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Biomedical subjects

G Grosser

Publications and source records attributed to G Grosser.

At least 19 recordsLinked to original sources
PubMed1993

Percutaneous recanalization of iliac artery occlusions: results of a prospective study.

PURPOSE: To evaluate the long-term results of recanalization of occluded iliac arteries with local low-dose thrombolysis, angioplasty, and, if necessary, stent implantation. MATERIALS AND METHODS: Forty-seven patients with acute or chronic occlusions of the common or external iliac artery, or both, underwent local low-dose thrombolysis (n = 47), percutaneous transluminal angioplasty (PTA) (with balloon dilation [n = 43] and rotational angioplasty [n = 30] in the patients in whom a retrograde recanalization was performed), and, if needed, intravascular stent placement (n = 18). Follow-up lasted 3-53 (mean, 21) months. RESULTS: The primary recanalization rate was 98% (46 of 47). The mean ankle-brachial index increased from 0.33 to 0.81 within 14 days after treatment and was 0.76 at the most recent follow-up. Two early (< 14 days) and two late reocclusions (after 24 and 30 months) occurred; one restenosis detected with duplex sonography and angiography was observed after 19 months. CONCLUSION: This therapy represents a true alternative to vascular surgery and a first-line treatment for acute or chronically occluded iliac arteries.

Adult↗
PubMed1991

[Captopril-renal function scintigraphy in the clarification of arterial hypertension].

Renal artery stenosis (RAS) is a rare cause of hypertension. Radiological tests can disclose the morphological changes, but not their functional effect on renal function and perfusion. Normalization of the blood pressure can be achieved by intervention (operation, percutaneous transluminal renal angiography; PTRA), in cases of prolonged RAS-induced hypertension long-term preservation of the organ function is most important. The purpose of this study was the validation of captopril renography as a screening test for hypertension secondary to RAS prior to PTRA. Captopril renography with 99mTc-MAG 3 has a high sensitivity (94%) and acceptable specificity (88%) for the screening of hypertensive patients. The positive predictive value is 74% and the negative predictive value 98%, compared with the "gold standard" of angiography.

Adolescent↗
PubMed1990

Diagnostic imaging in metastatic lung disease.

Chest radiographs, full lung tomography and computed tomography of the chest provide increasing sensitivity for evaluation of pulmonary metastases. Pulmonary nodules of 5-10 mm diameter are detectable with increasing frequency by use of high kilovoltage chest radiographs. Full lung linear tomography provides an overall accuracy of 72-97% in diagnosis of pulmonary nodules. Chest CT delineates pulmonary nodules as small as 3 mm within 10 mm slice sections. However, as sensitivity increases, specificity diminishes in identifying metastatic nodules. Sensitivity in CT is also reduced by false negative findings due to unequal respiratory cycles. Comparative radiologic-pathologic evaluation of nodule detection proved CT to be the most sensitive screening method for pulmonary metastases. Timing of follow-up studies for pulmonary nodule detection in cancer patients can be determined by tumor growth kinetics; 3-6 month intervals proved to be useful.

Humans↗
PubMed1989

[Embolization by the wall components after the PTA of pelvic arterial stenoses].

Quality and frequency of embolisation caused by angioplasty of stenoses of iliac arteries were investigated in 50 patients. In 18% emboli were found. They mostly consisted of atheromatous material and were visible by macroscopic view in 10% of the patients. Complications caused by embolisation during angioplasty of iliac artery stenosis however are very rare.

Aged↗
PubMed1989

[Renal artery aneurysm in Wegener's granulomatosis].

Microaneurysms of renal and visceral arteries are characteristic signs of periarteritis nodosa. Normally they are not found in Wegener's disease, where glomerulonephritis is commonly observed. We report on a patient with vasculitis of the upper and lower respiratory tract, focal glomerulonephritis, prostatic and pulmonary granulomas and anti-cytoplasm antibodies corresponding to Wegener's disease. The most striking findings in angiography were multiple small aneurysms of the peripheral branches of the renal artery. At necroscopy these angiographic findings were histologically proven as necrosis of the arterial wall with destruction of the elastic lamina, causing local vascular ectasia. These renal vascular changes are a characteristic sign of periarteritis nodosa. The combination of clinical, laboratory, radiologic and histologic findings in our patient can be explained as an overlap-syndrome of Wegener's disease and periarteritis nodosa. We assume that the combination of pathologic findings in our patient correspond to a rare atypical renal manifestation of Wegener's disease.

Aneurysm↗
PubMed1989

[Primary manifestation of Wegener's granulomatosis of the prostate].

In approximately 2-7% of patients with Wegener's granulomatosis involvement of the prostate has been demonstrated histologically. This usually comes about quite late in the course of disease, after generalization of the granulomatous vasculitis from respiratory tract to kidneys and other organs. The patient we present had a highly atypical first manifestation of Wegener's granulomatosis in the prostate, generalized vasculitis not developing until later. When a biopsy shows unclear granulomatous changes in the prostate, a test for anticytoplasmatic antibodies should be performed in addition to the conventional serologic and cultural examinations. Anticytoplasmatic antibodies are highly specific for the diagnosis of active Wegener's granulomatosis. Early diagnosis and immediate initiation of immunosuppressive therapy with cyclophosphamide and corticosteroids can prevent or limit organ damage and improve the prognosis in Wegener's granulomatosis.

Autoantibodies↗
PubMed1988

[Significance of a transthoracic imaging technic in shoulder arthrography].

Even in this era of sonography, arthrography of the shoulder is an important diagnostic investigation, making it possible to exclude unrecognized connective tissue lesions in patients with chronic shoulder pain resistant to therapy. Sometimes standard X-ray techniques do not yield all the information the surgeon needs about ventral or dorsal localization of a rotator-cuff rupture. An additional approach to the joint is needed: a transthoracic lateral-view X-ray provides the surgeon with adequate information to help in selection of the most appropriate operative approach to the shoulder.

Arthrography↗
PubMed1987

[Sonographic imaging and assessment of stomach wall changes].

By the use of a special method of investigation, the true value of percutaneous echography was investigated using 28 patients with primary gastric neoplasms and 3 patients with secondary infiltration of the gastric wall, for the proof and the judgement of the tumors, their extension and their metastases. Tumorous gastric wall thickening could be demonstrated in 87% (27/31), tumor invasion in neighbouring structures in 85% (12/14) and lymph nodes metastases in 66% (10/15). In all patients, who had liver metastases (4) or ascites (5) they were demonstrable. The sonographic appearance of the different gastric wall changes are described and discussed.

Adult↗
PubMed1987

[The thymus gland in computerized tomography. Normal findings and pathology].

The diagnostic value of CT in follicular thymic hyperplasia and in thymomas in 8 patients with myasthenia gravis and in 12 patients without myasthenia gravis suffering from thymic tumors was evaluated by correlating CT-findings to surgical results and pathological-histological findings. Thymic size of the six patients with histologically proven follicular hyperplasia were scattered within the normal range, but half of them were at the upper limit. Thymic tumors were differentiated between invasive and non invasive tumors by CT staging. Solid tumors with different histology could not be further classified; the attenuation values ranging from 15-55 HU were the same in tumors, follicular hyperplasia and normal thymus.

Carcinoid Tumor↗
PubMed1986

[Sonographic diagnosis of the gastrointestinal tract].

Ultrasound examination is an established screening procedure for illdefined abdominal complaints and is complementary to the abdominal plain film. The bull's eye phenomenon due to bowel wall thickening is the characteristic feature of bowel pathology. Ultrasound is the method of proof for hypertrophic pyloric stenosis, imperforate anus or ascites. Findings of edematous (intussusception), inflammatory (Crohn disease) and neoplastic stomach or bowel disease require confirmation by radiology or endoscopy. Ultrasound of the gastrointestinal tract allows the selection of further diagnostic procedures and thus accelerates the diagnostic work-up.

Anus, Imperforate↗
PubMed1985

[Value of computer tomography for evaluation of local operability and choice of surgical procedure in esophageal cancer].

The correlation of the preoperative staging by CT with the post-operative or postmortem staging was investigated in 74 patients with esophageal carcinoma. Criteria for the evaluation of local resectability were analyzed prospectively. According to TNM-classification, the pre- and post-operative staging showed identical results in T1 in 3/4, in T2 in 17/26 and in T3 in 42/44 patients. Thus, the preoperative staging turned out to be correct in 62/74 cases (83.7%). By conventional diagnostic methods identical results of pre- and postoperative staging were found in 28/74 patients (37.8%). The local resectability can be judged by the sagittal infiltration area and especially by the vertical extent of tumor infiltration of the aorta and/or trachea. Esophageal resection was not possible, if infiltration had been suspected in more than 4 tomograms (8 mm-CT-sections). Only palliative resection could be performed in cases with a 3 tomogram infiltration. A suspected infiltration up to 2 tomograms did not exclude a blind dissection of the esophagus without thoracotomy. The impression of the trachea with an irregular borderline of the lumen or tumor growth surrounding the trachea are additional infiltration signs in the CT. By the differentiated interpretation of local tumor growth the CT reached a central position planning surgical strategy.

Adult↗
PubMed1985

[Diagnostic value of computed tomography in stomach cancer].

60 patients with gastric cancer were checked by computed tomography; 57 underwent surgery. Small tumors could not be demonstrated reliably. Double contrast studies and gastroscopy remain the leading diagnostic procedures. In advanced cases computed tomography informs the surgeon about extragastric tumor expansion and the existence and location of metastatic disease. Nearly all carcinomas with a diameter of more than 2 cm in computed tomography proved to be stage T4 (UICC). In selected cases diagnostic laparotomy could be avoided. Because of the lack of therapeutic alternatives the influence of computed tomography on the regimen is limited. Therefore CT-studies are not absolutely necessary in gastric cancer, but can be very helpful in selected cases.

Adult↗
PubMed1985

[Computed tomography in esophageal carcinoma. A prospective study].

In a prospective study, 83 patients with esophageal carcinoma were examined by computed tomography. The CT data were compared with intraoperative, postmortem and microscopical findings in 74 patients. The T stage as determined by computed tomography was confirmed by surgery or autopsy in 88% of the cases and by microscopical examination in 82%. Infiltration of surrounding structures could be proved with a sensitivity of 87%, a specificity of 91% and an accuracy of 89%. Suspected lymph nodes were detected by computed tomography in 68% of the patients with lymph node metastases. Computed tomography enabled additional information on localisation, length and diameter of the tumors and the existence of metastases in the liver, lung and pleura. Due to the very good correlation between pre- and postoperative staging, computed tomography gives important information on local tumor resectability. In this manner, operations and therapeutic strategy can be planned with greater accuracy, and diagnostic thoracotomy can be reduced to a minimum.

Adenocarcinoma↗