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Biomedical subjects

G Wilms

Publications and source records attributed to G Wilms.

At least 19 recordsLinked to original sources
PubMed1995

Thrombolytic therapy of peripheral arterial occlusion with recombinant staphylokinase.

BACKGROUND: Recombinant staphylokinase (STAR) induces fibrin-specific coronary artery recanalization in patients with evolving myocardial infarction. The present pilot study evaluates its thrombolytic efficacy, safety, fibrin specificity, and immunogenicity in patients with peripheral arterial occlusive disease. METHODS AND RESULTS: Thirty patients (37 to 86 years of age) with angiographically documented thromboembolic peripheral arterial occlusion of recent origin (21 +/- 5.5 days, mean +/- SEM) were treated with heparin and intra-arterial STAR given as a 1-mg bolus followed by a 0.5-mg/h infusion in 20 patients or as a 2-mg bolus followed by a 1-mg/h infusion in 10 subsequent patients. With 7.0 +/- 0.7 mg STAR infused over 8.7 +/- 1.0 hours, recanalization was complete in 25 patients, partial in 2, and absent in 3. Two major hemorrhagic complications occurred: one fatal hemorrhagic stroke and one hypovolemic shock caused by bleeding at the angiographic puncture site. Administration of STAR did not induce fibrinogen breakdown or a significant prolongation of template bleeding time. STAR-neutralizing activity and anti-STAR IgG were low at baseline, increased markedly from the second week on, and remained elevated for several months. CONCLUSIONS: Intra-arterial administration of STAR restores vessel patency in patients with peripheral arterial occlusion in the absence of fibrinogen degradation.

Female↗
PubMed1995

External iliac artery fibrodysplasia.

We report a patient in the "atherosclerotic age" with symptomatic fibromuscular hyperplasia of both external iliac arteries. Our patient had a history of bilateral intermittent claudication secondary to a concentric narrowing of a long segment of both external iliac arteries. A typical associated involvement of both internal carotid arteries was present.

Carotid Artery, Internal↗
PubMed1995

[Spiral CT of the renal blood vessels].

Spiral CT angiography has been successfully applied to the detection and grading of renal artery stenoses. In this manuscript the technique, the diagnostic accuracy and the advantages and limitations of this new method are discussed.

Angiography↗
PubMed1995

[Spiral CT of cerebral aneurysms].

Spiral CT was performed in 9 patients with 13 cerebral aneurysms known from angiography. All lesions were detected by spiral CT, the smallest lesion measuring 3 mm in diameter. The neck of the aneurysm and the anatomical relations could be determined very accurately in all cases. Advantages of spiral CT over magnetic resonance angiography include: the short examination time, the independence of flow rate and cardiac output, and the excellent visualisation of calcification, thrombus and the bony landmarks. Disadvantages are the necessity of iodinated contrast media, the long postprocessing and reconstruction time and the possibility of overlap from bone and venous blood.

Cerebral Angiography↗
PubMed1992

Posterior fossa venous anomaly and ipsilateral acoustic neuroma: two cases.

The association of an acoustic neuroma with an ipsilateral venous anomaly or angioma is reported in two patients. In the first, the venous angioma was situated low in the posterior fossa, and was of no significance surgically. In the second, the angioma was strongly attached to the capsule of the tumour. On MRI and angiography the lesion appeared as a large draining vein, encircling the tumour. At operation, extensive dissection of the angioma from the neuroma appeared necessary to prevent venous infarction of the brain stem.

Adult↗
PubMed1992

MRI of herpes simplex encephalitis.

The magnetic resonance imaging (MRI) findings in eight patients with herpes simplex meningoencephalitis were reviewed: 14 examinations were analysed. The most striking finding was high signal intensity in the temporal lobe(s) with the typical configuration known from CT. Meningeal enhancement after Gd-DTPA administration was clearly seen in four patients. Haemorrhagic changes are much better seen on MRI than on CT. When adequate motion control can be achieved, MRI becomes the examination of choice in the diagnosis and follow-up of herpes simplex encephalitis. Localized 1H MR spectroscopy also proved promising in the study of neuronal loss.

Adult↗
PubMed1992

Isodense subdural haematomas on CT:MRI findings.

MRI findings are described in two patients with subdural haematomas isodense on CT. In one patient, admitted 6 weeks after trauma, a chronic subdural haematoma showed extreme hypointensity on T2-weighted images, suggesting acute trauma, and therefore acute rebleeding. In the second patient with severe anaemia, an acute subdural haematoma was hyperintense on T2-weighted images, suggesting chronic trauma; this may be explained by the low haematocrit and a possible mixture of blood with cerebrospinal fluid. The MRI features of subdural haematomas and hygromas have to be kept in mind, in order not to misjudge the age of the haematoma.

Female↗
PubMed1992

Intracavernosal injection of prostaglandin E1 as an alternative for papaverine in penile angiography.

Arteriography of the penile vasculature was performed after intracavernous injection of prostaglandin E1 in five patients. Penile tumescence was obtained in three patients with a dose of 10 micrograms and in the other two patients with a dose of 20 micrograms. Mean duration of penile tumescence was 1 h 36 min. Visualization of the penile vasculature was adequate in all patients. Local pain was a minor side effect in one patient. These preliminary results suggest that prostaglandin E1 might represent an alternative for papaverine in the angiographic study of male impotence.

Alprostadil↗
PubMed1992

Computed cranial tomography, magnetic resonance imaging and single photon emission computed tomography in hemorrhagic shock and encephalopathy syndrome: a report of three cases.

Three different neuro-imaging studies were performed in 3 infants with hemorrhagic shock and encephalopathy syndrome (HSE). Areas of cerebral infarction were noted on CT. Single photon emission computed tomography (SPECT) showed decreased perfusion in these areas in one infant. Magnetic resonance imaging (MRI) also identified the areas of infarction, noted on CT, but provided additional information showing non-haem iron deposition in the thalami and basal ganglia.

Brain↗
PubMed1992

Unilateral thalamic haemorrhage in the pre-term and full-term newborn.

One full-term and three premature newborns with a unilateral thalamic haemorrhage are reported. The lesion was diagnosed using cranial ultrasonography and confirmed in three using magnetic resonance imaging. Severe perinatal asphyxia occurred in all infants. The neonatal clinical history, subsequent neuro-developmental outcome and neuroimaging findings are discussed. As the prognosis appears to be much better than for infants with bilateral thalamic densities, it is important that this type of lesion is recognised as a separate entity.

Cerebral Hemorrhage↗
PubMed1992

[Hypothalamic hypopituitarism with hyperphagia and subacute dementia due to neurosarcoidosis: case report and literature review].

The frequency of neurologic involvement in sarcoidosis is about 5%. When the clinical picture presents with only neurological manifestations, as it did in our patient, the diagnosis at presentation is often difficult. Involvement of other tissues must therefore be actively searched. We describe a case of neurosarcoidosis, presenting with hypothalamic hypopituitarism, progressive loss of visual fields, subacute dementia and hypothalamic hyperphagia. The disease very well responded to high dose corticosteroids. The pathology, diagnostic procedures, prognosis and treatment of neurosarcoidosis are discussed.

Adult↗
PubMed1992

Clinical usefulness of Tc-99m HMPAO labeled white blood cell imaging in prosthetic vascular graft infections.

The reported frequency of prosthetic vascular graft infections after reconstructive vascular surgery is low. However, it is a serious and potentially catastrophic complication of this treatment, with high morbidity and mortality rates. Effective therapy involves graft excision and replacement. Tc-99m HMPAO labeled leukocyte scintigraphy appears to be an accurate method of detecting prosthetic vascular graft infections. The value of leukocyte scanning is illustrated by two case reports.

Aged↗
PubMed1992

Ventricular enlargement, clinical correlates and treatment outcome in chronic schizophrenic inpatients.

The ventricle-brain ratio (VBR) of 42 chronic schizophrenic patients was compared with that of 42 age-matched medical controls. For the schizophrenics, the relationship of various clinical parameters to the VBR was assessed, and the outcome of 12 weeks of double-blind treatment with either risperidone or haloperidol. The results confirm that schizophrenic patients have slightly enlarged lateral ventricles compared with medical controls. Only for schizophrenics, an effect of age, but not of duration of illness, was noticed. This study does not support the validity of a clinical subdivision of chronic schizophrenic patients on the basis of the VBR. Neither negative, positive nor general psychopathological symptoms, as measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), were related to the VBR, nor were abnormal involuntary movements or extrapyramidal symptoms. No association between season of birth or a family history of major mental disorder and VBR could be demonstrated. Treatment response was predicted by the total PANSS score and the PANSS general psychopathology subscale score at baseline. There was a trend for patients with higher VBR to have a more or haloperidol). or haloperidol).

Adult↗
PubMed1992

Sudden blindness in a child: presenting symptom of a sphenoid sinus mucocele.

A 10-year-old girl with no nasal or respiratory symptoms developed a headache lasting a few hours. The next day she became totally blind in the right eye and over 5 days vision in the left eye deteriorated to bare light perception. The diagnosis of a sphenoid sinus mucocele was made radiologically and drainage via an endonasal sphenoidectomy produced 12 ml of brownish fluid. Endoscopic biopsy of the wall confirmed the diagnosis of a mucocele. Steroid treatment was given postoperatively, but vision recovered to 6/12 in the left eye only. The importance of urgent clinical diagnosis and treatment is stressed.

Acute Disease↗