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Biomedical subjects

C Kuntz

Publications and source records attributed to C Kuntz.

At least 19 recordsLinked to original sources
PubMed2006

[Palliative bypass surgery].

Impaired intestinal passage considerably reduces quality of life irrespective of the underlying condition. Limited life expectancy and increased operative risk of advanced malignant disease add particular weight to this issue. The indication for operative therapy results from carefully weighing individual incapacity and potential gain vs operative risk and life expectancy. Exactly because life expectancy is quite limited, selection of an effective, low-risk procedure is of utmost importance to benefit the patient.

Constriction, Pathologic↗
PubMed2005

[Experimental testing of a new coil design for endoluminal MRI applied to the pig stomach].

PURPOSE: Experimental feasibility study of a new MR-Coil concept for enhanced visualization of the gastric wall. MATERIAL AND METHODS: The newly developed single-loop receiver coil for endoluminal imaging (Fraunhofer Institute, St. Ingbert, Germany) was evaluated in 4 explanted pig stomachs in a 1.5T MR unit (Siemens Symphony, Erlangen, Germany) with T1 w and T2 w MR sequences in three planes. The new coil consists of a foldable and self-expanding single loop coil (receiver coil) of a shape memory metal (nitinol). It was covered with a biocompatible material (silicone) to prevent direct contact of the wire with stomach tissue. The coil assumes a circular configuration with a diameter of 8 cm because of its memory metal properties. The flexible characteristics of the material used allow the passage through the instrument channel (13 mm diameter) of a specially designed MR-compatible endoscope. The purpose of our study was to assess feasibility of the coil design as a first step in developing a new endoluminal MRI-concept. Additionally the number and signal intensity of visible gastric wall layers were evaluated and findings were correlated with histopathological results of a pig stomach. RESULTS: The new coil concept was a feasible system in all 4 cases and showed good image quality for analysis. On T1 w images, 3 layers were visible in all cases, and on T2 w images 4 different gastric wall layers were seen in 2 cases. Due to histopathological correlation, the different gastric wall layers were identified as follows: mucosa, submucosa and muscularis propria if three layers were depicted; in cases of 4 visible wall layers, serosa and subserosa could be detected additionally. For each gastric wall layer, a distinct signal intensity was found. CONCLUSION: The new MR coil concept for endoluminal imaging proved to be a feasible technique. Good differentiation of gastric wall layers in the pig stomach could be demonstrated. We have shown that endoscopic MR-imaging with our new coil concept is a valuable technique for the visualization of gastric wall layers. Due to this fact, follow-up studies including assessing safety aspects are necessary to finally conduct an experimental-clinical study on in-vivo human gastric specimens to detect tumor growth and morphology within the gastric wall. Endoscopic MRI may have the potential in the future to overcome today's limitations of diagnostic imaging in gastric cancer.

Animals↗
PubMed2004

Influence of different gases used for laparoscopy (helium, carbon dioxide, room air, and xenon) on tumor volume, histomorphology, and leukocyte-tumor-endothelium interaction in intravital microscopy.

BACKGROUND: Previous studies indicate that helium pneumoperitoneum used for laparoscopic surgery suppresses whereas carbon dioxide pneumoperitoneum increases postoperative tumor growth. The pathomechanisms of decreased tumor growth by helium are unknown. This study was designed to examine the effect of the gases helium, carbon dioxide (CO(2)), and air, and xenon, which can be used to induce pneumoperitoneum in laparoscopy on tumor volume, histomorphology, and leukocyte-endothelium interaction measured by intravital microscopy in rats with implanted liver malignoma (Morris hepatoma 3924A). METHODS: In 46 rats, Morris hepatoma 3294A cells were implanted intrahepatically. After implantation, rats were randomized into two main groups. In the first main group, 10 animals were prepared for examination of leukocyte-endothelium interaction by intravital video microscopy and were randomized into two groups. Five days after implantation they underwent laparoscopy using either helium (n = 5) or CO(2) (n = 5). Ten days after implantation the rats underwent intravital video microscopy to assess leukocyte-endothelium interaction in the tumor and liver vessels. In the second main group 36 rats were prepared for examination of tumor volume arid histomorphology. They were randomized into five groups. Five days after implantation they underwent laparoscopy using helium (n = 7), carbon dioxide (n = 7), room air (n = 7), or xenon (n = 8). The control group (n = 7) received anesthesia only. Rats were killed 10 days after tumor implantation to assess tumor volume and histomorphology. RESULTS: Compared to the control group or groups that received CO(2), room air, or xenon for pneumoperitoneum, the establishment of helium pneumoperitoneum caused a significantly smaller tumor volume (Kruskal-Wallis test, p = 0.001; median tumor-volume: control group, 44 mm(3); helium 19 mm(3)). There was no significant difference in histomorphology between the groups. There was only a statistically significant difference in the development of central tumor necrosis in accordance to tumor volume (Mann-Whitney test, p = 0.03). In the tumor samples, roller counts were statistically significantly higher in the helium group compared to the CO(2) group (p = 0.04). For sticker counts, no statistically significant effects due to liver/tumor (p = 0.13) or treatment (p = 0.48) were observed. CONCLUSIONS: There was a significant decrease in tumor volume using helium pneumoperitoneum for laparoscopy compared to the other gases. Here, we demonstrate that suppression of tumor growth is not due to variation of histomorphology. It seems that helium pneumoperitoneum effects a higher leukocyte-endothelium interaction and thereby a higher immune activation. This could be one explanation for the statistically significantly smaller tumor volume after laparoscopy with helium compared to laparoscopy with CO(2).

Air↗
PubMed2003

Influence of different gases used for laparoscopy (helium, carbon dioxide, room air, xenon) on tumor volume, proliferation, and apoptosis.

BACKGROUND: Previous reports suggest that helium pneumoperitoneum used for laparoscopic surgery suppresses postoperative tumor growth. The present study was designed to determine the effects of gases used in laparoscopy on tumor volume, proliferation, and apoptosis in rats with implanted malignoma. METHODS: In 36 rats Morris hepatoma 3294A cells were implanted intrahepatically. Then, after 5 days, they underwent laparoscopy using helium ( n = 7), CO(2) ( n = 7), room air ( n = 7), or xenon ( n = 8). One group received anesthesia only ( n = 7). Rats were killed 10 days after implantation to assess tumor volume, proliferation, and apoptosis. RESULTS: Helium pneumoperitoneum caused a significant smaller tumor volume compared to other groups (Kruskal-Wallis test: p = 0.001; median tumor volume: control: 44 mm3; helium: 19 mm3). There was no significant difference in tumor cell proliferation (PCNA) and apoptosis (TUNEL reaction) between the groups. CONCLUSIONS: There was a significant decrease of tumor volume using helium pneumoperitoneum compared to the other gases, but no decreased tumor cell proliferation or increased tumor cell apoptosis.

Air↗
PubMed2003

Helium pneumoperitoneum reduces tumor recurrence after curative laparoscopic liver resection in rats in a tumor-bearing small animal model.

BACKGROUND: After exposure of neoplastic tissue to helium, a significant reduction of tumor growth has been detected in experimental studies, both in vitro and in vivo. This tumor-suppressive effect of helium is controversly discussed in the literature. It was therefore the aim of this study to investigate the influence of pneumoperitoneum with CO2, room air, or helium in a tumor-bearing small animal model comparing laparoscopic partial hepatic resection for hepatocellular carcinoma with conventional open partial hepatectomy. METHODS: One-hundred forty-eight male American Cancer Institute rats underwent partial hepatectomy for curative resection of previously induced hepatocellular carcinoma (Morris hepatoma 3924A). Resection was performed either in open laparotomy (n = 30) or laparoscopically under the employment of CO2 (n = 30), room air (n = 30), or helium (n = 30) for the pneumoperitoneum. Twenty-eight animals served as controls receiving anesthesia but no tumor resection. All animals were sacrificed on postoperative days 21, 35, or 56 for autopsy and evaluation of possible tumor recurrence and metastasis. RESULTS: Significant reduction of postoperative tumor recurrence and metastasis was observed in the group of animals receiving laparoscopic tumor resection under helium insufflation compared to open surgery or laparoscopic resection with air pneumoperitoneum. CONCLUSIONS: The results of this study suggest a suppressive effect of helium pneumoperitoneum on postoperative tumor growth and metastatic spread. Furthermore, tumor exposure to room air appears to have a stimulative influence on tumor recurrence and metastasis compared to a pneumoperitoneum established with CO2.

Animals↗
PubMed2003

In vivo assessment of angioarchitecture and microcirculation in experimental liver cancer: a new model in rats.

The rising incidence of unresectable hepatocellular malignancies remains a therapeutic challenge. Little is known about the mechanisms of angiogenesis and immunological aspects of liver tumor vessels. The aim of this study was to investigate hepatic and tumor microcirculation and leukocyte-endothelium interaction by means of intravital microscopy in a rat model of hepatocellular carcinoma. Off-line analysis showed that the angioarchitecture as well as blood flow velocity in liver cancer is heterogeneous. The leukocyte-endothelium interaction is significantly reduced compared to normal liver tissue. The data suggest that the main mechanism is a reduced expression of adhesion molecules demonstrating an effective immune escape mechanism of this tumor. The model represents a useful experimental tool to explore angiogenesis inhibition or immunological therapeutic strategies in experimental liver cancer.

Animals↗
PubMed2002

Comparison of laparoscopic versus conventional technique in colonic and liver resection in a tumor-bearing small animal model.

BACKGROUND: Laparoscopic procedures in oncological surgery are either done in curative or palliative intent. We present two experiments comparing laparoscopic to conventional surgery in the curative and palliative setting regarding short-term (stress and immune alteration) and long-term aspects (survival time and recurrence rate). METHODS: We established two syngenic tumor-bearing small animal models for curative liver resection (Morris hepatoma 3924A, ACI rats) and palliative colon resection (BSp73 ASML, BOX rats). Male rats were operated on, performing laparoscopic and conventional liver resection as well as laparoscopic and conventional colon resection; control groups (anesthesia) were included. The following parameters of the stress and immune system were measured: corticosterone, neopterine, Il-1-b, Il-6, and body weight as a parameter of postoperative recovery. Analyzed long-term parameters were survival time, tumor weight, and recurrence rate (histology). RESULTS: After colon resection, analysis of variance showed significant differences in all short-term parameters, including body weight after laparoscopic versus conventional colon resection (p <0.05). In the case of laparoscopic versus conventional liver resection, only Il-6 showed globally statistically significant differences for the short-term parameters (p = 0.05). Long-term parameters were not significantly different between the laparoscopic and conventional groups, regardless of the type of resection (colon or liver) or the operative setting (curative or palliative). However, there were differences after curative liver resection compared to the control group (anesthesia alone). CONCLUSION: These results suggest that the type of intraabdominal operation (colon or liver) may influence the degree of trauma of an operation more than the type of technique (laparoscopic or open). The perioperative alteration of stress and immune function has no implications on the long-term results, such as survival time or recurrence, neither in the curative nor in the palliative setting. The thesis that laparoscopic surgery results in less pain, which in turn means less stress and less alteration of the immune system and therefore results in a lower rate of postoperative metastasis is only valid for laparoscopic colonic resection in our model. The part of the thesis that states that fewer metastases should occur after laparoscopic oncological surgery cannot be confirmed in our study.

Adenocarcinoma↗
PubMed2002

[Prospective comparison of hydrosonography, endosonography and specimen sonography for TN staging of gastric carcinoma].

PURPOSE: To compare hydrosonography (HUS), endosonography (EUS) and experimental sonography (PUS) with respect to TN-staging accuracy of gastric carcinoma. MATERIAL AND METHODS: Thirty-six patients with gastric carcinoma underwent EUS (7.5/12 MHz transducer, Olympus GF-UM 20) and HUS (3.75 MHz transducer, Toshiba, Sonolayer SSA-270A) for TN-staging according to the UICC-classification. The resected specimens were reexamined (3.75/7.5 MHz transducer) and again TN-staging was performed. Findings were correlated with histopathological results. RESULTS: T- and N-staging accuracies were as follows: EUS 54 % (19/35) and 79 % (27/34); HUS 41 % (15/37) and 61 % (22/36); and PUS 51 % (19/37) and 72 %(26/36). Sensitivities and specificities for the detection of lymph node metastases were as follows: EUS 87 % and 54 %; HUS 57 % and 69 %; and PUS 83 % and 54 %. CONCLUSIONS: The accuracy of sonographic TN- staging is limited in patients with gastric carcinoma. Nevertheless, EUS may contribute to the preoperative management of patients with gastric carcinoma if indications are well defined. HUS is not suited for TN-staging of gastric carcinoma.

Adult↗
PubMed2001

Monocytes influence the fate of T cells challenged with oxidised low density lipoproteins towards apoptosis or MHC-restricted proliferation.

Atherosclerosis has been implicated in myocardial infarction, stroke and a host of cardiovascular diseases. The presence of activated T lymphocytes and macrophages, and the increased expression of HLA-DR antigen are consistent with the notion of immune activity in the atherosclerotic plaque. The nature of the causative antigen has not been established although oxidised low density lipoproteins (oxLDL) that accumulate in atherosclerotic plaques could fulfil this role. Here, we report that monocytes play a key role in influencing the fate of purified peripheral human T lymphocytes from healthy donors when the cells are exposed to LDL oxidised under the controlled conditions of water radiolysis. Our data showed that oxLDL generated under these conditions were chemoattractants for T cells. However, they induced a state of apoptosis in T lymphocytes cultured in the absence of monocytes. The extent of apoptosis was related to the degree of oxidation of LDL and the time of T cell exposure to oxLDL. OxLDL-dependent apoptosis did not involve a scavenger-like receptor. CD4(+) cells were more sensitive to the apoptotic effect of oxLDL than CD8(+) cells. OxLDL-primed (12 h) autologous monocytes triggered a robust proliferation of T lymphocytes cultured in the absence of oxLDL. The strength of T cell stimulation was related to the degree of oxidation of the LDL used in priming. Heterologous monocytes exposed to oxLDL under similar conditions induced a response that was not different than monocytes exposed to untreated LDL (natLDL) which did not induce T cell proliferation. Fucoidan did not modify the oxLDL-, monocyte-dependent T cell response to proliferation, suggesting that a scavenger-like receptor was not involved. The expression of the HLA-DR marker and the B7.2 protein were up-regulated in monocytes exposed to oxLDL but not to natLDL. The levels of B7.1 were unchanged. Our data are consistent with the notion that monocytes are critical for T cell survival in the presence of oxLDL and MHC-restricted T cell proliferative response to oxLDL.

Adult↗
PubMed2000

Type II odontoid fractures in the elderly: early failure of nonsurgical treatment.

The optimum treatment of Type II odontoid fractures in the geriatric population remains controversial. Coexisting medical conditions encountered in the elderly patient often increase operative risk and make cervical immobilization difficult to tolerate. Previous studies have shown increased morbidity and mortality and decreased fusion rates for Type II odontoid fractures treated with cervical orthoses in the geriatric population, whereas low morbidity and mortality rates with operative management have recently been documented. To investigate the role of surgical and nonsurgical treatment, a retrospective analysis was performed of patients with Type II odontoid fractures who were at least 65 years old and were consecutively admitted to a single medical center from 1994 to 1998. Twenty patients met inclusion criteria. In 12 patients nonsurgical management with a cervical orthosis was attempted. The nonsurgical management failed early in six patients, with one associated death. Eleven patients were treated surgically with either anterior odontoid screw fixation or posterior C1-2 transarticular screw fixation and modified Gallie fusion. Postoperatively one patient required revision of the C1-2 transarticular screws, and there was one death. In conclusion Type II odontoid fractures in this elderly population were associated with early 10% morbidity and 20% mortality rates. Nonsurgical management of Type II odontoid fractures failed early in six (50%) of 12 patients, whereas surgical treatment failed early in one of 11 (9%) patients. Both the nonsurgical and surgical treatments resulted in approximately 10% morbidity and 10% mortality rates.

Aged↗
PubMed2000

Absence of p53: no effect in a transgenic mouse model of familial amyotrophic lateral sclerosis.

Familial amyotrophic lateral sclerosis (ALS) has been linked in some families to dominantly inherited mutations in the gene encoding copper-zinc superoxide dismutase 1 (Cu-Zn SOD1). Transgenic mice expressing a mutant human Cu-Zn SOD1 (G93A) develop a dominantly inherited adult-onset paralytic disorder that replicates many of the clinical and pathological features of familial ALS. Increased p53 immunoreactivity has been reported in the motor cortex and spinal ventral horns of postmortem tissue from ALS patients. The nuclear phosphoprotein p53 is an important regulator of cellular proliferation, and increasing evidence supports the role of p53 in regulating cellular apoptosis. To assess the role of p53-mediated apoptosis in amyotrophic lateral sclerosis, mice deficient in both p53 alleles (p53-/-) were crossed with transgenic mice expressing the G93A mutant (G93A+), creating novel transgenic knockout mice. The animals (p53 +/+G93A+, p53+/-G93A+, p53-/-G93A+) were examined at regular intervals for cage activity, upper and lower extremity strength, and mortality. At 120 days from birth mice from each genotype were sacrificed, and L2-L3 anterior horn motor neurons were counted. There was no significant difference in time to onset of behavioral decline, mortality, or motor neuron degeneration between the different genotypes. Despite evidence that p53 plays an important role after acute neuronal injury, the current study suggests that p53 is not significantly involved in cell death in the G93A+ transgenic mouse model of familial ALS.

Amyotrophic Lateral Sclerosis↗
PubMed2000

Short- and long-term results after laparoscopic vs conventional colon resection in a tumor-bearing small animal model.

BACKGROUND: We designed a study to evaluate the short- and long-term outcome of laparoscopic vs conventional colonic resection in a tumor-bearing small animal model. METHODS: We operated on male BD X rats (260-300 g), performing either laparoscopic (n = 9) or open colon resection (n = 9) in order to evaluate stress and immunological response to laparoscopic vs conventional colon resection. A third group (n = 9) underwent anesthesia only. Immediately before and after surgery, as well as at 1, 7, and 21 days postoperatively, a sample of 1 ml blood was taken from the retrobulbar venous plexus. Stress (corticosterone) and immune parameters (neopterine and IL-1 beta, IL-6) and body weight as a parameter of postoperative recovery were measured to identify short-term alterations. Long-term changes were evaluated in terms of survival time and at autopsy by measuring the tumor weight and the number of tumor infiltrated nodules (histology). RESULTS: The analysis of variance (ANOVA) showed significant differences between the three groups over a period of 1 week (p < 0.001 for corticosterone, p = 0.009 for neopterine, p = 0.04 for IL-1 beta, p = 0.024 for IL-6). Additionally, significant differences by t-test were found between the laparoscopic (minor alteration) and conventional (major alteration) group regarding corticosterone (p = 0.0015), neopterine (p = 0.0024), IL 1-beta (p = 0.033), and IL-6 (p = 0.015) at the end of the operation. One week after the operation, the body weight was different depending on the type of operative procedure: 7 days postoperatively the rats lost 8% of their body weight after open surgery but only 4.3% after laparoscopic surgery. After anesthesia only, body weight increased by approximately 4.8%. The medium survival time for the lap group was 44 days, whereas it was 44.1 days for the conventional group and 46 days for the anesthesia group (ANOVA p = 0.625). The number of nodules was 13.5 in the laparoscopic group 10.5 in the open group, and 7.4 in the anesthesia group, (ANOVA p = 0.119). The tumor weight was 6.8 g in the laparoscopic group, 6.4 g in the open group, and 5.04 g in the anesthesia group (ANOVA p = 0.874). CONCLUSION: In a tumor-bearing small animal model, laparoscopic colon resection alters the stress and immune system less than open colon resection. This observation has no implications for the long-term results as measured by survival time and at autopsy. Therefore, laparoscopic colon resection has a short-term benefit and has no negative effect on long-term results compared to conventional operative procedures.

Adenocarcinoma↗
PubMed2000

Effect of pressure and gas type on intraabdominal, subcutaneous, and blood pH in laparoscopy.

BACKGROUND: According to the literature, the number of port-site metastases in laparoscopic surgery varies considerably depending on the type of gas used for the pneumoperitoneum. In order to investigate this observation we studied the changes in blood, subcutaneous, and intra-abdominal pH during laparoscopy with helium, CO(2) and room air in a rat model. In addition, we looked at the influence of intra-abdominal pressure and duration of pneumoperitoneum on the pH during the laparoscopy. METHODS: pH was measured by tonometry, intra-abdominally and subcutaneously. A pH electrode was additionally placed into the subcutaneous tissue and the results compared to those measured by tonometry. Blood samples were taken from a catheter in the carotid artery. The intra-abdominal pressure was 0, 3, 6, 9 mm Hg for 30 min in each case. We investigated the effect of pneumoperitoneum with CO(2), helium and air in randomized groups of 5 rats. In an additional series the pressure was held constant at 3 mm Hg and the pH was measured every 30 min. RESULTS: Due to the different absorption capacity of the peritoneum, laparoscopy with CO(2) decreases the subcutaneous pH from 7.35 to 6.81. Blood pH is reduced from 7.37 to 7.17 and the intra-abdominal pH from 7.35 to 6.24. Other, less absorbable gases induce smaller changes of blood and subcutaneous pH (only 10% of CO(2)). In a variance analysis the p value is less than 0.001. The influence of duration of laparoscopy (30 min vs. 90 min) on the subcutaneous pH is less compared to the influence of intra-abdominal pressure (0, 3, 6, 9 mm Hg). CONCLUSIONS: Depending on the type of gas (CO(2), air, helium) used for laparoscopy blood, subcutaneous and intra-abdominal pH are influenced differently. Because lower pH is known to impair local defense mechanisms, these results may be one explanation for the higher incidence of port-site metastasis in laparoscopy with CO(2) than with other gases, as reported in the literature.

Abdomen↗
PubMed2000

Laparoscopic liver surgery in the rat: description of a new technique.

BACKGROUND: We devised a safe and simple method of liver resection with a wire loop in a small animal model. Herein the method is evaluated and combined with a tumor model for further immunological, oncological, and laparoscopic research. METHODS: With the aid of a wire loop and an adapted electric generator, a liver lobe resection can be performed through three trocars (first trocar: camera; second and third trocars: instruments). This operative procedure was evaluated in 10 rats (group 1). In a second group of ACI rats, a Morris hepatoma (1 mm(3)) was induced. After 11 days, a liver lobe resection was performed. One week after the resection an autopsy and a histological examination were performed in all animals. RESULTS: Ten ACI rats underwent laparoscopic liver resection to evaluate the operative technique with the wire loop (group 1). All rats returned to normal feeding and activity on the 1st postoperative day. There were no deaths. At autopsy, the resection area was inconspicuous, without any sign of hematoma or bilioma. In the second group, 10 days after tumor induction, the induced hepatoma was increased (1 cm(3)) and localized in the left liver lobe. In all rats, the liver lobe was resected without touching or laceration of the tumor. At autopsy, the resection area was inconspicuous. No tumors were found in the histological workup of liver and lungs. CONCLUSION: This model of laparoscopic liver resection in the rat allows a safe and simple liver lobectomy, including a total tumor resection. It should also facilitate basic oncological, immunological, and laparoscopic research.

Anesthesia↗
PubMed1999

Distribution of the src-homology-2-domain-containing inositol 5-phosphatase SHIP-2 in both non-haemopoietic and haemopoietic cells and possible involvement of SHIP-2 in negative signalling of B-cells.

The termination of activation signals is a critical step in the control of the immune response; perturbation of inhibitory feedback pathways results in profound immune defects culminating in autoimmunity and overwhelming inflammation. FcgammaRIIB receptor is a well described inhibitory receptor. The ligation of B-cell receptor (BCR) and FcgammaRIIB leads to the inhibition of B-cell activation. Numerous studies have demonstrated that the SH2-domain-containing inositol 5-phosphatase SHIP (referred hereto as SHIP-1) is essential in this process. The cDNA encoding a second SH2-domain-containing inositol 5-phosphatase, SHIP-2, has been cloned [Pesesse, Deleu, De Smedt, Drayer and Erneux (1997) Biochem. Biophys. Res. Commun. 239, 697-700]. Here we report the distribution of SHIP-2 in mouse tissues: a Western blot analysis of mouse tissues reveals that SHIP-2 is expressed in both haemopoietic and non-haemopoietic cells. In addition to T-cell and B-cell lines, spleen, thymus and lung are shown to coexpress SHIP-1 and SHIP-2. Moreover, SHIP-2 is detected in fibroblasts, heart and different brain areas. SHIP-2 shows a maximal tyrosine phosphorylation and association to Shc after ligation of BCR to FcgammaRIIB but not after stimulation of BCR alone. Our results therefore suggest a possible role for SHIP-2 in the negative regulation of immunocompetent cells.

3T3 Cells↗
PubMed1999

Isolated intracranial mucocele.

Intracranial mucoceles have been previously reported as direct extradural extensions of mucoceles of the paranasal sinuses. We describe a patient with 2 silent mucoceles isolated within the parenchyma of the frontal lobe of the brain. The patient had undergone multiple previous intranasal polypectomy and ethmoidectomy procedures, and the unsuspected mucoceles were discovered on a computed tomographic scan obtained to evaluate recurrent rhinosinusitis symptoms. Craniotomy was required for removal of the mucoceles.

Brain Diseases↗
PubMed1999

Imaging diagnosis for staging of gastric cancer.

A more differentiated therapy regimen concept for gastric cancer requires more precise pre-operative diagnostic imaging. There are several methods for pre-operative locoregional tumor staging in gastric cancer: percutaneous abdominal ultrasound with hydrotechnique (HUS), endoluminal ultrasound in the stomach (EUS), computed tomography (CT), and magnetic resonance imaging (MRI). The advantages and indications for each method are described and an overview of the medical literature is given. The results in the literature are compared to our own findings, which were obtained in prospective studies comparing the four different imaging methods. On the basis of our experience and the literature, we conclude that the indication for the different diagnostic imaging methods primarily depends on the type of therapy concept followed in the respective surgical department. Endoscopy with biopsy remains the primary diagnostic procedure. Endosonography (EUS) is another diagnostic procedure, which can be performed simultaneously with endoscopy. Only special questions or reasons warrant the use of other imaging methods.

Biopsy↗