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Biomedical subjects

K J Pfeifer

Publications and source records attributed to K J Pfeifer.

At least 91 records · Page 5Linked to original sources
PubMed1979

[Alleviation of pain via lidocain in peripheral arteriography. Further experiences (author's transl)].

On comparing an ionic contrast medium with a contrast medium containing one or two mg Lidocain/ml contrast medium, the one with the higher Lidocain addition was found to be most effective in respect of pain alleviation. The feeling of flush could not be favourably influenced. The use of a higher dose of Lidocain in the contrast medium may involve more pronounced circulatory reactions, such as drop in blood pressure and enhanced pulse rate. Besides, the rate of side effects compared with the use of the pure contrast medium and contrast medium with one mg Lidocain/ml CM will be increased. For this reason, it is not recommended to add more than 1 mg/ml Lidocain to the contrast medium. In most cases, repeat examinations can be effected without any risk with 1 mg Lidocain/ml contrast medium. No absolute contraindications were found in the application to outpatients and risk patients. Relative contraindication exists in patients with bradycardia and bradyarrhythmia. Following preliminary injection of a vasodilatory substance, the Lidocain/contrast medium mixture is well suited for arteriography in the arm.

Analgesia↗
PubMed1978

[Lymphographic investigations of oedema of the extremities following reconstructive vascular surgery in the femoro-popliteal territory (author's transl)].

In 37 patients, oedema of the legs was observed following successful femoro-popliteal surgery; lymphangiograms were performed between the third and ninth post-operative days and the intact lymph vessels at the knee and at the groin were counted. In 27 patients there was partial to total disruption of the lymphatic vessels. There was a clear correlation between the degree of swelling of the leg and thigh with the number of not divided lymphatic vessels at the knee and groin. In the presence of more than three intact lymph vessels, swelling amounted to only 1 to 2 cm., whereas if all lymph vessels had been divided, swelling amounted to 7 cm. Extensive soft tissue trauma and repeat surgery resulted in a greater reduction in intact lymph vessels and correspondingly more oedema than was found with more conservative surgery and after initial operations. The pre-operative condition of the arteries, the presence of venous disease and the postoperative blood-flow in the leg had no influence on postoperative oedema. In order to avoid post-operative lymphoedema, it is necessary to preserve the lymphatics during surgery. Marked oedema requires treatment consisting of compression bandages and medicaments.

Arterial Occlusive Diseases↗
PubMed1978

[Anatomical directions for the placement of central venous catheters].

Based on approximately 70 dissection studies, the topographical situation of the central veins forming the superior vena cava is described. Actual problems and complications following punctures of central veins are commented upon, from the morphological point of view.

Catheterization↗
PubMed1977

Changes in blood flow and vasculature of the dog kidney undergoing normothermic and hypothermic ischaemia.

In 11 mongrel dogs both kidneys have been subjected to a 2 h ischaemic period. One kidney was cooled by perfusing the renal artery at 4 degrees C while the contralateral normothermic kidney was clamped for 2 h. Studying the renal blood flow using the Xenon wash out technique, sequential renal scanning and angiography, marked differences between hypo- and normothermic ischaemia kidneys were observed. One or two hours following hypothermic perfusion a marked decrease of blood flow in the first compartment and vasoconstriction was evident, while within this period following normothermic ischaemia an enhanced renal blood flow was observed. After 24 h renal blood flow and renal function tested by 131I-Hippuran clearance returned to normal values. Angiographic studies corresponding to the preoperative findings. In contrast, normothermic ischaemia kidneys showed a decreased renal blood flow, impairment of kidney function in isotope studies and pathological angiographic changes.

Animals↗
PubMed1977

[The value of quantitative functional scintigraphy of the kidneys in urology (author's transl)].

The results (in 221 cases) of quantitative functional scintigraphy (Q.F.S) using 125I-hipuran (sequential scintigraphy ROI-nephrography, unilateral clearance studies) were compared with the radiological, laboratory, surgical, histological and clinical findings. Clearance measurements were superior to estimates of blood urea and/or creatinin levels. The width of parenchyma in the urogram or the secretion value did not provide sufficiently valuable evidence regarding renal function. Agreement between the above findings and those on Q.F.S. was observed in 85.7%. In the absence of agreement, Q.F.S. proved the more sensitive method and was more frequently correct. Additional information was obtained in 78.8% and treatment influenced in 18 to 65%, depending on the underlying disease. Q.F.S, had a determining role in the choice of treatment (nephrectomy, preservation of the kidney, conservative treatment) in relation to the estimate of function of the other kidney and is of considerable value to the urologist in pre-operative diagnosis.

Creatinine↗
PubMed1977

[Renal perfusion during experimental hyper-acute rejection. 133-xenon perfusion compared with microscopy and angiography (author's transl)].

Twenty-two cat kidneys and 11 pig kidneys were incorporated into canine circulatory systems. The delayed hyper-acute and hyper-acute rejections produced by these models were studied with respect to blood flow and blood distribution with an intra-arterial 133-xenon wash-out technique at intervals of 7-30 minutes until the death of the kidney at 40 minutes to twelve hours. In addition, magnification angiograms and serial cortical biopsies were obtained for continuous histological study of the rejection phenomenon. At the beginning of the rejection process, there is a reduction in blood-flow through the cortex. During delayed hyper-acute rejection, cortical flow could no longer be demonstrated 180 minutes after the period of flow maximum. After A.L.G. treatment of dogs, rejection could be delayed for ten to twelve hours. Magnification angiograms showed characteristic changes consisting of irregular segmental and interlobar arteries, occlusion of small cortical vessels and focal contrast accumulation in the renal cortex. The changes in blood-flow and blood distribution measured with 133-xenon and the vascular findings on the angiogram could be correlated with the microscopic findings. Serial estimations of blood flow and blood distribution with the xenon blood wash-out technique permit differentiation between shock kidney and rejection following renal transplantation.

Acute Disease↗
PubMed1977

[Angiographic diagnosis of small intestine carcinoids (author's transl)].

A report is given on two cases of metastasizing ileum carcinoid in which the arteriography of the superior mesenteric artery and the hepatic artery lead to a correct diagnosis while no clear result could be obtained by conventional X-ray examinations (gastrointestinal passage and Irigoscopy of the colon). In the first case, the vascular alterations in the lower ileum, combined with numerous hyper-vascularized metastases in the liver allowed to diagnose the primary tumor and to determine its type. In the second case, a correct diagnosis could be made alone bacuse of the specific vascular alterations indicating the carcinoid which was growing by infiltration (vascular star, missing parenchymatous charge, belated venous drainage, in the tumor region). In one case, a second primary tumor whose growth was accompanied only by little infiltration could be early diagnosed. All diagnoses were confirmed by surgical and anatomicopathological findings. In order to ameliorate the prognosis, bad until now, by an earlier diagnosis, arteriography should be used whenever a (metastasizing) small intestine carcinoid is suspected.

Aged↗
PubMed1976

[The infrared contact coagulator for hemostasis in the renal parenchyma (author's transl)].

Investigations on hemostasis with the infrared contact coagulator (ICC) after renal pole resections in dogs with and without clamping of the renal vessels are reported. Clamping the renal vessels led to less bleeding, but the coagulation time was distinctly prolonged. In addition the use of ICC in renal pole amputations in humans is described in two cases of urogenital tuberculosis. In both cases we were able to stop the bleeding quickly and satisfactorily without clamping the renal vessels. The results of animal experiments and the significance of using the ICC in man are discussed.

Animals↗
PubMed1976

[Angiography of urotuberculosis (author's transl)].

119 kidneys demonstrating changes consistent with renal tuberculosis were studied in a total of 94 patients by means of selective, transfemoral renal antiography. In the first stage of the disease, this method detected parenchymal involvement which could not be visualized by excretory urography. In stage II the arcuate arteries and occasionally the intralobular arteries, showed typical changes. Cavitation, pathognomonic for the presence of renal tuberculosis were found in 39.3% of these cases. In 40% of the cases the angiographic findingd were more extensive than the apparent findings of excretory urography. Angiography, thus, can render valuable information pertaining to the course of the disease and the necessity of operative intervention. Stage III was usually characterized by extensive changes specific for parenchymal destruction. Typical vascular lesions were readily recognized. Cavitation was found in 86.5% of these cases. Tortuosity and dilatation of the renal pelvis- and/or ureter-arteries revealed evidence of ureteral involvement (stage III2). In the presence of a non-functioning kidney angiography is mandatory to rule out renal aplasia and to differentiate between a kidney destroyed by other disease processes and the complete cavitary destruction of end-stage renal tuberculosis (stage III3).

Angiography↗
PubMed1976

[Changes in perfusion and blood flow distribution following normo- and hypothermic ischemia of the kidneys].

Experimental examinations were performed in 22 dogs to find out the mechanism which leads to a permanent or a reversible damage of the renal parenchyma after normo- and hypothermic ischemia. For this reason the perfusion and the distribution were examined with 133Xe, the vascular changes by angiography, and the parenchymal function with 131I-Hippuran. After normothermic ischemia a short-term reactive hyperemia appeared, which however could not compensate the damage of the renal tubular cells and the resulting excretory insufficiency. After hypothermic ischemia the perfusion was reduced, probably as a consequence of a vasconstriction by cold, however, the function of the tubular cells remained intact, because of the protective mechanism of the hypothermia. The importance of these findings for the development of the so-called "shock-kidney" (acute tubular necrosis) and for the conservative renal surgery in hypothermia is discussed and the application of measures beneficial to perfusion, are suggested.

Animals↗
PubMed1975

[Selective kidney angiography. Indispensable diagnostic method in urogenital tuberculosis].

Selective angiography of the kidneys was performed in 119 patients with urogenital tuberculosis. The diagnosis was confirmed by bacteriological and/or histological examinations. Diagnostic value. Under optimal technical conditions changes of the small renal arteries even in the parenchymal stage I of renal tuberculosis can be seen. These cannot be diagnosed with other methods. In stage II and III the degree of destruction and the localisation of the specific process can be demonstrated more efficiently by angiography than by urogram. In stage III/3 (kidney without function) the differential diagnosis between tuberculosis and the late form of polycystic renal disease is possible. Therefore the selective renal angiography ought to be performed more frequently for intensive diagnosis and also to reach a definite diagnosis before surgical procedures. Special surgical planning is more precise and knowledge of vascular anatomy reduces the operative risk.

Diagnosis, Differential↗
PubMed1975

[Radio-iodine therapy of toxic adenoma of the thyroid (author's transl)].

Between 1963 and 1971, radioiodine (133I) treatment of a toxic thyroid adenoma was performed in 229 patients, in 70% the dosage being 30000 rd. In 188 patients the results were checked an average of 2 1/2 years later. Subjective improvement or freedom from symptoms was achieved in 76% (in 85% within 3-6 months), body weight increased, serum cholesterol level rose significantly, while pulse rate, pulse amplitude, PB127I and index of free thyroid hormones significantly fell. The 131I two-phase test was inconclusive. 72% of toxic adenomas were inactivated and 88% of patients with still active adenomas were improved or free from symptoms. Clinical improvement apparently preceded the scanning results. Corresponding to the index of free thyroid hormones, 94% were euthyroid, 0.6% hyperthroid, and 2.8% suspected of being hypothryoid. In combination with other findings, especially isotope scanning, 1.7% of patients were suspected of having T3 hyperthyroidism after treatment. A recurrence was observed in 2.1%. The success rate increased with rising radiation dose up to 30000 rd.

Adenoma↗
PubMed1975

[Value of quantitative camera functional scintigraphy in urogenital tuberculosis].

131-J-Hippuran dynamic camera studies were performed in 50 patients suffering from tuberculosis of the kidney. Sequential scintigraphy indicated marked defects of the parenchyma in 50%, contracted kidneys in 14% and a loss of kidney function in 22%. 58% of the tested cases showed a disturbed drainage of urine. The decrease of function of the involved kidney could be evaluated quantitatively by simultaneous measurement of the J-Hippuran-Clearance. In uro-tuberculosis the advantages of the dynamic camera studies consist in the determination of the function status of the involved and the contralateral kidney. Indications of dynamic camera studies of the kidney in urotuberculosis are: 1. prior to surgery: exact determination of the function of both kidneys, 2. following surgery and during medicamental therapy: control of the postoperative course and control of the functional status during chemotherapy.

Female↗
PubMed1975

[Value of sequential scintrigraphy and clearance determination following normo- and hypothermic renal ischemia].

Using quantitative sequential camera scintigraphy and simultaneous separated clearance determinations with 131-I-Hippuran and 169-Yb-EDTA renal function was measured applying a new surgical method which permits in-situ kidney perfusion and cooling in animals and patients. While mongrel dogs of 15 kg average weight (control group of N = 5) showed after 1 hour of normothermic ischaemia a postoperative delay of intrarenal transport of 131-I-Hippuran with reduction of 131-I-Hippuran and 169Yb-EDTA clearances, renal function returned to normal on the first postoperative day after 1-hour (N = 5) and 2-hour (N = 5) hypothermic ischaemia. In patients (N = 9) with hypothermic in-situ perfusion of between 40 and 92 min duration a transient postoperative delay of intrarenal 131-I-Hippuran transport and a reduction of the 131I-Hippuran clearance was observed which returned to almost normal 1 1/2 to 3 months after surgery. The results and the significance of the method discussed and are compared with clinical findings and with radiological and laboratory renal function studies.

Animals↗
PubMed1975

[An approximation for improving the accuracy of compartmental analysis after intravenous 133Xe].

Perfusion of transplanted kidneys is studied in our clinic by intravenous injection of 133Xe with subsequent graphic compartmental analysis of time-activity curves. Where there is poor perfusion of the renal cortex, it is not possible to obtain a half-value time for the first compartment--which is the significant measure for specific blood flow -- since few points are available for the tail end of the curve. A correction is described which produces an approximation to a bolus, based on the time-activity curve of the expired air. If this is applied to the proximal part of the time-activity curve, with respect to background activity, compartmental analysis can be performed with a higher degree of accuracy in the calculation of renal perfusion.

Air↗