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G W Kauffmann

Publications and source records attributed to G W Kauffmann.

At least 91 records · Page 5Linked to original sources
PubMed1996

[Spiral CT portography in preoperative diagnosis of liver metastases].

Within a period of 12 months we preoperatively performed spiral CT portography (CT-AP) including individual determination of contrast injection kinetics, in 18 consecutive patients. The findings were compared with the microscopic findings in 15 resected specimens. A total of 51 perfusion defects were identified with CT-AP, 40 of which were finally diagnosed as metastases. A total of 36 hepatic lesions were identified at microscopy. 28 of which were metastases, all seen at CT-AP. 12 perfusion defects were misdiagnosed false positive as being of metastatic origin. Thus the sensitivity of CT-AP was 100%, the specificity 65% and the overall accuracy 78%. Therefore, CT-AP using the spiral CT technique is currently the most accurate method for preoperative staging of metastatic disease of the liver. Improvements of the scanning and contrast injection techniques will further improve the clinical value of this examination.

Adenoma, Liver Cell↗
PubMed1996

[Postoperative MRI morphology of the anterior cruciate ligament after primary ligament suture or ligament-plasty. A prospective study of 50 patients].

AIM: Identification of typical postoperative change after anterior cruciate ligament reconstruction (sutures, tendon grafts) and comparison with clinical tests and ultrasound. PATIENTS AND METHODS: 50 patients with anterior cruciate ligament ruptures were examinated with MRI (1.0 T, surface coil, sagittal T1-3DFT-Fast and sagittal spin-echo), US and clinical function tests (Lachmann, pivot-shift, anterior drawer test). RESULTS: In 19 of 21 patients with continuous low-intensity ligament structures in the MRI, knee stability was very good or good in the clinical tests and US. In 17 of 20 patients with a diagnosis of partial rupture at MRI, we also found a stable knee. 5 of 7 patients with the MRI-signs of ligament rupture showed knee stability at US and clinical tests. Furthermore, at MRI we found minor effusions in 10 patients, meniscus tears in 8 patients and ligament impingement in 2 patients. CONCLUSION: MRI is a valuable method for evaluating and assessing anterior ligament reconstructions. We found a good correlation between the continuous low-intensity ligaments at MRI and knee-stability. In contrast there is a bad correlation between discontinuous ligament structures at MRI and clinical stability of the knee. MRI seems to provide more information than US and clinical tests (for example: minor effusion, meniscus tears, ligament impingement, bone lesions).

Anterior Cruciate Ligament↗
PubMed1995

[The sonographic and computed radiographic findings in perigraft reactions after the surgical implantation of vascular prostheses].

Between January 1988 and January 1994, 24 patients with heterologous vascular bypasses were examined with suspected diagnosis of a perigraft reaction (PGR). All patients were subjected to ultrasound and CT. PGR ist defined as a sterile inflammation along the course of a vascular prosthesis. The typical clinical presentation is a fluctuating tumour with a localised painless swelling. In all cases liquid formations could be confirmed by diagnostic imaging procedures; signs of infection could be excluded. The synopsis of the clinical presentation, the time interval after implantation of the prosthetic material and the signs of sonography and CT can reliably exclude infection of the prosthesis and confirm the diagnosis of a PGR.

Aged↗
PubMed1995

[Pulmonary infiltrations in Sjögren syndrome--a radiodiagnostic study].

We report on the radiological findings of 8 female patients with primary Sjögren's syndrome and pulmonary infiltrations. In the chest x-ray, all patients featured an interstitial diffuse bilateral reticular pattern which was most prominent in the bases. The apices of the upper lobes were not involved. There were no pleural effusions. The radiologic appearances changed only slowly. In three cases the lesions progressed to form a patchy confluent pattern. 4 of 8 patients developed within 24 months a nodal or extranodal lymphoma of low-grade malignancy.

Aged↗
PubMed1995

[Computerized tomography diagnosis of a secondary extramedullary situated, non-secreting plasmacytoma of the right plica ventricularis].

We report the case of a 62-year-old male patient with an extramedullary non-secreting plasmacytoma of the right plica ventricularis. Although his skeletal lesions remained stable, the patient developed hoarseness. This was interpreted as mycotic laryngitis and computed tomography showed a tumor of the right plica ventricularis. Differential diagnosis included neoplasms of the larynx, thyroid gland or a lymphoma. After biopsy, however, histology revealed the rare diagnosis of a secondary extramedullary non-secreting plasmacytoma.

Biopsy, Needle↗
PubMed1995

[Portal hypertension and percutaneous transjugular portasystemic stent shunt].

This paper reports 1) the historic development of TIPSS, the transjugular intrahepatic portosystemic stent shunt from experimental evaluation to clinical realization. 2) The evolution of the instrumental technique during a period of 6 years of clinical applications is described in detail. 3) Results based on 204 consecutive procedures are demonstrated: e.g. the early technical success defined as successful completion of the procedure and 30-day survival was 95%; the clinical success defined as technically successful procedure and no rebleeding during the first 30 days was 83%, the 30-day mortality rate was 6.3%; the 30-day encephalopathy rate was 14.1%; the one-year re-bleeding rate was 11%; the one-year survival rate was 74%, the 3-year survival rate was 41%. 4) Problems of the TIPSS procedure are discussed including a 3-months re-stenosis rate of 46% and a cumulative one-year re-stenosis rate of 84% which requires correction by interventional procedures such as shunt dilatation or additional vascular stent placement. 5) Limitations and indications of TIPSS are elucidated based on hemodynamic and functional aspects of liver cirrhosis.

Esophageal and Gastric Varices↗
PubMed1994

[Palliative therapy of malignant bile duct stenoses].

The majority of patients (up to 80%) with malignant obstructive jaundice will not be eligible for curative treatment. Palliative treatment of choice is the percutaneous or endoscopic placement of endoprostheses with a low periprocedural morbidity and mortality. The development of expandable metallic stents led to improved patency rates compared to plastic endoprostheses. Reocclusion rates of approximately 20%, however, necessitate further improvements to optimize design and materials of these stents.

Bile Duct Neoplasms↗
PubMed1994

[Stent angioplasty of the intrarenal aorta and aortic bifurcation. Clinical and angiographical results of a prospective study].

PURPOSE: The study was carried out to evaluate clinical and technical success, early and late complications and patency rates after stent angioplasty of atherosclerotic stenoses and occlusions of the infrarenal abdominal aorta and aortic bifurcation. PATIENTS AND METHODS: This was a prospective study in 20 consecutive patients treated by implantation of balloon-expandable stents. All patients were followed-up after 6 and 12 months and at yearly intervals thereafter by physical examination, Doppler sonography and angiography. RESULTS: Nineteen of 20 patients had clinical and technical success. In two patients clinically relevant complications occurred. During a mean observation time of 19 months (range 3-51 months) restenosis occurred in one stent after 15 months and was successfully treated by balloon angioplasty. Two patients became symptomatic again due to new atherosclerotic disease. CONCLUSIONS: Percutaneous stent angioplasty of the infrarenal aorta and aortic bifurcation yields high immediate and mid-term success rates with primary patency of 90% and secondary patency of 95%. These results are slightly better than those with balloon angioplasty, but the limited number of patients in our and others' studies does not yet justify general recommendations.

Adult↗
PubMed1994

[Transluminal stent prosthesis in aneurysm of the abdominal aorta. Initial experiences with a new procedure].

We report our initial experience with percutaneous treatment of aortic aneurysms in three patients by stent grafts. A newly developed balloon-expandable Palmaz stent in combination with predilated PTFE was used. In two patients a tube-type reconstruction was performed and in the third patient an aorto-bi-iliac reconstruction. Total exclusion of the aneurysm was achieved in one patient. The other two patients had an acceptably minimal amount of residual perfusion, which slightly decreased during the follow-up period of 6 months. One iliac rupture occurred that was immediately treated by insertion of another stent graft. This study confirms the feasibility of such a concept. Further investigation is warranted.

Aged↗
PubMed1994

[Color Doppler controlled compression therapy of puncture aneurysms--a noninvasive therapy concept].

After transfemoral catheterization, pseudoaneurysms can occur in about 0.1-0.05% of cases, especially after the use of large instruments and a faulty puncture technique. Today, pseudoaneurysms can be easily and accurately diagnosed with the help of duplex and color Doppler ultrasound. Apart from its diagnostic application, color Doppler ultrasound also offers a noninvasive and cheap alternative therapy mode as compared to surgical repair. The purpose of our study was to evaluate the therapeutic efficiency of an ultrasound-guided compression technique for postpunctional pseudoaneurysms. Over a 12-month period, nine patients were sonographically diagnosed with postpunctional pseudoaneurysm of the femoral superficial artery. The compression therapy was only applied if no contraindications (e.g. rupture, retroperitoneal site of the lesion, infection, large haematoma with suspected ischaemia, and necrosis) were present. Two of the nine patients were primarily excluded from therapy because of a high risk of rupture or a large haematoma. Five patients of the remaining seven have been successfully treated. In one of the unsuccessfully treated patients, only a partial thrombosis of the aneurysm was obtained, followed by complete spontaneous thrombosis 4 days later. The second compression failed because of the 4-month time interval between angiography and compression therapy. A successful therapy clearly depended on the time interval between puncture and compression. We could not find any significant correlation between the aneurysm volume and the duration of compression. Color Doppler ultrasound-guided therapy is a noninvasive easily applicable, and cheap alternative to surgical repair of postpunctional pseudoaneurysms.

Adult↗
PubMed1994

[Historical and conceptional aspects of TIPSS].

The concept of a percutaneous approach to portosystemic shunting to treat variceal bleeding from portal hypertension dates back to the 60s. However, the clinical realization of this idea was based on the development of metallic endoprotheses (stents), which were essential for long-term patency of a parenchymal tract between the portal circulation and (systemic) hepatic veins that was created by a percutaneous transjugular approach (TIPSS: transjugular intrahepatic portosystemic stent shunt). The first clinical success of TIPSS was achieved in 1988 at the University of Freiburg, Germany. Since then, however, the concept and methodology of TIPSS have been constantly refined, so that this method has become a standard procedure for the interventional radiologist.

Catheterization↗