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Biomedical subjects

H D Weiss

Publications and source records attributed to H D Weiss.

At least 91 records · Page 5Linked to original sources
PubMed1980

[Endoscopic retrograde cholangiography (ERC) in congenital cystic biliary anomalies (author's transl)].

Cystic anomalies of the bile duct are rare conditions found mostly in the younger age groups and four times more frequently in women than in men. The introduction of retrograde contrast filling of the bile ducts has led to a marked improvement in the pre-operative diagnosis. Precise demonstration of the anatomical relationships is of the utmost importance for surgical intervention. A number of variants of cystic bile duct anomalies must be differentiated from double gall bladders, bile duct fistulas, pancreatic cysts and pseudocysts; small cysts (type IV) must be distinguished from the autoimmune form of cholangitis-pericholangitis and from acquired generalised bile duct dilatation. The prognosis of cystic biliary anomalies is determined by the complications of these conditions. These include ascending cholangitis, stone formation and malignant change.

Adult↗
PubMed1980

Diagnosis of cryptococcal meningitis by cytologic methods: an old technique revisited.

In six patients with cryptococcal meningitis, diagnosis was made by routine cytologic examination of cerebrospinal fluid (CSF). A seventh patient had a false-positive cryptococcal antigen titer, and no organism was seen on SCF examination. The patient had herpes simplex encephalitis on brain biopsy. Cytologic examination is recommended whenever cryptococcal meningitis is suspected.

Adolescent↗
PubMed1979

[Percutaneous transhepatic bile duct drainage for obstructive jaundice (author's transl)].

Palliative percutaneous bile duct drainage was carried out in five patients with obstructive jaundice due to inoperable tumours. In four patients drainage was continued for a long period, in one patient for only one day. The bile duct was punctured by transhepatic cholangiography. It was then catheterised and a drainage catheter introduced into the duodenum in order to produce both internal and external drainage. This procedure, which carries few complications, produces a rapid reduction of jaundice and disappearance of pruritus. It does not increase the expectation of life, which depends on the underlying disease. Experience with this method may be of value in benign stenoses or in pre-operative drainage.

Bile Ducts, Intrahepatic↗
PubMed1979

[The value of xerotomography of the lung and mediastinum in routine diagnosis (author's transl)].

Using controlled case material (n = 55), the weighted value of xerotomography is compared with that of conventional film tomography for the examination of mediastinum and lung. The validity of information of both methods for the final diagnosis is compared. In the visualisation of bronchial units and vascular structures, xerotomography is slightly superior to tomography with silver halogenide films, due to high degree of sharpness of detail, great object range and amplification of the marginal areas. Nodular hilar processes which are in spatial relationship to plane, pulmonary infiltrations or are overshadowed by the cardiac shadow, can be better clarified via conventional technique because of the differences in film density. Overshadowing of linear structures can simulate calcifications in the xeroradiographic image. In our opinion, a combination of film tomography in two planes with xerotomography in an optimal sectional plane can be recommended as a suitable procedure.

Bronchi↗
PubMed1978

Endoscopic retrograde pancreaticocholangiography in chronic diseases of the pancreas and in papillary stenoses.

The extensive experience of the authors in endoscopic retorgrade pancreaticography is correlated with data in the literature to illustrate the spectrum of characteristic changes and diagnostic accuracy in several entities. These include chronic pancreatitis, calculous pancreatitis, necrotizing lesions and pseudocysts, carcinoma of the pancreas, and papillary stenosis, spasm, and carcinoma.

Acute Disease↗
PubMed1978

[Rare arterial variations during upper abdominal and pancreatic angiography (author's transl)].

Selected cases showing rare variations of the arteries of the upper abdomen indicate how difficult the exact identification of individual vessels can be. In the presence of such variations, which usually involve several vessels, it is essential to find and demonstrate all vessels in the upper abdomen. Vessels which are not seen easily must also be specially searched for. In the presence of anomalous vessels, angiography may prevent the surgeon from ligating the incorrect arteries during operation on the pancreas, the liver, stomach, spleen or colon.

Abdomen↗
PubMed1978

Solitary brainstem metastasis.

Progressive cranial nerve palsies and long-tract signs without increased intracranial pressure developed in three patients. All had a history of cancer, but two had been in remission for more than 5 years and were thought to be cured of the malignancy. The patients were treated with cranial irradiation and glucocorticoids, following which one patient made a dramatic neurologic recovery. In each case, postmortem examination showed a brainstem metastasis with no metastatic lesions elsewhere in the nervous system. An occult metastasis should be considered when signs or symptoms suggest brainstem tumor in an adult.

Adult↗
PubMed1978

[A correlative retrospective study of the histological findings and arthrograms in degenerative disease of the meniscus (author's transl)].

The ability to diagnose degenerative changes of the menisci by means of arthrograms was studied retrospectively by correlating the histological and operative findings and arthrographic appearances in 45 cases. It was shown that degenerative changes, as indicated histologically, could be diagnosed by arthrography, but that the arthrogram gave no certain indication of its severity. On the other hand, it appears that fairly severe changes must be present before they become radiologically visible. In negative cases the presence of degenerative changes in bone and cartilage may indicate meniscus degeneration. Problems in the diagnosis of cartilage abnormalities in the arthrogram are discussed.

Adult↗
PubMed1977

[Complication with contrast medium in endoscopic retrograde cholangiopancreaticography (author's transl)].

After more than 2000 endoscopic retrograde cholangiopancreaticographies (ERCP) without contrast medium allergy, a case of severe allergic shock induced by contrast medium injected into the pancreatic duct is reported. The indication for ERCP in patients with known allergy to contrast media must therefore be restricted to those cases in which other examination procedures have given no useful results and yet diagnostic evaluation is vital to the interests of the patient.

Cholangiography↗
PubMed1977

[Basic pressure in the pancreatic duct and in the bile duct: results from 50 standardized duodenoscopic transpapillary pressure measurements (author's transl)].

In 90 patients pressure measurements in the pancreatic duct (50 cases) and in the common bile duct (20 cases) were performed endoscopically. In the normal pancreas an averaged basis pressure in Wirsung's duct of 22.2 cm H2O was found with a range of 9.6 to 37.0 cm H2O. In two cases of marked chronic pancreatitis and in one case of pancreatic carcinoma the secretion pressure was considerably diminished. The mean basic pressure of the common bile duct amounted to 12.0 cm H2O with a range of 7.3 to 17.0 cm H2O. The pressure values in the duodenum were found to be considerably lower than in the pancreatic duct and the bile duct; they amounted to 5.3 cm H20 with a range of 0.6 to 10.9 cm H20. In both ducts two different patterns of ondulations were found: tracings of slight ondulations, i.e. slow pressure changes with a constant average pressure and tracings of coarse ondulations with quick increase and drop in pressure. It will be discussed, how these findings can be related to physiology and pathophysiology of the pancreatic and biliary duct system. The clinical relevance for detection of excretory insufficiency of the pancreas and of pathologic changes leading to stenosis of the duct system are considered.

Adult↗
PubMed1977

[Transvenous xerotom-angiography of the pulmonary hilus (author's transl)].

Normal-size lymph-nodes and air-filled bronchi do not contribute significantly to the shadow of the normal hilus. This consists mainly in pulmonary arteries and veins of the upper lobes. Any enlargement beyond the vascular shadow has to be considered as pathologic. Xerotom-angiography following injection of contrast medium into the cubital vein shows the pulmonary vessels near the hilus more clearly. Pulmonary arteries towards the truncus are better shown. This improves the clarity of the hilus. Coincident demonstration of the superior vena cava may show pathologic processes in the upper mediastinum.

Angiography↗
PubMed1976

Intrathecal N, N', N"-triethylenethiophosphoramide [thio-TEPA (NSC 6396)] in the treatment of malignant meningeal disease: phase I-II study.

N, N', N"-Triethylenethiophosphoramide [Thio-TEPA (NSC 6396)] is the third drug to be evaluated for the treatment of meningeal neoplasia. Eleven patients with meningeal leukemia, lymphoma, or ependymoma were treated with intrathecal thio-TEPA in doses from 1 to 10 mg/m2 of body surface area. There was no hematologic toxicity definitely attributable to thio-TEPA, and neurologic toxcity was limited to mild transient paresthesias of the lower extremities during lumbar sac injection in three patients. Two of those experiencing such paresthesias received concentrated drug solutions to decrease the large injected volumes associated with the higher dosages of thio-TEPA. Three patients achieved complete meningeal remission, and five others had a partial response to therapy.

Adolescent↗
PubMed1975

[Serum lipase activity and endoscopic retrograde pancreatography in chronic pancreatitis and pancreatic neoplasm (author's transl)].

Serum lipase activity was measured in 360 patients with the clinical suspicion of chronic pancreatic disease, 60 of them also having the lipase evocation test (serum lipase activity before and after pancreatic stimulation with secretin and pancreozymin). Of 48 with chronic pancreatitis (40 confirmed at operation) the diagnosis was made by endoscopic retrograde pancretography in all but one. Serum lipase activity was abnormal in 38. Without those cases associated with pancreatic insufficency, serum lipase activity-spontaneously and after the evocation test-was abnormal in 46 patients. Nine of 10 patients with papillary stenosis had the diagnosis confirmed at surgery, the pancretographic findings co-inciding with the surgical ones in all instances. All the five patients with abnormally high serum lipase activity also had chronic pancreatitis on pancreatography. In all of the 18 patients with pancreatic neoplasm pancreatography gave the same results as operation or post-mortem findings. In eight of these serum lipase activity was spontaneously elevated. The lipase evocation test was shown to be most effective if 2 C.H.R.- U/KG-h each of pancreozymin and secretin were administered. Serum lipase results were falsely positive in 17 of 300 patients with clinical suspicion of pancreatic disease but normal pancreatographic findings.

Adult↗
PubMed1975

[Pancreatic carcinoma on endoscopic retrograde pancreatico-cholangiogram (author's transl)].

The pancreaticographic appearances of carcinoma of the pancreas have been divided into two types: 1. Canalicular carcinoma arising from the duct system. If arising from the main pancreatic duct, it occludes this, or causes displacement or deformity of its branches in the immediate neighbourhood. If arising from branches, it causes cystic ectasia of the minor ducts; these appear fragmented and deformed while there is stenosis and displacement of the main duct. Simultaneous origin from the main and smaller ducts, as in the Gallert carcinoma, causes extreme lacunar ectasia of the minor ducts and occlusion of the main duct. 2. Carcinoma arising from the acinar epithelium. This causes primarily displacement and the secondarily stenosis of the main duct. Accuracy of ERCP is satisfactory. It is limited by technical failure or difficulties due to the pathology preventing demonstration of the pancreatic duct. It is increased by cytological examination of aspirated pancreatic secretion. Difficulties in the differential diagnosis from chronic pancreatitis can be overcome. The possibility of an early diagnosis of the carcinoma presented by this method loses some of its impact because the patients are seen at a late stage and because of the lack of early symptoms of this disease.

Adenocarcinoma↗
PubMed1975

The diagnosis of necrotizing pancreatic lesions by means of duodenoscopic pancreatography.

Direct demonstration of intrapancreatic abscesses and pseudocysts can be made by means of duodenoscopic retrograde pancreatography. The most important findings are escape of contrast medium from the duct system into a cavity and its visualization, the tryptic perforation of one or more ducts and the concomitant deformity which may be general or limited to the vicinity of the lesion. The differential diagnosis of pancreatic abscess and carcinoma with penetration of contrast medium in the tumor tissue is supported by the fact that the contours of a necrotic cavity are rather well defined, whereas in carcinoma the extraductal opacification is diffuse. As a rule in a necrotic lesion the ductal system is distorted locally or the whole excretory duct system may be involved. In carcinoma the ductal system generally appears normal distally to the tumor. Accurate demonstration of the necrotic lesion, the assessment as to its localization and size are of decisive importance for indication and choice of the surgical procedure.

Abscess↗
PubMed1975

[Pancreaticography and its correlation with angiography and ultrasonography in diagnosis of the pancreas (author's transl)].

The endoscopic retrograde pancreaticography demonstrates - when suspecting "pancreas anulare" - the part of the pancreatic duct system that forms a ring around the duodenum, helping to recognize this anomaly. In chronic pancreatitis deformities of the pancreatic ducts may be visualized 2-3 years after the onset of the disease. There are deformities of the outlining and the course of the ducts as well as solitary and multiple stenosis and -most important- dilatation of the main duct and its branches. In pancreas abscess, necrotic cavities, and pseudocysts the retograde pancreaticography visualizes solitary or multiple perforations of the duct and pooling of contrast medium in cavities. Carcinoma of the pancreas presents stenosis, occlusion and deviation of the main duct and its branches and sometimes with lakes of contrast medium in ares of necrosis. Pancreaticography following trauma demonstrates similar to chronic pancreatitis laking of contrast medium following perforation. The endoscopic retrograde pancreatico-cholangiography has - like angiography and ultrasound - its special indications in diagnosis of the pancreas. They are important in cases which have affected primarily or secondarily the duct system. Its reliability in confirming and differentiating a disease increases with more accurate indication. In this journal in 1965 a critical review of roentgenologic examinations of the pancreas presumed that development of a valid preoperative pancreaticography would lead to priority of this method. This priority has become true in chronic pancreatitis, calculous pancreatitis and visualization of necrotic cavities. In those examples the endoscopic retrograde pancreatico-cholangiography is still not dominating all cases.

Angiography↗