism with a normal adrenal computed tomography, however, differentiation between a small unilateral adrenal adenoma and bilateral adrenal hyperplasia remains problematic.

Adrenal Gland Neoplasms↗
PubMed1981

Validity of computerized tomography in adrenal diseases.

For diagnosis of adenomas in primary aldosteronism CT proved to be helpful. Although microadenomas have to be ruled out by selective venous sampling from both adrenal glands adenomas down to 8 mm in diameter can be visualized. Scintigraphy does not always permit reliable differentiation of unilateral adenoma from bilateral hyperplasia. -- in endogenous Cushing's syndrome adrenal carcinomas are underlying etiologically in about 10% of the cases. Since carcinomas are detected easily by CT it should be performed in the first place. Whereas adenomas and hyperplasia are easily diagnosed by scintigraphy carcinomas may escape scintigraphy. -- Pheochromocytomas, if situated in the vicinity of the kidneys, can be localized safely by CT. Contrary to adenomas, carcinoma and pheochromocytomas may be detected by CT without difficulty because of their size.

Adenoma↗
PubMed1980

Lateralization procedures in primary aldosteronism.

The diagnostic validity of adrenal isotopic scanning, adrenal venous aldosterone, adrenal phlebography and computed abdominal tomography (CT) was studied in 44 patients with primary aldosteronism. In all patients the diagnosis was confirmed by surgery (unilateral adrenal adenoma n = 32, bilateral adrenal hyperplasia n = 12). Both adrenal scintiscan, adrenal venous aldosterone and CT allowed in a comparable high percentage of patients (71%0 the exact classification of the adrenal lesion(s), whereas adrenal phlebography could distinguish adenoma from hyperplasia in 57%. Marked differences between the lateralization procedures, however, were observed in predicting incorrect preoperative indentification: adrenal scintiscan 29%, adrenal venous aldosterone 3%, adrenal veno-graphy 6% and CT 0%. Finally, the percentage of patients in whom no differentiation between the two main subgroups of primary aldosteronism could be obtain varied between 0% with adrenal isotopic scanning and 37% with adrenal phlebography (CT 29% and adrenal venous aldosterone 26%). Both scintiscan and adrenal venous aldosterone were not improved by the administration of dexamethasone. Our findings document that adrenal venous aldosterone determinations, adrenal isotopic scanning and computed tomography are equally valid in differentiating unilateral adenoma from bilateral adrenal hyperplasia in primary aldosteronism. However, adrenal scintiscan is hampered by a relative high percentage of incorrect results independant whether dexamethasone was used or not. Contrary, adrenal venous aldosterone and computed tomography seemed to have no or only a minor risk in assuming an incorrect classification of the adrenal lesion(s).

Adenoma↗
PubMed1980

[The use of contrast media in computer tomography (author's transl)].

There are a variety of applications for contrast media in CT. They can be used for better anatomic demonstration or for showing pathological processes. Nearly all available contrast media may be found useful. Intravenously injected renographic contrast media are most commonly employed. In addition to their inherent contrast, specific pharmaco-kinetic changes may be of diagnostic value. This adds some knowledge of function to the purely morphological information obtained by computer tomography. For this purpose, contrast has to be injected rapidly and a fast scanner must be used (so-called angio-CT).

Contrast Media↗
PubMed1980

[Computer tomographic localisation in primary aldosteronism. Comparison with adrenal scintigraphy (author's transl)].

13 patients with verified primary aldosteronism (unilateral adrenal adenoma = 10, bilateral idiopathic hyperplasia = 3) underwent examination by CT and 131J-cholesterol-scintigraphy. CT-scan can successfully employed for localization of unilateral adenoma exceeding 10 mm in diameter. Small lesions and hyperplasia are rare CT-findings. The value of 131J-cholesterol-scintigraphy for differentiation of the two main subgroups of primary aldosteronism--adenoma and hyperplasia--is limited. In our experience both non-invasive methods are helpful to avoid misleading interpretation. In controversial cases bilateral adrenal venous blood sampling by catheterization is mandatory.

Adenoma↗
PubMed1978

Interstitial handling of aminoglycoside antibiotics and radiographic contrast media in the kidney.

Lymphatics of the mammalian kidney originate in the loose connective tissue around large blood vessels. This paravasal tissue drains the interstitum. The intarenal lymphatic system consists of interlobular, arcuate, and interlobar vessels according to the architecture of the arterial system. The interlobar vessels drain into the hilar lymph vessels. Capsular lymphatics are connected with the interlobular lymphatics inconsistantly. The renal medulla is drained by the venous vasa recta exclusively--there are no lymphaties in the medulla. Lymphatic fluid is mainly formed along the small renal veins as vascular transudate. After i.v. bolus injection concentrations of aminoglycosidic antibiotics in renal lymph reflect plasma values closely. Radiographic contrast media in renal lymph also showed a close correlation with plasma values with some indication of tubular secretion.

Aminoglycosides↗
PubMedDate not supplied

Renal artery stenosis: changes in intrarenal Doppler waveform following percutaneous transluminal angioplasty.

PURPOSE: To examine the extent of the changes in the intrarenal spectral waveform patterns after percutaneous transluminal angioplasty (PTA) and whether there is a correlation with the angiographic and clinical results. METHODS: In 44 patients with 68 PTAs we analyzed the intrarenal spectral waveform regarding the existence of a tardus-parvus pattern before and after PTA. RESULTS: In 51 of the 60 cases with a tardus-parvus pattern prior to PTA, a complete normalization of the spectral wave-form was noted. There was no correlation between the Doppler result after PTA and the angiographic and clinical result. In contrast there was a significant correlation between the Doppler result before PTA and the clinical outcome: patients with a normal intrarenal spectral waveform before PTA showed no improvement in their arterial hypertension. CONCLUSION: Our results indicate that a patient with a normal spectral waveform analysis does not response to PTA. However, there is still an unpredictable clinical response even if a patient has an abnormal intrarenal spectral waveform prior to PTA and a complete normalization after PTA.

Adult↗
PubMedDate not supplied

Relationship between renal lymph flow and changes in kidney size during urography.

Using direct cannulation of renal lymphatic vessels and simultaneous photography of the exposed dog kidney during urography, the time schedule of variations in lymph flow and kidney size was established. The intravenous contrast injection produced heavy increase of renal lymph flow during the first 8 minutes of urography. Peak values were observed 3--4 minutes after injection. From 8 to 11 minutes after injection the lymph flow was depressed below the baseline, followed by a tendency of reestablishment. Generally after 25 minutes the lymph flow returned to its baseline level. The earliest response of kidney size upon intravenous contrast injection was a rapid, short-lived decreased, followed by a distension during the first 3 minutes. Thereafter a tendency to return to the preurographic size was observed. However none of the kidneys returned entirely to the baseline size during one hour of observation. The possible physiologic explanations of the observations are discussed.

Animals↗