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C Ell

Publications and source records attributed to C Ell.

At least 217 records · Page 12Linked to original sources
PubMed1990

[Extracorporeal shock-wave lithotripsy of a salivary stone].

Ultrasonography revealed a 12 mm concrement in the left parotid duct of a 67-year-old man with an acute exacerbation of a left-sided purulent parotitis. After the acute phase had subsided under antibiotic therapy it was not possible to remove the stone either by bougie or cutting into the duct close to the papilla. Piezoelectric shockwave lithotripsy with a total of 1000 shock-waves fragmented the stone, and sonography 48 hours and four weeks later demonstrated that the parotid gland was free of stone.

Aged↗
PubMed1990

Piezoelectric lithotripsy: stone disintegration and follow-up results in patients with symptomatic gallbladder stones.

One hundred symptomatic patients with radiolucent gallbladder stones were treated with a new piezoelectric lithotripter and oral chemolitholytic agents. Stone disintegration was achieved in 99 of these patients (99%) with a mean (+/- SD) maximum fragment size of 5.1 +/- 4.1 mm. Significant differences were found when the mean (+/- SD) fragment sizes of single stones less than or equal to 20 mm (4.2 +/- 2.5 mm) were compared with those of single stones greater than 20 mm (5.8 +/- 3.4 mm; P less than 0.05) and multiple stones (6.2 +/- 3.8 mm; P less than 0.05), respectively. None of the patients required anesthesia, analgesics, or sedatives before or during the treatment. The stone-free rates for all patients followed up for up to 4-12 months (mean +/- SD, 10.7 +/- 2.9 months) were 18% (1 month), 25% (2 months), 38% (4 months), 52% (8 months), and 67% (12 months). Partly significant differences were obtained in stone-free rates for single stones (less than or equal to 20 mm) compared with larger stones (greater than 20 mm) and multiple stones (P less than 0.05), respectively. Serious adverse reactions (i.e., cholestasis and pancreatitis) were observed in only 3 patients (3%). These conditions were induced by fragment impaction in the common bile duct. In 2 of these patients, endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy was required. It is concluded that piezoelectrically generated shock waves are suitable for the effective and safe disintegration of gallbladder stones in humans. The anesthesia-free and analgesia-free shock-wave application opens up the possibility to perform biliary lithotripsy as an outpatient procedure. The stone-free rate achieved in combination with oral bile acids is most promising for single stones (less than or equal to 20 mm).

Adult↗
PubMed1990

[Tissue reactions with administration of piezoelectric shock waves in lithotripsy of salivary calculi].

Before clinical application of an extracorporeal piezoelectric lithotripter to treat sialolithiasis, tissue reaction during shockwave application was examined in vitro and in experiments with animals. Application of shockwaves to human tissue in vitro showed neither macroscopic nor microscopic effects. In animal experiments, the acute experiment (16 rabbits, Chinchilla-Bastard) revealed minor bleeding in the parenchyma of the parotid gland, while the chronic experiment (14 rabbits, Chinichilla-Bastard) revealed no morphologic tissue damage to the parotid region of the rabbit, as a result of piezoelectric shockwaves. However, when the eye was placed in the shockwave focal area and the shockwaves were transmitted via the fissura orbitalis to the endocranium, brain damage could be detected morphologically. In conclusion, the authors feel that the clinical application of extracorporeal piezoelectric fragmentation of salivary stones is justified, provided that a reliable positioning of the patient and exact sonographic location of the concrement are possible.

Animals↗
PubMed1990

[Extracorporeal piezoelectric lithotripsy of salivary calculi. Initial clinical experiences].

Piezoelectric lithotripsy was performed in 14 patients with salivary stones. None of the patients required anaesthesia, analgesics or sedatives. All of the salivary stones could be fragmented totally during the first lithotripsy procedure. Three months after treatment with extracorporeal shock waves all the patients were free of symptoms and in 7 out of 14 patients no concrement could be found by sonography. The piezoelectric lithotripsy of salivary stones had caused no serious side effects as proved by clinical, biochemical, sonographic and magnetic resonance imaging examinations. Extracorporeal piezoelectric lithotripsy is a new and promising non-surgical therapy for selected cases of sialolithiasis of the large salivary glands of the neck.

Adult↗
PubMed1989

[Dissemination of endoscopic procedures in gastroenterology. A survey of hospitals in West Germany].

With the aim of establishing the prevalence of diagnostic and therapeutic endoscopic procedures in the field of gastroenterology, a survey was conducted of the medical and surgical departments of university hospitals as well as of all other hospitals in the FRG. Of the 1,382 hospitals approached, 1,116 (80.7%) provided the information required. An analysis of the data revealed that in the medical departments of university hospitals, virtually all the diagnostic and therapeutic endoscopic procedures are practised, with the exception laser therapy, endoprosthesis implantation and local chemolitholysis. Also, the diagnostic endoscopic procedures have become firmly established in the surgical departments of the university hospitals and the general medical hospitals in the Federal Republic. In contrast, therapeutic endoscopy has not met with unqualified acceptance in the surgical departments of the university hospitals (in particular the pancreo-biliary system) and in the small to medium-sized medical-gastroenterological hospitals (less than 100 medical beds) (in particular endoprosthesis implantation, laser therapy and variceal sclerotherapy).

Endoscopy↗
PubMed1989

Fragmentation of biliary calculi by means of extracorporeally generated piezoelectric shock waves.

A new extracorporeal piezoelectric lithotripter was tested for its gallstone disintegration capability. A total of 177 surgically removed gallbladder stones were submitted to piezoelectric shock-wave treatment. Prior to shock-wave application, the diameter, weight, and volume of all the stones and CT density and MR signal intensity of selected stones were determined. After shock-wave application, the chemical composition of the stones was investigated by x-ray diffractometry and/or infrared spectrometry. All the stones (maximum diameter 6-30 mm) were successfully fragmented; calculi with a maximum diameter of 17 mm, a maximum weight of 1800 mg, and a maximum volume of 2 cc were regularly disintegrated into fragments less than or equal to 4 mm. The number of shock waves required correlated most closely with volume (r = 0.82, P less than 0.001), weight (r = 0.81, P less than 0.001) and, to a somewhat lesser degree, diameter (r = 0.62, P less than 0.001). No correlation was found between the chemical composition, CT density, or MR intensity of the calculi and the number of pulses needed for fragmentation.

Cholelithiasis↗
PubMed1989

Extracorporeal piezoelectric shockwave lithotripsy of multiple pancreatic duct stones under ultrasonographic control.

The first ultrasonographically controlled fragmentation of multiple pancreatic duct stones of up to 14 mm size by means of extracorporeal, piezoelectric shockwave lithotripsy is reported. On account of the ultrasound localization and continuous control during therapy a nasopancreatic tube for instillation of contrast medium and frequent x-ray checks were not necessary. The 48-year-old patient did not experience any pain during the four treatment sessions and during the follow-up period. No complications were noted.

Calculi↗
PubMed1989

Tissue reactions under piezoelectric shockwave application for the fragmentation of biliary calculi.

The tissue reactions that occurred during piezoelectric shockwaves for the fragmentation of biliary calculi were investigated in 10 surgically removed stone containing human gall bladders and in acute (six dogs) and chronic (six dogs) animal experiments. Before and after shockwave (500, 1500 or 3000) in the anaesthetised dogs, computed tomography (CT), magnetic imaging (MRI) and laboratory tests were done; treatment was carried out under continuous ultrasonographic control. Shockwave applications to the human gall bladders resulted in disintegration of the stones with no macroscopically or microscopically detectable tissue changes. In acute animal experiments, small haematomas were observed in all six animals at surfaces, but also inside the liver and gall bladder (max diameter 25 mm). Perforation or intra-abdominal or pleural bleeding did not occur. In chronic experiments, no macroscopic, and only slight microscopic residual lesions (haemosiderin deposits) were seen three weeks after shockwave. In almost all instances, the lesions were detected by CT, MRI, and ultrasonography, while laboratory tests were negative.

Animals↗
PubMed1989

[Extracorporeal piezoelectric lithotripsy of salivary calculi. In vitro studies].

The feasibility of fragmentation of salivary stones by a new extracorporeal piezoelectric lithotripter was investigated. A total of 40 salivary stones were submitted to piezoelectric shockwave treatment. Prior to shockwave application the diameter, weight and volume of all the stones were determined. After shockwave application the chemical composition of the stones was investigated by X-ray diffractometry. Fragmentation was achieved in 35 of 40 (87.5%) stones. Of these 40 stones, 25 (62.5%) were disintegrated adequately (residual fragments less than 1.5 mm). No statistically significant correlation was observed between the number of discharges required for disintegration and the diameter, weight, volume or the chemical composition of the stones.

Humans↗
PubMed1988

[Piezoelectric lithotripsy of gallstones. Initial clinical experiences].

Piezoelectric lithotripsy was undertaken on 50 patients with gallbladder stones, none of them requiring anaesthesia, analgetics or sedatives. Stone fragmentation was achieved in all patients during the first treatment. In 44 patients the maximum fragment size was less than 50% of the initial stone diameter. The mean maximum fragment size after the first treatment was 4.3 mm (+/- 3.3 mm). After a follow-up of 0-2 months in 14 of the 50 patients and of 2-4 months in 6 of 13 patients, no more stones could be seen by ultrasonography. After an average period of 8 weeks, 17 of 50 patients were free of stones. Piezoelectric lithotripsy did not have any severe side effects besides a mild pancreatitis in one patient.

Adult↗