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Biomedical subjects

H Jantsch

Publications and source records attributed to H Jantsch.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Incidence and prognostic significance of pulmonary artery thromboses in patients with acute respiratory failure: a study of 106 patients using bilateral pulmonary balloon occlusion angiography].

In 106 patients suffering from acute respiratory failure of different severity 157 bedside balloon occlusion pulmonary angiographic studies have been performed through a pulmonary artery catheter to assess the frequency and extent of intravascular occlusive disease. The vascular alterations in acute respiratory failure impair the prognosis essentially. The decreasing pulmonary vascular cross-section causes a greater pulmonary vascular resistance and consecutive pulmonary artery hypertension and finally right heart failure. In 33% of patients multiple thrombosis and in 15.1% singularly pulmonary artery filling defects could be shown. In 21.7% a decreased background opacification caused by extensive microthrombosis was present. Only in 30.2% the angiography was interpreted as normal. The mortality rate was significant higher in patients with multiple macro- and microthrombosis (82.9% respectively 52.2%) compared to patients with singular pulmonary artery filling defects and normal angiography (37.5% respectively 28.1%). The angiographic result was further correlated with the severity of the acute respiratory failure, the haemodynamic and haemostasiologic data, the degree of consolidation in the chest-X-ray and the post mortem angiographic studies.

Adolescent↗
PubMed1988

The relationship between the common femoral artery, the inguinal crease, and the inguinal ligament: a guide to accurate angiographic puncture.

The variability of the extraperitoneal puncture space between the inguinal ligament and the inguinal crease was evaluated in 100 patients. The distance between the inguinal crease and the inguinal ligament varied from 0 to 11 cm (average 6.7 cm +/- 1.9 SD), the average value for women (7.5 cm +/- 1.9 SD) being significantly greater than that for men (6.3 cm +/- 1.9 SD, p = 0.0128). The bifurcation of the common femoral artery was found below the inguinal crease in 20%, at the same level in 3.5%, and above it in 76.5% of cases. Consideration of these results will help avoid intraperitoneal puncture and improve the rate of successful antegrade puncture of the femoral artery.

Biometry↗
PubMed1988

Percutaneous drainage of mediastinal pseudocysts.

Percutaneous catheter drainage of a mediastinal pseudocyst was performed in two patients. Access was gained through computed tomography (CT)-guided puncture of the abdominal portion of the pseudocyst in one patient, and a transhepatic-subxiphoid approach was used in the other. Guide wires and catheters were advanced into the mediastinal pseudocysts under CT control. Drainage was technically successful in both patients, with no procedure-related complications. Percutaneous drainage is an alternative to the surgical treatment of symptomatic and nonresolving mediastinal pseudocysts, provided that a safe access route can be found.

Adult↗
PubMed1987

[Sonography of acute cholecystitis. A report on 58 cases with a correlation of pathomorphological and histological findings].

Sonography has become the method of choice for evaluating acute diseases of the right upper quadrant. Prior to the ultrasound the diagnosis of acute cholecystitis was based on clinical and laboratory data. The pathohistomorphology of 58 opertively and histologically proven cases of acute cholecystitis has been correlated with preoperative sonography. An acute cholecystitis can be diagnosed based on the following sonographic criteria: Thickening of the wall of the gallbladder to more than 4 mm, sonolucent areas in or around the wall of the gallbladder, an increased ap. diameter of more than 4 cm as well as gallstones. A hyperechoic content of the gallbladder correlating to an empyema of the gallbladder was found in 31% and a perforation in 27.6% of the cases.

Acute Disease↗
PubMed1987

[Functional choledochus diagnosis following cholecystectomy].

50 patients after cholecystectomy and right upper quadrant pain have been examined by ultrasound for obstructive biliary disease. The value of dynamic changes of the common hepatic duct after a fatty meal in the evaluation of bile duct obstruction was investigated. The accuracy of a negative test in the group of patients with normal bile ducts (n = 27) was 100%. However in patients with dilated bile ducts (n = 23) the value of this test is limited. In this group 3 false negatives in patients with multiple small moveable stones occurred resulting in an accuracy of 86.9%.

Cholangiography↗
PubMed1987

Pulmonary vascular obstruction in severe ARDS: angiographic alterations after i.v. fibrinolytic therapy.

IV streptokinase was infused to test the potential reversibility of adult respiratory distress syndrome (ARDS) associated pulmonary vascular thrombosis in five patients suffering from severe ARDS with elevated mean pulmonary artery pressure, increased pulmonary vascular resistance, and angiographically documented pulmonary vascular thrombosis. At 48 hr there was clearance of obstructions in arteries larger than 1 mm in diameter in all patients, increased filling of the microvasculature and small arteries less than 1 mm in diameter in four patients, a fall in pulmonary vascular resistance in all patients, a rise in cardiac output in four patients, improved oxygenation (PAO2/FlO2) in three patients, and variable changes in shunt fraction and ventilator pressures. Expressed as a mean fraction of the preinfusion controls, the postinfusion physiologic values were pulmonary artery pressure = 0.89 mm Hg, pulmonary vascular resistance = 0.68 mm Hg X min/L, cardiac output = 1.36 L/min, central venous pressure = 0.77 cm H2O, pulmonary capillary wedge pressure = 0.92 mm Hg, PAO2/FlO2 = 1.08, and shunt fraction = 0.95. Follow-up angiography showed no evidence of reocclusion. Postmortem studies of the three nonsurvivors confirmed recanalization of thrombosed pulmonary arteries. One documented bleeding episode occurred. We conclude that fibrinolytic infusion can lyse thrombi and possibly improve hemodynamics and oxygenation in ARDS-associated pulmonary vascular thrombosis.

Angiography↗
PubMed1987

[Percutaneous drainage of complicated abscesses and fluid collections].

The original concept of percutaneous, radiological abscess drainage was confined to well circumscribed, solitary abscesses, that could be reached by a short access avoiding transgression of uninvolved organs or compartments. With increasing experience criteria for percutaneous abscess drainage have been expanded to radiological treatment of pancreatic, periappendiceal, diverticular, interloop and mediastinal abscesses and fluid collections. The authors present their experience with percutaneous treatment of such "complicated" abscesses in 140 patients.

Abdomen↗
PubMed1987

[Percutaneous gastro-enterostomy].

Percutaneous gastrostomies or gastroenterostomies serve for temporary or permanent enteric feeding in patients with obstruction or functional derangement of the esophagus or hypopharynx. In addition, this radiological procedure may be indicated for small bowel decompression. The authors present their experience in 71 patients. Insufflation of air through a nasogastric tube or catheter is the preferred method for gastric distension. The inferior margin of the left lobe of the liver and the transverse colon are localized sonographically and fluoroscopically prior to puncture. Either Seldinger or Trocar-techniques have proven effective in establishing access to the stomach. The feeding tube is advanced into the proximal jejunum to reduce the likelihood of gastroesophageal reflux and possible aspiration. Complications were encountered in four patients and included catheter dislocation in three and respiratory distress in one patient.

Female↗
PubMed1986

[The accuracy of ultrasound in the diagnosis of intra-abdominal abscess formations].

During the last two years 73 patients with a total number of 84 abdominal abscesses have been investigated by ultrasound. Two thirds of the patients (67%) had postoperative abscesses. Spontaneous abscesses occurred in the remaining 33%. Multiple abscesses occurred in the postoperative group only (7 patients). The overall sensitivity in detecting an abscess was 84%. The sensitivity was much better with spontaneous abscesses (92%) than with postoperative abscesses (80%). One third of the patients have also been investigated by computed tomography. The diagnosis was confirmed either by needle aspiration or by operative drainage. Ultrasound was most useful in detecting abscesses in the right and left upper quadrant and in the pelvis, while CT was superior in the mid-abdomen and when dealing with multiple abscesses.

Abdomen↗
PubMed1985

[Short wave therapy in diabetic prodromata].

Short-wave therapy has been an established form of therapy for many decades and is unanimously regarded as harmless when properly applied. The possibility of burn injuries occurring is known, yet hardly any cases have been reported. In the case under review, a diabetic, after only a short treatment, suffered very severe burns that ultimately led to the amputation of three toes. Clinical and histopathological analysis established the presence of mediasclerosis of the large leg arteries as well as microangiopathy and peripheral neuropathy. These findings explained why, despite proper application of the short-wave therapy, severe complications arose that had so far not been observed. The findings are discussed from the medicolegal and histopathological view, with indications of the special type of physical trauma.

Amputation, Surgical↗
PubMed1985

[Evaluation of the thermal technic for the quantitative measurement of extravascular lung water].

To evaluate the accuracy of the method, sequential measurements (n = 159) of extravascular lung water (EVLW) using the thermo-dye double-indicator dilution technique were performed in 22 critically surgical ill patients. Radiographic grading of lung water content served as clinical standard. Normal mean EVLW defined radiographically without evidence of pulmonary edema was 4.8 +/- 1.1 ml/kg. Early interstitial fluid accumulation was quite accurately detected with 6.9 +/- 2.1 ml/kg EVLW (p less than 0.001 vs normal lung water content). The mean EVLW present with definitive interstitial and alveolar edema was 11.5 +/- 3.8 ml/kg and 19.1 +/- 4.5 ml/kg, respectively. Despite some objections to the method (diffusion limitation of the thermal indicator, uneven regional lung perfusion), this technique for measuring EVLW reliably assesses the degree of pulmonary edema. Even when properly performed, chest roentgenograms only confirm gross changes in the lung water content.

Adolescent↗
PubMed1984

Asbestos-related pleural thickening: effect of threshold criteria on interpretation.

Radiographic evidence of pleural thickening was evaluated in 1,216 shipyard workers (high-risk group) and 214 executives (low-risk group) and classified according to two threshold levels: low (any detectable thickening) and high (thickening less than or equal to 2 mm excluded). Results were markedly different, affecting the low-risk group more than the high-risk group. Changing from the high to the low threshold markedly increased pleural findings and scores as well as inter-reader correlation while reducing both differences between risk groups and detection of additional findings on supplementary oblique views. When data on prevalence and extent of pleural thickening were combined, differences between risk groups were maximized; however, when only prevalence was considered, such differences were minimized, particularly with a low threshold. These findings indicate that different or ambiguous threshold criteria produce divergent results in screening surveys for asbestos-related disease. The authors recommend that explicit minimal pleural threshold criteria be adopted.

Adult↗