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Biomedical subjects

C Enzweiler

Publications and source records attributed to C Enzweiler.

8 recordsLinked to original sources
PubMed2000

Disaster with a new type of band for gastric banding.

BACKGROUND: Laparoscopic gastric banding has become an established therapy for morbid obesity. Typical complications are band dislocation, pouch dilatation and stomach slippage. A new type of adjustable silicone band with eyes for suture fixation was proposed to avoid these complications. The experience with this new kind of band is reported. METHODS: Between April 1998 and August 1998, 15 morbidly obese patients were treated by laparoscopic adjustable gastric banding using a new band type (manufactured by MEDING, Heinsberg, Germany). The band was fixed by single sutures using the eyes at each side of the buckle. There were 13 women and 2 men, with mean age 34 (range 21-54) years and mean body-weight 138.6 (range 113-213) kg. RESULTS: Intraoperative complications did not occur. Postoperatively 8 patients (53%) had increasing capacity for food intake and 2 (13%) had uncharacteristic abdominal pain. Radiographs revealed band rupture in 13 of 15 patients 3-11 months postoperatively. These patients were operated laparoscopically using a new technique for band change. Now, a Lap-band (BioEnterics, Carpinteria, CA, USA) was inserted and fixed to the ventral stomach with three sutures similar to a ventral fundoplication. Radiographic and clinical follow-up have been uneventful in all patients until now. CONCLUSION: This series demonstrated: 1) the importance of clinical follow-up; 2) a material defect of a new band type; and 3) development of a new laparoscopic technique for band change.

Adult↗
PubMed1999

Tube thoracostomy complicates unrecognized diaphragmatic rupture.

A case of traumatic diaphragmatic rupture is reported in which herniated stomach mimicked a tension pneumothorax. Tube thoracostomy by trocar caused insertion of the pleural drain into the intrathoracic stomach. CT scan of the thorax after oral administration of contrast material revealed the correct diagnosis. After removal of the drain and retraction of the stomach into the abdomen the gastric perforation and diaphragmatic defect could be closed by suture. The further course of the patient was uneventful. This case report underlines the importance of differential diagnosis of symptoms in a case with a history of blunt chest trauma and shows the risks of unnecessary use of a trocar.

Adult↗
PubMed1998

[Thoracic diagnosis with electron-beam computed tomography].

The electron beam computed tomography (EBCT) is characterised by an up to 10-fold increased speed in comparison to a spiral CT scanner. Although originally designed for diagnosing the heart, some indications in the chest and for the vessels have also become well established. In the forefront exists the possibility to exam a large volume with a small slice thickness in a short time period without having to sacrifice on important features of spiral CT scanning. During one breathhold, the thorax can be continually examined with 1.5 mm slice thickness, which means that indications for high-resolution (HR-) CT, spiral-CT and for virtual bronchoscopy can be combined into one examination. Beyond the artefact-reduced images, the EBCT presents image data which, following image processing (sliding MIPs, coronal reconstructions), allow recognition of a new horizon in thoracic diagnostics.

Aged↗
PubMed1998

[Pneumocysts juxta-articular to the ilial bone and the sacral bone].

PURPOSE: The purpose of the study was to detect and safely diagnose pneumatocysts by means of computed tomography. METHODS: From September 1995 to May 1996 computed tomography of the pelvis was performed in six patients for various indications. A slice thickness of 8 mm was employed for all studies. One patient had undergone surgery for hyperparathyroidism nine years previously. Attenuation values within the coincidentally diagnosed pneumatocysts were obtained. RESULTS: We found a total of 14 pneumatocysts juxtaarticular to the sacroiliac joint. Three patients demonstrated a bilateral intraarticular vacuum phenomenon, yet a joint communication was not found. The lesions did not coincide with inflammation, tumour or trauma. CONCLUSION: Pneumatocysts are benign bone lesions associated with arthrotic changes of the sacroiliac joint. Computed tomography is the modality of choice for the diagnosis of pneumatocysts.

Aged↗
PubMed1993

Hormonal responses to the new potent GnRH antagonist Cetrorelix.

GnRH antagonists, unlike the GnRH agonists, immediately suppress gonadotropins and testosterone secretion without initial stimulatory effect. We report here on a single-dose study with the new GnRH antagonist Cetrorelix (Ac-D-Nal(2)1, D-Phe(4C1)2, D-Pal3, D-Cit6, D-Alal0) in 25 normal men. The study involved five different dose groups (0.25, 0.5, 1.0, 1.5 or 3.0 mg) and subjects were observed over a 40 h period. Five men served as controls. Serum levels of LH, FSH and testosterone decreased rapidly with a dose-related decline for testosterone of 25%, 24%, 41%, 53% and 72%, respectively, for testosterone within the first 8 h of antagonist administration. All effects were reversible and no serious side effects were observed. Thus, this GnRH antagonist is active in men even in small doses and could become a new therapeutic tool for sex hormone-dependent diseases. Cetrorelix seems to have the highest suppressive rate per mg peptide of all other antagonists from the literature, such as Nal-Glu (Ac-D-Nal(2)1, D-Phe(4Cl)2, D-Pal3, Arg5, D-Glu6(AA), D-Alal0), Detirelix (Ac-D-Nal(2)1, D-pCl-Phe2, D-Trp3, D-hArg(Et2)6, D-Alal0) or 4F (Ac-delta 3Prol, 4F-D-Phe2, D-Trp3,6). During the time of suppression after a dose of 3 mg there was an LH and testosterone peak in the early morning coinciding with the testosterone peak in untreated men. The GnRH antagonist seems to unmask the circadian rhythm of LH secretion.

Adult↗
PubMedDate not supplied

Use of contrast enhanced magnetic resonance imaging to detect spinal inflammation in patients with spondyloarthritides.

Inflammation of spinal structures is a characteristic feature of the spondyloarthritides (SpA). The term SpA covers patients with inflammatory back pain and/or peripheral arthritis who can be further categorized. Ankylosing spondylitis (AS), the prototype of the SpA, the most frequent inflammatory spinal disease in adults, usually starts in the sacroiliac joints. Pathologic spinal changes occurring in AS are spondylitis, spondylodiscitis and inflammation and ankylosis also at other sites in the axial skeleton. In the later stages of AS such changes can be well recognized by spinal x-rays. In the early disease stages it has been more difficult to analyze the exact anatomic localization of spinal inflammation to date, because conventional imaging systems have only a limited capacity to demonstrate such changes early. There is some evidence that magnetic resonance imaging (MRI) with fat saturation and contrast enhanced MRI are useful to visualize early and late inflammatory changes in the sacroiliac joints. In this paper we report that MRI is also useful to localize the site of inflammation to distinct regions of the spine in AS and other SpA.

Adult↗