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Biomedical subjects

G Küffer

Publications and source records attributed to G Küffer.

At least 19 recordsLinked to original sources
PubMed1991

[Simpson's atherectomy in embolizing leg artery stenoses].

We report on the treatment and follow-up of six patients with an unilateral "blue toe" syndrome. This is caused by atheromatous micro-embolisation to the digital arteries and requires urgent attention due to the painful cutaneous necroses and impending digital gangrene. In all patients, Simpson's atherectomy of proximally situated femoropopliteal stenoses caused the pre-gangrenous digital changes to heal completely. In a mean observation period of ten months no relapse occurred. The embolising material was presumably parietal fibrino-platelet thrombi which could be observed with angioscopy and were regularly detectable histologically in the excised tissue.

Aged↗
PubMed1990

Sclerosing epitheloid angiosarcoma of bone and lung--intravascular sclerosing bronchioloalveolar tumor.

A 39-year-old woman was admitted to hospital with severe pain in the left shoulder due to an endothelial bone tumor. The tumor showed the same histologic signs as an intravascular sclerosing bronchioloalveolar tumor of the lung (IVBAT) which had been enucleated 2 years previously. This combination is uncommon. It is discussed whether the IVBAT is a malignant tumor with metastases or a benign tumor with coincidental tumors in other organs of the same endothelial vascular origin. We consider this to be an epitheloid angiosarcoma of the lung with, in our case, bone metastases; this is in agreement with some most recent reports on the disease.

Adult↗
PubMed1990

Value of 67gallium scintigraphy in primary diagnosis and follow-up of opportunistic pneumonia in patients with AIDS.

Opportunistic pneumonias are a life-threatening complication in patients with AIDS. Early diagnosis and therapy is necessary to improve the prognosis. This study was designed to assess the value of 67gallium scintigraphy in the primary detection and follow-up of these special pneumonias. 67Gallium scintigraphy was performed in 40 patients: 10 normal controls and 30 HIV-positive patients with AIDS or AIDS-related complex (ARC). 67Gallium scan results were compared with current chest x-rays and the results of pathogen detection. The evaluation of positive scans was based on a quantification of the pulmonary uptake, expressed as a pulmonary/soft tissue uptake ratio. Only 8 of 30 patients had a normal scan, while 22 of 30 showed diffuse (13/22) or focal (9/22) increases of pulmonary uptake. In seven of eight patients with normal scans the chest radiograph was negative as well. The one patient with negative scan but positive chest radiograph had pulmonary Kaposi's sarcoma. In 11 of 22 patients, the 67gallium scan and chest x-ray were positive simultaneously. In the other 11 of 22 patients with positive scans, chest radiographs were initially negative but showed pathology in five cases within 1-2 weeks. The reason for positive scans in most cases was an opportunistic lung infection; other forms of pneumonia were observed only in two cases. The defined uptake ratio was demonstrated to be a highly sensitive parameter for monitoring pneumonia and the effects of therapy in follow-up studies. In conclusion, quantitative 67gallium scintigraphy proved to be a reliable and highly sensitive method for primary detection and follow-up of opportunistic pneumonias in patients with AIDS.

AIDS-Related Complex↗
PubMed1990

[Simpson's atherectomy of the peripheral arteries: early results and follow-up].

Over a seventeen-month period, a percutaneous transluminal removal of stenosing plaque material from leg and pelvic arteries was performed successfully and without complication in 43 patients. A complete atherectomy in the femoropopliteal vessels succeeded in 99% of cases. In the pelvic region, the primary results were much lower (58%). After six months, the angiographically checked restenosis rate was 17% for femoropopliteal vessels and 11% for iliac arteries, and the corresponding Kaplan-Meier cumulative patency rates were 73.8 and 78.7% respectively. Simpson's atherectomy is the only method of its kind that is therapeutically effective and diagnostically significant, since the removed plaque can be used for further tests.

Aged↗
PubMed1990

[Arthrographic imaging of ganglions of the hand].

In the genesis of ganglions synovial herniation is discussed with an existence of a valve mechanism which prevents the synovial fluid from returning into the joint space. Arthrography of the wrist was performed in 34 patients with suspicion of ganglions on the dorsal and volar aspect of the wrist. By injection of contrast medium in 6 cases directly into the ganglion no connection with the carpal joint cavity was seen. On the contrary, wrist arthrography with examination of the midcarpal and radiocarpal joint showed regularly a communication by a torturous narrow duct between the midcarpal joint and the dorsal ganglion and the radiocarpal joint and the volar ganglion. Other pathologic findings were seen, like tears of the scapholunate ligament and of the triangular fibrocartilage. The consequences for surgical therapy and conclusions for the aetiology of the ganglions are shown.

Adolescent↗
PubMed1990

[Peripheral Simpson atherectomy. Indications and results of a new transluminal procedure for vascular recanalization].

A report is given on the experience acquired to date with a new catheter method (Simpson atherectomy, S-AE) for reducing arteriosclerotic stenoses in the pelvic and leg arteries of 47 patients. If the correct instrument size is selected, one can regularly perform complete atherectomies in femoropopliteal vessels. The result of recanalization is not affected by the form of the stenosis, but eccentric, calcified or ulcerated lesions are ideal indications. Percutaneous transluminal angioplasty and atherectomy can be used as complementary methods to optimize percutaneous peripheral vascular recanalization. The histological findings, methodological limitations, and clinical results are discussed.

Adult↗
PubMed1989

[Experiences with rotation atherotomy and atherectomy].

In addition to currently available, low risk procedures for reestablishment of patency in arteriosclerotic vascular segments with bougier techniques as described by Dotter and the balloon dilatation modification according to Grüntzig, as necessary together with local thrombolysis, important new developments based on mechanical principles are the atherectomy according to Simpson as well as the rotation atherotomy with a flexible catheter and slowly rotating milling head or rapidly rotating head as used by Kensey. To provide a larger lumen of recanalization, we developed an atherotomy lathing catheter with a rapidly rotating head and various diameters which is now available for intraoperative use. The thrombendarterectomy as described by Vollmar with the "ring stripper" is used only intraoperatively and can only be performed retrograde. The effect of laser systems encompasses disintegration and ablation of occlusive material. The rotation atherotomy is based on the capability of discrimination between hard occlusive material and elastic vascular wall through suitable construction of the lathe head (Figures 1 a to 1 e). Since, in passive catheters, the capability of lathing at the tip is associated with a high risk of perforation and a lateral possibility for lathing is not achievable, the lathing performance should be small, at the center of rotation and orthogonal to the axis of rotation at the outer radius. Through combination with a spherical disc face perpendicular to the axis of rotation, which protrudes only slightly from the hemispherical catheter tip, with a maximum at the center and minimum at the lateral borders, the lathing head has only a slight risk of perforation and no undesired sheering forces (Figures 2a to 2d).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[Determining the position of the prosthesis using arthrography of the wrist joint].

During the last twelve months twelve patients with different silicone prostheses of the wrist region underwent examination with arthrograms two to twenty-four months after the operation. The arthrography showed the relation of the implant to its surrounding structures. For either radiocarpal or intercarpal arthrography a very distant access was used. In eight patients the prostheses were surrounded entirely by contrast medium. There was no contrast-medium on one side of the implant in two patients. In one patient a complete disconnection from the capsule to the site of the prosthesis was seen. In one other patient there was evident shrinking of the capsule. Wrist arthrography was very helpful for the evaluation of further clinical proceeding and control of wrist-function.

Arthrography↗