PubMed Health⌕ Search

Biomedical subjects

F Winkelbauer

Publications and source records attributed to F Winkelbauer.

32 records · Page 2Linked to original sources
PubMed1991

Submucous large-bowel lipomas--presentation and management. An 18-year study.

Gastrointestinal lipomas are rare, but commonest in the colon and rectum, characteristically submucosal and seldom subserosal. An 18-year analysis revealed 17 cases of large-bowel lipoma, 13 presenting with colicky pain, abdominal discomfort, blood-stained feces or rectal bleeding and altered bowel habits and four asymptomatic. The 17 patients had totally 21 lipomas, all submucosal. No patients with multiple lipoma had evidence of lipoma at other sites. The ileocecal valve and cecum were most commonly affected, followed by the rectum, sigmoid colon and descending colon. Tumor size (largest diameter) was 0.5-10 cm, averaging 3.1 cm (3.5 cm in symptomatic, and 1.8 cm in asymptomatic patients). The primary diagnosis (with barium enema, colonoscopy and CT) was lipoma in only five cases, but CT gave the correct diagnosis in all three cases in which it was used. Two lipomas were found in surgical specimens from colorectal malignancy, while nine were misinterpreted as polyps and one as angiodysplasia. In symptomatic patients unnecessary colotomy or colonic resection may be avoidable by colonscopic removal of lipoma.

Adult↗
PubMed1991

[Therapy and the natural course of axillary vein thrombosis--review of 765 patients and analysis of our personal patient sample].

UNLABELLED: Thrombosis of the axillary vein is a rare event. The incidence of 0.5, -1.5% of all venous thromboses makes comparative studies concerning therapy in a single center impossible. 15 own patients and 750 patients with axillary vein thrombosis collected from literature were studied, to compare the different therapeutic modalities. 36% received no therapy (NV), 15% anticoagulation (AG: heparin, warfarin, coumarins), 18% thrombolytic therapy (TL streptokinase, urokinase, locally and systemic) and 31% were treated by surgery (OP). Mean follow up was 32 months in NV, AG: 16, 3, TL: 35, OP: 38 months. RESULTS: NV; No complaints: 12%, PTS I: 29%, PTS II: 25%, PTS III: 33%. CONCLUSION: Untreated axillary vein thrombosis leads to functional disability of the affected extremity in one third. AG reduces this rate to 25%. After surgery and thrombolytic therapy a severe PTS is found only in 12% and 13.7% respectively. Loss of extremity was found in 5 cases (0.6%). A mechanic factor seems to be important in thrombogenesis. Rapid restitution of venous backflow and promotion of collateralisation is important to avoid disability of the patient. The low difference between AG and OP is pointed out indicating that invasive surgery should be restricted to special cases.

Adult↗
PubMed1990

Sonography versus palpation in the detection of regional lymph-node metastases in patients with malignant melanoma.

High-resolution real-time sonography was done in 217 patients with malignant melanoma to compare its value in detecting regional lymph-node metastases with that of palpation. Lymph-node metastases were found in 29 patients by ultrasound whereas, by palpation, metastases were detected in 15 patients only. The presence of metastases was proven by histopathology after surgical lymphadenectomy in these ultrasound positive cases. Thus sonography was superior to palpation, and in addition permitted distinction between metastatic changes and inflammatory lymph-node enlargement. Ultrasound is recommended for preoperative staging as well as in postoperative monitoring of patients with malignant melanoma.

Adult↗
PubMed1989

[Primary lymph node metastases in malignant melanoma studied via high-resolution real-time sonography--its value and indications].

To detect regional lymph node metastases 217 patients with melanoma were examined both sonographically and clinically. Metastases were found in 15 patients by means of palpation, and in 26 patients via ultrasound. Sonography was evidently superior and enabled differentiation between metastatic changes and inflammatory enlargements of lymph nodes. Because of its excellent accuracy ultrasound examination should be performed both in preoperative tumour staging and in posttherapeutic monitoring.

Adult↗
PubMedDate not supplied

Covered self-expanding transhepatic biliary stents: clinical pilot study.

PURPOSE: We report our preliminary results with a new type of self-expanding covered stent for treatment of malignant biliary obstruction. METHODS: Wallstents, fully covered with high elasticity polyurethane, with an unconstrained diameter of 10 mm and a total length of 69 mm, were placed transhepatically under fluoroscopic guidance in five patients. The length of the biliary obstruction varied between 30-50 mm. At 1 and 3 months (82-98 days) clinical assessment, serum bilirubin measurement, and ultrasound examination of the biliary tree were performed. RESULTS: Initial uncomplicated deployment of the stents and internal drainage was possible in all patients. Distal stent migration resulted in early biliary reobstruction in one patient. At 3-month follow-up, partial reobstruction, most probably due to sludge formation, was found in another patient. CONCLUSION: Our initial results indicate that the covered, self-expanding Wallstent endoprosthesis can be reliably and safely deployed transhepatically for malignant biliary obstruction.

Aged↗
PubMedDate not supplied

Spiral computed tomographic angiography of the renal arteries: a prospective comparison with intravenous and intraarterial digital subtraction angiography.

PURPOSE: To assess the accuracy of computed tomographic angiography (CTA) in the evaluation of the renal arteries in comparison with intravenous (IVDSA) and intraarterial digital subtraction angiography (IADSA). METHODS: In 18 patients, 35 CTAs and DSAs (27 IADSA, 8 IVDSA) of the renal arteries were performed. CTA was done with 2-3 mm collimation,2-4 mm/sec table speed, after intravenous injection of 80 ml of contrast medium at 4 ml/sec with a scanning delay time of 14-21 sec. No previous circulation time curve was performed. CTA data were reconstructed with maximum intensity projection (MIP) and shaded surface display (SSD). The presence of stenosis was assessed on a three-point rating scale (grade 1-3). The quality of the examinations; visualization of the ostium, the main artery, and its branches; vessel sharpness, linearity, and intraluminal contrast filling were evaluated. We compared CTA with DSA. RESULTS: CTA had 96% sensitivity, 77% specificity, and 89% accuracy in the detection of stenoses > 50%. Due to technical errors two stenoses were erroneously diagnosed as positive but there were no false negative diagnoses. The quality of CTA was good in 56% and moderate in 34% of cases. Visualization of the ostium and main artery was graded as 1.74 (out of 2) points and of the renal branches as 1.02 (out of 2) points and of the renal branches as 1.02 (out of 2) points. The quality of CTA images was worse than that of IADSA in 52%, equal in 41%, and better in 7% of cases. CTA was equal to IVDSA in 25% and better in 75% of the cases. CONCLUSION: CTA is an accurate noninvasive method for the evaluation of renal arteries. Examination quality is essential for the diagnosis. CTA is limited in its ability to visualize the branches of the renal artery and accessory arteries. CTA seems to be superior to IVDSA.

Adult↗
PubMedDate not supplied

Successful exclusion of a large femoropopliteal aneurysm with a covered nitinol stent.

A 70-year-old woman presented with a large femoro-popliteal aneurysm. A covered nitinol stent was implanted successfully and complete exclusion of the aneurysm was achieved. At follow-up 5 months later the stent was still patent and the patient was free of symptoms. However, moderate stenosis was seen at the proximal end of the stent.

Aged↗
PubMedDate not supplied

Percutaneous angioscopy: improved technique.

Ten angioscopies with a pressure infusion set resulted in similar visualization times and irrigation volumes as 42 angioscopies with a specially constructed roller pump. Diagnostic image quality, however, was obtained almost exclusively with the roller pump. Three examinations were nondiagnostic. Total viewing time per patient was approximately 1 min with the roller pump and 2 min with the pressure infusion system. In the 30 patients examined, angioscopy changed the initially chosen form of therapy in 5 patients.

Aged↗
PubMedDate not supplied

Arterial hepatic embolization of unresectable hepatocellular carcinoma using a cyanoacrylate/lipiodol mixture.

PURPOSE: A survival analysis in 16 patients with unresectable hepatocellular carcinoma (HCC) undergoing transcatheter arterial embolization (TAE) using a combination of lipiodol and N-butyl-2-cyanoacrylate (5:1) was performed in a retrospective study. METHODS: A combination of lipiodol and N-butyl-2-cyanoacrylate (5:1) was used for TAE. All patients had disease compatible with Okuda stages I and II. RESULTS: Twenty-four embolizations were done; five patients had more than one embolization. Median alpha-fetoprotein levels declined from 116 to 48.6 ng/ml. A median of 0.3 ml cyanoacrylate was administered per patient. Median survival was 8.5 months (range 2-49 months). After a median follow-up of 4 years, 12 patients have died (75%). Okuda stage I and II patients had a median survival time of 34.4 and 5.5 months respectively. Few side effects (19%) were seen. CONCLUSION: We conclude that the TAE procedure used [lipiodol and N-butyl-2-cyanoacrylate (5:1)] is safe and produced only few side effects, thus constituting a valuable therapeutic option for patients with Okuda stage I and II HCC.

Aged↗
PubMedDate not supplied

Spiral CT angiography in the assessment of abdominal aortic aneurysms after stent grafting: value of maximum intensity projections.

PURPOSE: Our goal was to evaluate the value of maximum intensity projections (MIPs) rendered from spiral CT in the assessment of abdominal aortic aneurysms after stent graft implantation. METHOD: Spiral CT of the aorta was performed in 28 patients 1 week after implantation of covered aortic stent grafts. MIPs were evaluated in a blinded fashion. Transaxial scans and intravenous angiographs were considered the reference standard. RESULTS: Stent deformity was evident on the MIPs in 5 cases and stent angulation was seen in 24 cases. The excluded aneurysmal sac was visualized in 14 (50%) cases. MIPs depicted the patent inferior mesenteric artery in 20 of 23 cases (87%). Renal artery occlusion (n = 3), leaks (n = 8), and parietal thrombi, (n = 3) were detected on the MIPs in all cases. CONCLUSION: MIPs are a valuable tool in the assessment of aortic stent grafts.

Aged↗