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Biomedical subjects

H Milbradt

Publications and source records attributed to H Milbradt.

At least 19 recordsLinked to original sources
PubMed1999

[Greater success by cooperation between claim review experts and the police].

The examination of claims settlement in life assurance usually begins when police investigation is finished. During the acute phase of police investigation there is very rarely contact between the police and the life insurance company concerned. The advantages of early cooperation are demonstrated by two case reports. Immediate communication during the first four days after death initially helps the police investigators; later the life insurance company profits from the accelerated examination of the insured event.

Adult↗
PubMed1997

[Ultrasound diagnosis of soft tissue changes in dialysis-associated amyloidosis].

AIM: To develop criteria for the detection of long term dialysis-associated soft tissue changes due to amyloid deposits in various joints. METHOD: Ultrasonographic examination of the shoulder (15 patients), hip (5 patients), knee (6 patients) and elbow (2 patients) using a 7.5 or 5 MHz scanner. A total of 28 joints were examined. RESULTS: Soft tissue changes in long term dialysis were found to be associated with an increased thickness of the supraspinatus tendon and/or biceps tendon as well as joint effusions with echogenic zones. Moreover, increased thickness of the joint capsule and echogenic proliferation of the synovia were observed. CONCLUSION: Ultrasound is an inexpensive and suitable method in the diagnosis and follow-up of soft tissue changes in patients on long term dialysis.

Adult↗
PubMed1993

[Percutaneous drainage of abscesses, biliomas, seromas and hematomas following liver surgery. Experiences with 46 patients].

Fifty-two fluid collections following hepatic surgery were diagnosed in 46 patients, mostly by sonography. These were treated percutaneously. In 7 patients ultrasound-guided puncture was used, in 36 patients catheter drainage was employed and in three drainage was instituted by a catheter in a pre-existing fistula. One patient with a bile leak in the hilar region had to undergo surgery. One patient died of multi organ failure following liver transplantation and another patient with advanced tumour died 78 days after the drainage procedure. The other patients recovered following conservative treatment (93.5%).

Abscess↗
PubMed1993

[Diagnostic possibilities of sonography: ankle joint, foot and Achilles tendon].

In patients with soft tissue swelling and pain of the foot and ankle, ultrasonography is a simple and reliable diagnostic procedure to demonstrate joint effusions or a tendovaginitis which may have caused the symptoms of the patient. The diagnostic puncture of a joint is only necessary to determine the kind of effusion. The diagnostic workup of patients with acute and chronic instability of the proximal ankle joint benefits from the sonographic measurement of the talus tilt and of the anterior drawer. As the diagnostic performance is equal to the radiologic stress test, X-ray exposure can be avoided. As the anatomic structure of the achilles tendon causes the typical fibrillary sonographic pattern, structural changes due to tendinitis or tendon rupture can easily be diagnosed.

Achilles Tendon↗
PubMed1992

[The visibility of a central venous catheter using digital luminescence radiography in intensive care radiology].

The aim of the following study was to assess the impact of dose alterations on the detection of catheters. We compared the performance of well-exposed conventional and digital portable chest radiographs in the detection of thin catheters and tested the influences of dose alterations. Portable chest radiographs of 20 patients were obtained with conventional film/screen (FR) and with storage phosphors at 50% (SRL), 100% (SRN), and 250% (SRH) of the conventionally required exposure dose. The region of the mediastinum was subdivided into an average of 18 fields, 50% of which were superimposed with thin catheter segments. ROC analysis of 11,600 observations by 8 readers found only SRH equivalent to FR in catheter visualisation. Performance decreased significantly with SRN and SRL. Detection of low contrast catheters was found to be significantly decreased in storage phosphor radiographs obtained with standard exposure dose. A dose reduction is not feasible with current equipment if performance equivalent to conventional radiography is to be achieved.

Catheterization, Central Venous↗
PubMed1992

[Primary sonographic diagnosis and follow-up of muscular and tendon injuries of the lower extremity].

Ultrasound examination has become an important diagnostic method in muscle and tendon injuries. In addition dynamic ultrasound examination allows evaluation of the course of healing from various aspects. Starting with the sonoanatomy, the pathologic ultrasound patterns typical for injuries to muscle and to Achilles, patellar and quadriceps tendons are demonstrated. As complement to clinical examination, ultrasonography enables appropriate adaptation of the therapy concept to the course of healing. In the hands of experienced operators, ultrasound examination has reached a high level of sensitivity and specificity in these injuries and can justifiably be routinely performed.

Achilles Tendon↗
PubMed1991

Sonography and scintigraphy in the diagnosis of diseases of the major salivary glands.

This is a prospective study of 73 patients with diseases of the major salivary glands. The sonographic diagnosis could be confirmed by the course of the disease and/or the histologic result after operation in 67 (93%). In 29 patients, salivary gland scintigrams also were carried out. There was a tendency for signs of hypervascularization to be seen in patients with acute inflammation and reduction or loss of function in the presence of a chronic inflammation of the salivary glands. Scintigraphy did not provide diagnostic information on tumors of the salivary glands with regard to the type and location, with the exception of the Warthin's tumor. In selected cases it adds additional information, especially in functional therapy control.

Adenoma, Pleomorphic↗
PubMed1991

Use of sonography in the follow-up of preoperatively irradiated efferent lymphatics of the neck in oropharyngeal tumours.

The applicability of sonography in the control of preoperative radiotherapy of neck lymph nodes in patients with malignancies in the region of the head and the neck was established in a prospective study. Lymph nodes with positive reactions showed a simultaneous reduction in size and structure. Postoperative histology showed no malignancy in these lymph nodes. All metastases were found in lymph nodes without sonographic changes under irradiation. In establishing the surgical procedure, clinical criteria should be considered primarily, and these should be supplemented and completed by the sonographic investigation.

Carcinoma↗
PubMed1990

[Ultrasonic evaluation of homologous bone and cartilage transplants of the femoral condyles].

Evaluation of the weight-bearing articular cartilage of the femoral condyles is possible by sonography. Bone and cartilage transplants can be examined by conventional radiological methods combined with sonography. This provides clinically relevant information. Sonography is a cheap imaging method for providing additional information on the post-operative course of cartilage transplants.

Adult↗
PubMed1990

[Importance of screening for antibodies to cytomegalovirus in organ transplantation].

The influence of screening blood donors for CMV antibodies on the incidence of CMV infection after transplantation was examined in 81 heart and 81 liver transplant recipients. All heart recipients received CMV-seronegative blood, while the liver recipients were given both CMV-positive and CMV-negative blood, due to the large number of units of blood required. In CMV seropositive organ recipients CMV reactivations occurred at about the same rate in heart and liver recipients (60.4% to 63.4%), independently from the CMV status of the organ donor. In CMV seronegative organ recipients a CMV infection rate of 60-70% was recorded for the recipients of CMV-positive organs. The recipients of hearts from CMV-IgG-negative donors remained CMV-negative. By contrast, 5 CMV infections occurred in recipients of CMV-negative livers. These CMV infections were probably caused by transfusion of CMV-IgG-positive blood. Our results suggest that CMV negative recipients should be given exclusively CMV negative blood, if possible.

Antibodies, Viral↗
PubMed1990

[Sonography of the wrist and the hand].

Sonographic examination of the hand requires high-frequency linear transducers. As the relevant structures are located very close to the surface, water stand-off pads are mandatory. Owing to the high sensitivity of sonography in the detection of fluid, exudative synovitis, tenosynovitis and ganglia can be easily diagnosed. Sonographic information on muscle atrophy and alterations of the shape and echogenicity of the median nerve in patients with carpal tunnel syndrome may be useful in evaluating the extent of disease. Further indications for the sonographic examination of the hand include suspected tumors, foreign bodies and synovial proliferation. Osseous destruction can be visualized in patients with rheumatoid disease, but the precise extent is hard to determine.

Arthritis↗
PubMed1990

[Diagnosis of carotid body tumor by imaging procedures].

The imaging techniques available for the diagnosis of tumors of the glomus caroticum are discussed with reference to four cases (three patients, one with tumor bilaterally). Taking into consideration the practicability and invasiveness of the investigations as well as the risks and costs involved, we propose that the procedures be performed in the following sequence: ultrasonography, Doppler ultrasonography, computed tomography (CT) or (even better) magnetic resonance imaging (MRI), and selective angiography. In most cases where there is a non-inflammatory mass in the neck, ultrasonography and Doppler ultrasonography may be adequate to establish the diagnosis of a glomus caroticum tumor. B-scan ultrasonography reveals an inhomogeneous mass that pushes the carotid arteries apart and an arteriovenous shunt may be seen using the Doppler technique. CT and MRI show the full extent of the tumor and provide information about infiltration of adjacent structures. Selective intra-arterial angiography confirms the diagnosis, demonstrating a profound vascularized tumor in the carotid bifurcation. If angiography leads to identification of an afferent vessel, selective embolization of the tumor may be performed, thus enabling a much safer operation with less blood loss.

Adult↗
PubMed1989

[Experiences with a "rapid test" in detecting antibodies to cytomegalovirus].

Transmission of cytomegalovirus (CMV) to CMV negative transplant or blood recipients should be avoided in organ transplantations, since CMV infection of immunocompromised patients can result in severe illness. The infectivity of organ and blood donors is judged on the basis of CMV antibody, considering CMV IgG positives as potentially infectious. Several sensitive test systems are available for testing organ and blood donors for CMV IgG antibody which should be carried out prior to each transplantation. A series of sera were tested comparatively for CMV IgG antibody by latex agglutination test, ELISA and immunofluorescence. It was found that the rapid and easily performed latex agglutination test was much less sensitive than were the other techniques employed. As a consequence, positive latex agglutination test results are acceptable, only, while negative results should be controlled by more sensitive methods.

Antibodies, Viral↗
PubMed1989

"Conservative" treatment of intra-abdominal complications after total gastrectomy with interventional radiological techniques.

Septic complications following total gastrectomy usually require relaparotomy, which is associated with a high operative mortality. Due to the improvement of percutaneous drainage of abdominal abscesses we prefer this therapy for septic complications after total gastrectomy. Among 141 total gastrectomies, 14 patients developed subphrenic abscesses. While 2 patients required relaparotomy, 12 had interventional therapy by sonographically guided drainage and insertion of a pigtail catheter. The catheters were irrigated daily, and the patients received systemic antibiotics. Complete resolution of the abscess cavity was achieved, even in 1 case with simultaneous duodenal stump insufficiency without increasing morbidity. The hospital stay was prolonged for an average of 20 days by this "conservative" treatment. The management of septic complications following total gastrectomy with interventional techniques may reduce the number of operative reinterventions. The indication for such a therapy, however, needs to be evaluated on an individual basis.

Anti-Bacterial Agents↗