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Biomedical subjects

A Thalhammer

Publications and source records attributed to A Thalhammer.

28 records · Page 2Linked to original sources
PubMed2001

[Transarterial chemoembolization in hepatocellular carcinomas: technique, indications, results].

BACKGROUND: At time of diagnosis 80% of the patients with hepatocellular carcinoma (HCC) could not be treated with surgical treatments, so that transarterial chemoembolization (TACE) was used as an neoadjuvant or palliative treatment modality. MATERIAL AND METHODS: 60 patients were treated with 217 TACE courses, in the mean 3.6 TACE treatments per patient with an 4 week interval. TACE was performed with a dispersion of lipiodol, mitomycin C and spherex. 11 patients (18.3%) were treated in a neoadjuvant protocol with successful ablation. Lipiodol retention and size of the tumors were evaluated by CT and MRI. RESULTS: 60 patients were successful treated with TACE. After treatment a primary high lipiodol retention was displayed and in 68 (63.3%) patients a reduction of the tumor size and in 11 (20%) patients a reduction of tumor growth rate was noted. The 1 year survival rate was 59%. After response to TACE and reducing the tumor size 11 patients could be treated with MR-guided LITT 4 to 6 weeks post embolization. CONCLUSION: Chemoembolization is a minimal invasive and outpatient treatment protocol for HCC. TACE might be indicated as a palliative treatment to control the diseased liver. If repeated TACE alters the size and structure of primary unresectable HCC TACE expands the indication for MR-guided LITT.

Adult↗
PubMed2001

Older patients with high-risk fungal infections can be successfully allografted using non-myeloablative conditioning in combination with intensified supportive care regimens.

Leukaemic patients with advanced disease and severe fungal infections as well as older patients with substantial co-morbidity are usually excluded from conventional allotransplantation because of increased morbidity and mortality. We approached allogeneic transplantation in four patients with a median age of 62 years (one chronic myeloid leukaemia in blast crisis, one high-risk acute myeloid leukaemia (AML) in first complete remission (CR1), one AML in 2nd relapse, one AML in CR2 with pre-existing fungal lung infections (two aspergillus, two mucor) and additional co-morbidity (diabetes n = 2, aortic aneurysm n = 1, arterial sclerosis n = 2) by combining non-myeloablative conditioning with an intensified supportive care regimen, including amphotericin B and 4-12 (median 9) prophylactic granulocyte transfusions from granulocyte colony-stimulating factor (G-CSF)-stimulated volunteer donors. G-CSF was also given to patients until neutrophil recovery. All four patients recovered to a neutrophil count of 0.5 x 109/l after a median of 11.5 d (range 11-13 d). Prophylactic granulocyte transfusions also reduced the need for platelet transfusions and minimized mucositis. All patients were discharged at a median of 25 d (range 18-59 d) and are alive and well after a median follow-up of > 390 d (range 336-417 d) without evidence of leukaemia. Regression of the fungal lesions was documented in three patients, with a slight progression detected by computerized tomography scan of the chest in one patient. We conclude that pulmonary fungal infections are not a contraindication for allogeneic stem cell transplantation, if non-myeloablative conditioning regimens are used in combination with granulocyte transfusions, intravenous amphotericin B and G-CSF.

Acute Disease↗
PubMed2000

[Percutaneous transvenous recovery of foreign bodies using a self-made wire loop].

AIM: Several techniques exist to retrieve catheter and guide wire fragments. In this report we summarize our cost-saving method. MATERIALS AND METHODS: A 7-8F guiding catheter and a self-made loop consisting of a 260 cm/0.035 in. Terumowire was used. RESULTS: 45 of 48 fragments were retrieved completely using this method. For the three remaining fragments (all pacemaker electrodes), retrieval was attempted with a "Goose-Neck" loop, two of them failed. The procedure was well tolerated, there were no severe complications. CONCLUSION: Usually venous foreign bodies can be retrieved completely by this cost-saving method, the use of expensive industrial loops or baskets can be avoided.

Angiography↗
PubMed1999

A desensitization-inhibiting mutation in the glutamate binding site of rat alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor subunits is dominant in heteromultimeric complexes.

Recently, it has been shown that a single leucine-to-tyrosine mutation in the agonist binding domains of the homomerically expressed alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors GluR3 and GluR1 is sufficient to completely block receptor desensitization. In the present study we tested heteromeric subunit combinations of AMPA receptors to demonstrate that the block of desensitization afforded by this mutation is dominant in heteromeric subunit complexes containing the leucine-to-tyrosine mutation in at least one of the subunits. In addition, by comparing mutated, desensitization-deficient forms of unedited GluR1 and GluR1 edited at the Q/R-site of the ion pore we demonstrate that the desensitization properties of AMPA receptors are not linked to the editing state of the ion pore domain and thus are independent of the permeability properties of the ion channel.

Amino Acid Sequence↗
PubMed1999

Pulmonary lymphangioleiomyomatosis: high-resolution CT findings.

Lymphangioleiomyomatosis (LAM) of the lung is a very rare disease. There are obvious discrepancies in the literature concerning the appearance of LAM on CT scans of the lung. This study adds the imaging findings of 11 patients and demonstrates how the imaging findings changed over time in four patients. Twenty-two CT examinations, and radiographs that had been obtained close to the CT examinations, of 11 patients with LAM confirmed by open lung biopsy were retrospectively evaluated with particular attention to the size of cystic lesions and wall thickness. Furthermore the CT scans were analysed for the type of pulmonary infiltration process and its distribution, presence or absence of pleural effusion, pneumothorax and lymph node enlargement. Clinical and CT follow-up studies were available in four patients. The CT scans revealed an increase in the interstitial pattern in all patients. Architectural distortion was seen in two patients and cystic lesions were present in all. The size of the cysts varied from small lesions to bullous emphysema. The cystic lesions revealed a wall thickness up to 2 mm but a wall was not perceptible in all. Pneumothorax was seen in only two patients; pleural effusion was seen in two patients. CT examination of patients with LAM reveals neither a uniform nor a pathognomonic appearance. In the early stages of LAM or in cases with interstitial changes the differential diagnosis of centrilobular emphysema or idiopathic pulmonary fibrosis seems to be more difficult than most authors believe.

Adolescent↗
PubMed1999

Value of a laser guidance system for CT interventions: a phantom study.

The aim of this study was to check the handling and usefulness of a laser puncture system. The laser has tacking optics and is fastened to a sledge with angle graduation. The sledge runs on a bar fixed to the computerized tomograph (CT) parallel to the scan level. By means of a phantom, three experienced and seven inexperienced physicians made punctures with and without laser, using varying angles in single and double angulation. The distance from needle tip to target was measured. The handling of the puncture system proved to be problem-free. With both single and double angulation, the measurement differences with and without support were so small among experienced puncturers that there was no significant difference, with the exception of one double angulation (10 degrees/45 degrees). Among the beginners, there was a significant difference (P < 0.001, P < 0.05), with both single and double angulation. The accuracy of the beginners improved with use of the laser; experienced puncturers may profit from practice with small and hard-to-reach focuses. In terms of educational benefits, the laser guidance system offers great advantages and increased confidence for beginners.

Biopsy, Needle↗
PubMed1999

[Indications and contraindications of lacrimal duct balloon dilatation].

PURPOSE: The aim of the study was to determine the indications and contraindications for balloon dacryocystoplasty. MATERIAL AND METHODS: So far 85 patients with severe epiphora because of relative stenosis (n = 47) or occlusion (n = 38) of the nasolacrimal duct have undergone dilation. The success rates were evaluated during the acute phase and the follow-up period of 6-12 months. Treatment failures and recurrence of stenosis were analyzed and compared to the clinical and dacryocystographic indications prior to treatment. RESULTS: A recanalization success rate of 79% was achieved in patients with isolated postsaccal stenoses or short-distance occlusions of the nasolacrimal duct. Patients with additional presaccal and saccal stenoses, filling defects in the duct lumen, or long-distance occlusions had lower initial recanalization rates (66%). Main predictors for recurrent obstructions were active inflammation, filling defects due to calculi, extensive occlusion and post-traumatic lesions. In the absence of these factors 12-month patency rates of 80% were proved. CONCLUSION: Dacryocystoplasty procedures should preferably be performed in patients with circumscribed functional postsaccal stenosis. In these cases a success rate of about 80% is possible. Otherwise the value of the intervention is limited by high failure and recurrence rates.

Adult↗
PubMed1997

[Radiologic appearance of primary anomalies of the lymphatic vessel system of the lung. Review and personal results].

Congenital disorders of the lymphatics of the lung are rare. On the basis of a literature review and our own experiences the disorders are divided into four groups and their radiographic findings are described. Pulmonary lymphangiectasia shows not typical signs. As an expression of the underlying pathophysiologic processes CT shows thickening of interlobular septs, interstitial edema and pleural effusions. Neither architectural distraction nor thickening of intralobular septs was seen. Lymphangioleiomyomatosis shows rather typical findings with multiple thin-walled bullae. In contrast to the opinion that architectural distraction is not seen in LAM we sometimes found signs of fibrosis. Disseminated pulmonary lymphangioma is characterised by proliferation of lymph vessels. CT-findings of this disorder have not been described before. CT shows multiple disseminated nodules of up to 2.5 cm accompanied by multiple bullae of similar distribution and size.

Humans↗