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Biomedical subjects

C Düber

Publications and source records attributed to C Düber.

At least 91 records · Page 5Linked to original sources
PubMed1995

[Spondylogenic psoas abscess: long-term follow-up after percutaneous drainage].

Iliopsoas abscesses originating from bacterial lumbar spondylodiscitis were successfully treated by CT-guided percutaneous abscess drainage, antibiotics, and immobilization in two patients. Vertebral fusion of the affected segments was observed in both patients in the follow-up period (1 and 6 years, respectively). Percutaneous abscess drainage can replace surgery for iliopsoas abscesses following vertebral osteomyelitis.

Discitis↗
PubMed1995

[Diagnostic and therapeutic strategy in multiple insulinoma].

Four of 59 patients with organic hyperinsulinism had multiple insulinomas and two patients a micro- and macroadenomatosis. Excluding patients with adenomatosis 3 of 10 tumors could be detected preoperatively by ultrasound (5 of 10 by CT). 6 of 7 macroadenomas could be visualized by angiography. Intraoperatively 9 of 10 macroadenomas were palpable. The nonpalpable tumor could be localized by intraoperative ultrasound. Pancreatic resection had better results than multiple enucleations. Excisional biopsy is recommended to exclude nesidioblastosis or microadenomatosis.

Adenoma, Islet Cell↗
PubMed1994

[Reliability of imaging procedures in multi-visceral gynecologic operations of the pelvis].

Between March 1989 and December 1992, a total of 85 pelvic exenterations were performed in the Department of Gynaecology and Obstetrics of the University of Mainz. To assess the accuracy of preoperative Magnetic Resonance Imaging (MRI) and Computer Tomography (CT) with regard to tumour localisation and spread, the results of 28 MRI and 14 CT examinations were compared with the postoperative histological findings. For this widely varying patient group that had undergone a broad range of previous treatments, MRI produced an accurate forecast in 56% of cases (CT, 36%). In 33% of the patients tested, the diagnosis based on MRI was partially correct (CT, 43%), whereas the MRI results fundamentally disagreed with the actual findings in 11% of cases (CT, 21%). We conclude that both MRI and CT are of great value in the planning of operations and for informing patients about their condition; however, in individual cases, an intraoperative quick-section diagnosis is necessary to provide details of tumour spread. If the extent of tumour spread is uncertain, the results of CT and/or MRI should not deter the surgeon from the radicality of the planned operative intervention.

Adult↗
PubMed1994

[Gadolinium-DTPA (Magnevist) as contrast medium for arterial DSA].

16 DSA investigations using intra-arterial Gd-DTPA were performed on 12 patients. The contrast medium was administered either as a 0.5 molar gadolinium solution (commercially available) or diluted with distilled water to a 0.2-0.4 molar gadolinium solution. The injection was made either by pressure injector or by hand. The aortic arch, abdominal aorta and pelvic and lower limb arteries were examined. 14 of the 16 procedures were diagnostically adequate, but compared with iodinated contrast materials, contrast was less marked. There were no cardiovascular, neurological or allergic side effects. Three patients suffered a feeling of heat and one patient had mild pain during the injection. Even large volumes rapidly injected (up to 20 ml/s of the commercially available solution) were well tolerated. DSA with intra-arterial Gd-DTPA seems to be a suitable alternative for vascular imaging if iodine-containing contrast materials are contraindicated.

Angiography, Digital Subtraction↗
PubMed1994

Pulmonary arteries and lung parenchyma in chronic pulmonary embolism: preoperative and postoperative CT findings.

PURPOSE: To evaluate the role of computed tomography (CT) in diagnosis of chronic thromboembolic pulmonary hypertension, assessment of surgical operability, and follow-up after surgery. MATERIALS AND METHODS: Seventy-five patients with chronic thromboembolism were examined with CT; 63 underwent thromboendarterectomy, and postoperative CT scans were acquired in 23. CT scans were analyzed for vascular and parenchymal changes, and findings were compared with those on lung scintigrams and with surgical results. RESULTS: CT findings allowed confirmation of the diagnosis of chronic thromboembolism and ensured technical operability (sensitivity, 77%; specificity, 100%; overall accuracy, 80%) by means of direct visualization of thrombi in central pulmonary arteries in 53 patients. CONCLUSION: CT enables demonstration of pulmonary thromboembolism with criteria pertaining to pulmonary arteries and to lung parenchyma and enables assessment of technical operatibility and confirmation of surgical success.

Adult↗
PubMed1993

[Angiography in infancy and childhood].

Between 1973 and 1991 we performed 160 percutaneous angiograms (130 arteriograms, 30 phlebograms) in children and infants; 12 patients were less than one year and 52 less than ten years old. 44 of the examinations were done by a DSA technique. The examinations were carried out under general anaesthesia except in 8 cases. In 50.7% an arteriogram was carried out for the investigation of a suspected or known tumour, in 9.3% an arteriogram was required following trauma. The most common phlebographic examination was for the demonstration of the spermatic vein; in 27 patients this was done for cryptorchidism or a varicocele. The only complication following a diagnostic angiogram was perforation of one spermatic vein. There were no other complications requiring treatment, such as thromboembolic events. With a total complication rate of 0.6%, angiography in childhood is a relatively safe diagnostic method.

Anesthesia, General↗
PubMed1993

[Detection of chronic recurrent pulmonary emboli using spiral-CT].

Chronic recurrent pulmonary emboli may lead, in rare cases, to progressive pulmonary arterial hypertension which cannot be treated medically. These patients may be helped by bilateral pulmonary thrombendarterectomy. The value of spiral CT in the diagnosis of this condition was demonstrated in 31 patients. In 12 patients, thrombi could be shown to be the cause of the pulmonary arterial hypertension. Indirect criteria were vascular occlusions, changes in calibre and mural irregularities which were shown in varying degrees in all patients. In 22 of 31 patients there was non-homogeneity of perfusion with greater opacification of the perfused lung parenchyma. In 11 patients scars related to pleural surfaces were seen. Typical changes of right heart insufficiency (cardiomegaly, widened central pulmonary arteries) were shown in all patients by CT.

Adult↗
PubMed1993

[99mTc-MAG3-kidney function scintigraphy without and with captopril in the diagnosis of renovascular hypertension].

In this study, the diagnostic value of renal function scintigraphy performed both without and with ACE inhibition has been evaluated using the new radiopharmaceutical 99mTc-MAG3. In cases of decompensated renal artery stenoses, the typical scan finding with this tubular excreted agent was shown to be a distinct parenchymal nuclide retention in combination with a delayed appearance of the radiotracer in the pelvic system. Using this criterion in 43 patients with suspected renovascular hypertension, sensitivity and specificity were 89 and 88%, respectively. Bilateral positive findings were non-specific; excluding them from the study, specificity increased to 100%. In renal insufficiency, captopril scans seem to be of reduced diagnostic value. Summarising our experiences, renal function scintigraphy using 99mTc-MAG3 without and with captopril was proved to be a reliable non-invasive method to detect or exclude haemodynamically relevant renal artery stenosis.

Captopril↗
PubMed1993

[Results of angiographic follow-up of percutaneous stent implantation in the pelvic arteries with a comparison between Wall and Palmaz stents].

51 occlusions of iliac arteries and 67 stenoses have been treated, including 22 patients with bilateral lesions. Indications for stent implantations were: vascular occlusions (51), restenosis following previous PTA (22) and immediate unsatisfactory results or extensive dissection after PTA (45). Successful placement of a stent was achieved in 116 out of 118 attempts. Period of observation averaged 16 months (3-36 months). Stent occlusion was observed in 8 cases. There was mild intima hyperplasia in 25 patients and in a further 14 intima hyperplasia exceeded 75%. Patency rate after 36 months was 67%; 74 wall stents and 39 Palmaz stents were patent, a patency rate of 73 and 65% respectively after 24 months.

Adult↗
PubMed1993

[Jejunogastric invagination: plain radiologic, sonographic and computed tomographic findings].

Jejunogastric intussusception is a rare complication after gastric surgery and when its diagnosis is delayed a high mortality rate can be expected. This paper reports on the characteristic findings of this entity at ultrasound and CT examination. Both diagnostic procedures have a high sensitivity. Sonography is the method of first choice because the diagnosis can be made with a high grade of certainty. CT allows the differentiation of the distinct stages of the disease and the views given by CT are often more easily accepted by the surgeons.

Adult↗
PubMed1993

[Evaluation criteria for captopril-kidney function scintigraphy using 99mTc-MAG3].

Renal function scintigraphy under ACE inhibition has gained an important role in the diagnosis of renovascular hypertension. Using the radiopharmaceutical 99mTc-MAG3, 54 kidneys with angiographically verified renal artery status were evaluated with respect to the following scintigraphic parameters: intraparenchymal tracer transport, urine drainage, kidney size, and functional side-to-side ratio. In cases of decompensated renal artery stenosis, the typical scan finding using MAG3 was shown to be a distinct parenchymal nuclide retention in combination with a delayed appearance of the radiotracer in the pelvic system. In our patients, the visual impression of the renal sequential scans was superior to quantitative evaluation methods. Using these criteria in 43 patients with suspected renovascular hypertension, sensitivity and specificity were 89% and 88%, respectively. Bilateral positive findings were nonspecific; when excluding them from the study, specificity increased to 100%.

Adult↗
PubMed1992

[Percutaneous sonographic angioplasty. Initial experimental results].

Aim of the present study was to examine in vitro the effects of a new ultrasound catheter system on atherosclerotic and normal vessels before employing the system in humans. 141 attempts were made on 32 vascular preparations obtained at autopsy. The vessels were opened longitudinally within 24 hours of death, dilated with gelatine and were then "treated" in a waterbath using varying degrees of pressure, angle of incidence, sound intensity and duration of sound. Macroscopic and histological examinations of the preparation showed no morphological change in normal vessels except evidence of pressure by the catheter. In particular, there were no perforations of the vessel wall. In atherosclerotic segments there was significant reduction in the size of plaques following treatment.

Angioplasty, Balloon↗
PubMed1992

[Intestinal contrasting in abdominal computed tomography].

In 56 patients undergoing abdominal CT the gastrointestinal tract was defined by negative contrast instead of the conventional positive contrast from an iodine containing contrast medium. The contrast material was a 2 1/2% mannitol solution and was used for filling the rectum. Filling of the gastrointestinal tract was of similar quality to that obtained with positive contrast media. The number of artifacts due to high contrast boundaries was slightly greater with the negative contrast than it would have been with positive contrast. Differentiation of the gastrointestinal tract from other abdominal organs was equally good for both methods. The negative contrast method was poor in diagnosing cystic tumours but proved much better than positive contrast for evaluating the wall of the gastrointestinal tract.

Adolescent↗
PubMed1991

[Intra-arterial preoperative chemotherapy of advanced cervix cancer].

Three patients suffering from very advanced primary cancers of the cervix uteri (FIGO II B or III B) were treated. By preoperative selective perfusion of both uterine arteries, using cis-platinum alone, a distinct reduction of the tumour volume was achieved. This was demonstrated clinically and also by CAT scan and NMR technique. The elevated serum CEA and SCC levels decreased to normal values. The histomorphology of the Wertheim-Meigs specimens revealed no tumour invasion of the initially infiltrated parametria. This treatment modality has been developed to minimise the toxic side effects of the inductive (neo-adjuvant) chemotherapy for cervical cancers.

Adult↗
PubMed1991

[Regional lymph node metastases in malignant tumors of the head and neck: value of diagnostic procedures].

Sonography and computed tomography are used in staging of lymph nodes of patients with head and neck cancer. The accuracy of sonography (90%) and computed tomography (85%) is comparable or better than the palpatory accuracy (85%). The better delineation of reactive swollen cervical nodes leads to a higher sensitivity of sonography (90%) and computed tomography (84%) versus palpation (74%), but a lower specifity (palpation 94%, sonography 90%, computed tomography 86%). A literature survey shows that sonography, computed tomography and magnetic resonance imaging of cervical lymph nodes are comparable good methods.

Carcinoma, Squamous Cell↗
PubMed1991

[Intravascular sonography: initial clinical results].

Intravascular ultrasound is a new diagnostic modality which, for the first time, provides high resolution images of the vessel wall. 91 intraluminal ultrasound studies were performed in 50 patients during the course of 55 diagnostic and therapeutic catheterizations. A F-6 ultrasound catheter (20 MHz) was used. The method is an easily and rapidly performed addition to angiography. Changes in vessel walls (arteriosclerosis, dissection, tumour infiltration) can be readily diagnosed and their extent can be accurately described. The ability to determine luminal cross sectional area is particularly helpful for planning and performing therapeutic interventions.

Adult↗
PubMed1991

[Intestinal contrast imaging in abdominal computed tomography: water or contrast medium?].

The suitability of water as an oral or rectal contrast medium for abdominal CT was studied in 56 patients and compared with an iodine-containing water-soluble contrast medium (ioxital amino acid). In some cases it was impossible to differentiate gastrointestinal structures from extraluminal fluid collections (cystic tumours, ascites, abscesses) and there was poor filling of distal small bowel and colon. The routine use of water can, therefore, not be recommended. In some cases, however, water can result in improved image quality by reducing artifacts and improving the demonstration of the mucosa.

Adolescent↗