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H J Brambs

Publications and source records attributed to H J Brambs.

At least 127 records · Page 7Linked to original sources
PubMed1996

Computer assisted determination of the dose-area product in retrograde urethrography.

Retrograde urethrography (RUG) is a dynamic radiological procedure in which the cumulative dose-area product (DAP) comprises radiation doses derived from both fluoroscopy and radiography. In the present prospective study, digital retrograde urethrographs (Prestilix 1600X/DRS, General Electric) were obtained in 40 consecutive male patients (mean age 60.6 years; range 23-88 years) presenting for evaluation of urinary pathology. The radiation dose was recorded as the dose-area product. From these data, a computer program (Diasoft 2.0, PTW, Freiburg, Germany) then determined the respective proportions of the total radiation dose deriving from fluoroscopy and radiography, as well as the number of radiographic exposures. The average total radiation dose was 316 cGy cm2. In five of the 40 patients examined (12.5%), the number of radiographic exposures registered by the program and, hence, the calculated DAPs were erroneous. In the remaining 35 patients, the average proportion of the cumulative DAP resulting from fluoroscopy was 81%, while that deriving from radiography was 19%. The computer program utilized in this study makes possible an intelligent evaluation of the DAP in dynamic procedures such as RUG. Since fluoroscopy is responsible for 81% of the cumulative DAP at RUG, a significant decrease in applied radiation dose may be achieved by reducing fluoroscopy time or by using pulsed fluoroscopy.

Adult↗
PubMed1996

[Therapeutic interventions in benign bile duct strictures].

Surgical treatment of benign bile duct strictures continues to be associated with significant lethality. Thus, radiological interventions become increasingly important. A total of 32 patients were treated. Their bile duct strictures had different origins. We performed percutaneous transhepatic cholangiographies in 32 patients, cholangioscopies in 7, and biopsies in 2 patients. Therapeutic interventions included percutaneous transhepatic drainages in 30 patients, laser lithotripsies in 5, and dilatations in 8 patients. As a total, 36 stents (mostly Palmaz stents) were implanted in 27 patients. Acuflex stents were implanted in 2 of these patients and were extracted after successful clearance of the bile ducts following stone fragmentation. No severe complications were observed. Five out of 8 dilatations were unsuccessful, so that stents were implanted. Five patients died. Three stent occlusions and 1 spontaneous stent migration occurred after an average of 29 months; the latter could be treated by means of radiological procedures. The remaining patients are living symptom-free, on average, since 18.6 months.

Adolescent↗
PubMed1996

[Experiences with an alternative distension medium in oral contrast imaging of the small intestine].

PURPOSE: The image quality of oral small bowel imaging is often poor on account of the small bowel enema. A new contrast medium should increase the image quality due to better compliance of patient because of the better taste of substance. The loading of patient with radiation or time should not increase. METHODS AND PATIENTS: We investigated prospectively 40 patients, randomized in two groups of 20 patients each. Two different substances were used as contrast medium: barium-methylcellulose and Barium-Mucofalk, respectively. The quality of the double contrast, profile of the mucosa, duration of radiation, duration of examination, dose-area product, and taste of the substance were judged for significance. RESULTS: The taste of the new contrast medium was judged to be better: twice as often as "good" and five times less often as "bad", the difference was not significant due to the small number of patients. There is no significant difference in the other criterias. CONCLUSION: Mucofalk is an alternative contrast medium for oral small bowel radiology in cases of difficult placement of the tube for enema. The quality of double contrast and visualization of the profile of mucosa are the same while the taste is better.

Administration, Oral↗
PubMed1996

[Management of iatrogenic hemorrhage after mechanical vascular recanalization].

Nine patients with hemorrhage due to revascularization procedures underwent successful embolization (5), surgery (2), covered stent implantation (1), or long-lasting ballon dilatation (1). Bleeding was the result of Fogarty thrombectomy (3), ring stripper revascularization (1), balloon dilatation (3), or perforation of the artery with the guide wire (1). In all cases, bleeding was stopped successfully without sequelae for the patients. In spite of the preceeding hemorrhage, local fibrinolysis with 1,000,000 units of urokinase was performed on the same day in 3 patients without any complications being observed.

Adult↗
PubMed1996

Papillary cystic and solid tumor of the pancreas.

The papillary cystic and solid tumor of the pancrease (PCSTP) is a primary pancreatic neoplasm of unknown etiology occurring most commonly in young women and regularly containing hemorrhagic areas. Clinical symptoms are non-specific. Although these tumors reach an average diameter of 10 cm, they are often discovered by accident. Because patients with surgically resected PCSTP have very good prognoses, it is important to distinguish these tumors from other growths in the pancreas, for example mucinous cystadenoma. Whereas, due to the variable proportion of fluid components, these tumors offer non-characteristic structure at ultrasonography, computed tomography (CT) possesses high specificity for PCSTP, particularly when calcifications are present. Angiography distinguishes these tumors from hypervascular neoplasms, such as the endocrinologically inactive islet cell tumor. Magnetic resonance tomography (MRT) is especially suited for imaging the hemorrhagic areas in solid tumor formations, as well as hemorrhagic debris in the fluid portions and layer phenomena are frequently observed.

Adult↗
PubMed1995

[The measurement of the femoral torsion angle in children by NMR tomography compared to CT and ultrasound].

PURPOSE: Anteversion of the femoral neck was measured by MRI in 19 children (37 hips) preoperatively before femoral rotation osteotomies. MATERIAL AND METHODS: The results of this new technique were compared with values for anteversion obtained by CT and ultrasound. The measurements were performed independently by two observers to determine the correlation between the three different methods and to assess their reliability. RESULTS: It was possible to show a high correlation coefficient (Pearson) between MRI and CT (r = 0.77) as well as MRI and sonography (r = 0.81). The mean angles obtained by CT (34 degrees, range +5 to +82 degrees) and ultrasound (25.6 degrees, range +10 to +40 degrees) appeared larger than the MRI values (mean angle 23.2 degrees, range 0 to +65 degrees), which can be explained by the different measurement techniques. Mean inter- and intra-variability was low for MRI (r = 0.97 and r = 0.97) and CT (r = 0.99 and r = 0.96) but slightly higher for sonography (r = 0.88 and r = 0.88). MRI is a new reliable and precise method to evaluate femoral anteversion that does not require ionising radiation. CONCLUSION: MRI is recommended for preoperative planning of paediatric femoral rotation osteotomy patients.

Adolescent↗
PubMed1995

[First clinical experience with a new nitinol stent in the biliary system].

PURPOSE: To evaluate the clinical usefulness of a new nitinol biliary stent (Memotherm) in patients with malignant biliary obstruction. 32 self expanding nitinol stents were applied in 17 patients. The following parameters were investigated: Difficulty of placement, lateral stability and patency over an observation time between 3 weeks and 11 months. RESULTS: In 29/32 stent application could be performed with high precision. In 3/32 we observed a displacement about 1 cm--according to the optimal stent position. Stent shortening was about 5 mm in 31/32 stents, secondary shortening only occurred in one patient with primarily distracted stent design. Lateral stability was sufficient in 21/25 stenoses with the consequence that dilatation was only performed in 4 cases. Average stent patency was 4.8 months, the average survival 5.1 months. Because of his special design, this stent may not be used for a stenosis with angulation higher than 90 degrees. CONCLUSION: Basing on a small calibre introducing system, easy placement, predictable minimal shortening and good lateral stability, the Memotherm seems an interesting alternative to other metal stents.

Alloys↗
PubMed1995

[Value of the AMBER system in interstitial lung changes].

PURPOSE: To evaluate the diagnostic value of the AMBER technique in the diagnosis of interstitial lung disease. METHODS: A prospective comparison of conventional and AMBER chest radiographs of 52 patients was performed using HR-CT as a gold standard on the same day. ROC analysis based on the results of 5 observers was carried out to quantify the diagnostic value of both chest radiograph techniques. RESULTS: The ROC area for the AMBER system (0.860) showed statistically significant superiority in comparison to the conventional technique (0.828). This was mainly due to the better sensitivity of the AMBER system (65.3%) compared to the conventional chest radiographs (39.8%) within the lung regions superimposed by the diaphragm or the mediastinum. No difference between both methods was observed within the lung regions without superimposion. CONCLUSION: AMBER technique improved conventional chest radiography in the diagnosis of interstitial lung disease due to superiority in the superimposed lung regions.

Evaluation Studies as Topic↗
PubMed1995

[Percutaneous drainage of refractory necrotizing tumors: experience in 9 patients].

PURPOSE: The ranking of percutaneous drainage treatment in necrolytic advanced tumours was assessed. METHOD: 9 patients with refractory symptomatic necrolytic tumours were treated for alleviation by percutaneous drainage. Additionally, an attempt to sclerose the necrotic cavity was performed in 6 patients (6 x mitoxantrone 30 mg/24 hrs, of which 1 x additionally 98% alcohol). RESULTS: In 5 of the 9 patients symptomatic relief was obtained, but complete sclerosing of the necrotic cavity succeeded in only two patients. In two patients with necrotic tumours of the pelvis there was a bacterial superinfection of the tumour necrosis. CONCLUSION: Percutaneous alleviation is only occasionally successful in patients with necrolytic tumours. Therapy becomes effective probably only in case of successful sclerosing of the tumorous cavity.

Adult↗
PubMed1995

TIPS: a new therapy for esophageal variceal bleeding caused by EHBA.

Clinical and procedural experience using transjugylar intrahepatic portosystemic shunt (TIPS) on 7 children with recurrent hemorrhage of esophageal varices is reported. Recurrent hemorrhage from esophageal varices following repeated paravasal sclerosing of the varices as well as severe-grade hypersplenism are proposed as the indication for its use. The technical details of TIPS, observed and possible early and late complications, the demand for a decrease in the portosystemic pressure gradient to less than 15 mmHg and the influence of TIPS on improvement of the varices, hypersplenism and the frequently observed malabsorption are described.

Adolescent↗