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Biomedical subjects

H Strunk

Publications and source records attributed to H Strunk.

At least 19 recordsLinked to original sources
PubMed1992

[Ultrasound-proven adrenal gland tumor. References for diagnostic management].

Due to the increasing number of ultrasonographic examinations, tumors of the adrenal glands are being detected more and more often. In the present paper, suggestions for the further diagnostic evaluation are made: in the case of sonographically detected solid tumors of the adrenals, computed tomography is the next procedure of choice. If CT scan also fails to enable an unequivocal diagnosis, the next step must be laboratory investigations. Hormone-producing tumors, irrespective of size, as well as non-hormone-producing tumors larger than 6 cm in diameter or symptomatic neoplasms are all treated by surgery. In the case of an oncological patient with an asymptomatic non-hormone-producing tumor, differential diagnosis via needle aspiration should be attempted in all tumors measuring less than 6 cm in diameter. In the event of an incidental finding, fine needle aspiration is performed only in lesions measuring between 4 and 6 cm; for tumors of less than 4 cm, we consider a wait-and-see approach, with follow-up examinations at 3-month intervals to be justified.

Adrenal Gland Neoplasms↗
PubMed1992

[Percutaneous sonographic angioplasty. Initial experimental results].

Aim of the present study was to examine in vitro the effects of a new ultrasound catheter system on atherosclerotic and normal vessels before employing the system in humans. 141 attempts were made on 32 vascular preparations obtained at autopsy. The vessels were opened longitudinally within 24 hours of death, dilated with gelatine and were then "treated" in a waterbath using varying degrees of pressure, angle of incidence, sound intensity and duration of sound. Macroscopic and histological examinations of the preparation showed no morphological change in normal vessels except evidence of pressure by the catheter. In particular, there were no perforations of the vessel wall. In atherosclerotic segments there was significant reduction in the size of plaques following treatment.

Angioplasty, Balloon↗
PubMed1992

[The incidence of focal liver lesions in patients with colorectal carcinoma].

The preoperative sonographic findings in 166 patients with confirmed colorectal carcinomas were analysed to determine the frequency of focal liver lesions. In 15 patients liver metastases were found at the first examination and in a further 16 patients they were detected subsequently. Homogeneous high-intensity echoes were found in only one patient. Cysts occurred in 13 and haemangiomas in 11 patients. The latter showed solitary lesions which exceeded 25 mm in only one patient and otherwise measured between 6 mm and 15 mm. Focal abnormalities of fat distribution were found in 12 patients. Even in a tumor patient, the first differential diagnosis of a solitary, homogeneous liver lesion of less than 2 cm is a hemangioma and further investigation is mandatory.

Colorectal Neoplasms↗
PubMed1992

[Long-term observation after percutaneous transluminal angioplasty in the pelvic and leg areas].

In this study 163 patients had long term follow ups after PTA; the value of a test which had previously hardly been used, the "Cox proportional hazards model", for prognostic purposes is stressed. In this test account is taken of the severity of the stenosis before PTA, the extent of re-stenosis following PTA and the distance of the occlusion from the aorta and these are related to the likelihood of success. The use of the Cox proportional hazards model with an accurate description of the clinical material and the use of the Kaplan-Meier method is recommended in order to obtain comparable figures for the results obtained in various centres. In this study patency after six months was 77%, after a year 67%, after three years 46% and after five years 37%.

Angioplasty, Balloon↗
PubMed1992

[Distribution of the incidence of sonographically detected focal liver changes in patients with colorectal cancer].

Aim of the following study was to investigate how often liver metastases are detected in oncologic patients as compared to other focal liver lesions. Preoperative sonographic examinations of 209 patients with proven colonic or rectal cancer were studied. In 19 liver metastases were detected, which in only one patient were homogeneous echogenic. Liver cysts were found in 17, hemangiomas in 15 patients, all of whom where solitary lesions and between 6 and 25 mm in diameter. Focal fatty infiltration was diagnosed in 14 patients. In conclusion, a sonographically detected liver lesion, which is homogeneous echogenic and less than 20 mm in size, is most likely to be a hemangioma and should be further investigated, if therapeutically relevant.

Colorectal Neoplasms↗
PubMed1991

[Early and late results of percutaneous transluminal angioplasty (PTA) in diabetic patients].

Results of 127 iliac and femoropopliteal transluminal angioplasties in 97 diabetic patients are presented. Patients who had undergone iliac (n = 70), femoral (n = 41), and popliteal (n = 16) angioplasties for stenoses up to 15 cm long were followed up for 6-60 months. In diabetic patients presenting with only claudication or adequate runoff, the 5-year iliac patency rate was 76% and the femoral patency rate was 60%; these results were comparable with those found in non-diabetic patients. For limb salvage, 3-year patency rates were 66% for iliac, 37% for femoral, and 37% for popliteal angioplasties, and 5-year patency rates were 29% for iliac, 7% for femoral, and 0% for popliteal angioplasties. Our findings suggest that the overall decreased PTA success rates typically associated with diabetes are due to the larger percentage of these patients who present with symptoms of severe peripheral vascular disease and not to the presence of diabetes per se.

Adult↗
PubMed1991

[Sonographic findings in trauma-induced liver injuries].

In 12 of 49 patients operated on for liver injuries we performed sonographic examination of the abdomen on admission to hospital within the framework of emergency diagnostics. The most sensitive finding was the identification of the presence of intraabdominal free fluid. The liver injury itself was sonographically diagnosed in only 5 patients. Sonographically, an additional injury of the spleen was found in 2 of 3 patients; in one patient it was possible to detect an injury of the kidney.

Abdominal Injuries↗
PubMed1990

[Focal liver lesions as incidental findings. 2: Diagnostic procedures in sonographically homogeneous echo-rich, echo-poor or inhomogeneous lesions].

Hemangioma is one of the most common incidental findings in the ultrasonographic image. In 80% to 90% of the cases, the hemangioma presents as a homogeneous lesion in the US image. In asymptomatic patients and a lesion diameter of less than 2 cm, further clarification additional to ultrasonography is not necessary. Major differential diagnoses are focal nodular hyperplasia, metastasis, hepatocellular carcinoma and liver cell adenoma. With exceptions, the biological significance of echo-poor or inhomogeneous lesions cannot be established on the basis of the US image. In such cases, additional diagnostic procedures are required.

Angiography↗
PubMed1990

[Focal liver lesion as an incidental finding. 1: Diagnostic management--procedure in sonographically echo-free tumors].

The spread of diagnostic ultrasound has led to an increase in the incidental detection of lesions of the liver in patients with unrelated symptoms and no history of tumor disease. In this article, suggestions are made on how to proceed with the further diagnostic workup of such patients. In part 1 these suggestions are aimed at identifying patients who might benefit from further investigation, while at the same time avoiding unnecessary procedures.

Biopsy↗
PubMed1990

[Endosonographic staging of rectal tumors].

Pre-operative staging was performed in 81 patients with rectal tumours by means of endorectal sonography. In 87% of cases (70 out of 81), the endosonographic findings corresponded with the histopathological appearance; the recognition of T0 and 1 tumours, which is important in deciding surgical procedures, was possible in 94% (51 out of 54). Differentiation between T0 and T1 tumours (i.e. between adenomas and carcinomas infiltrating the submucosa) was not possible. Five out of ten of T2 and 14 out of 16 T3 tumours were staged correctly. One T4 tumour was placed in too low a stage. A comparison of the echo structure of adenomas and carcinomas in 76 patients showed that 28 out of 43 adenomas (65%) have homogeneous echoes, while 24 out of 33 carcinomas (73%) showed inhomogeneous low intensity echoes.

Adult↗
PubMed1990

[High-resolution thin-section CT in the preoperative staging of rectal tumors: a comparison with endoluminal sonography and histology].

Rectal carcinomas are amongst the most common malignant tumours. The aim of this work was to determine whether high resolution CT with thin sections (1 mm) can provide satisfactory delineation of perirectal tumour infiltration. Correct determination of local tumour spread was possible in four out of nine patients and distinction between those tumours confined to the rectal wall and those infiltrating the perirectal tissues was possible in four out of eight patients.

Aged↗
PubMed1990

[Computerized tomography findings in hormonally inactive adrenal gland tumors].

CT examinations of 6 years served as basis for the incidence of hormonally inactive space-occupying masses at the adrenal. Of a total of 25,000 patients, 313 (1.3%) suffered from disease of the adrenals, and of these 261 patients had a hormonally inactive adrenal tumour. Adenomas were the most frequent space-occupying growths (101 patients), followed by metastases of the adrenals (77 patients), whereas adrenal carcinomas (4 patients), myelolipomas (3 patients), ganglioneuromas (3 patients) adrenal cysts (3 patients) and adrenal haemorrhages (2 patients) were rare findings.

Adenoma↗
PubMed1989

[Traumatology and diagnosis of scaphoid fracture].

In 9 years, 1,104 patients had one or more roentgenological studies of the scaphoid; 252 fractures of the scaphoid were found. The most reported traumatic mechanism was a fall on the extended wrist. The form of fracture most seen was transverse fracture of the scaphoid; most of the fractures were found in the middle third of the scaphoid. The primary radiodiagnostic procedure should contain pictures of the wrist in two planes and four special pictures of the scaphoid. The "fat-pad sign" seems to be an unreliable indicator of fracture, but nearly two-thirds of fractures of the scaphoid showed a swelling of the soft tissues in the X-ray picture.

Accidental Falls↗
PubMed1989

[Diagnosis of unusual fractures of the wrist bones].

Fractures of the navicular bone are the most frequent fractures in the region of the wrist bone. Injuries of the other carpal bones are often primarily overlooked, since the examiner commands over less routine in diagnosing these rare fractures and the carpal bones are often superimposed over one another. We examined 9.723 x-ray films of the hand performed because of suspected fracture of the os naviculare, in order to find out how often lesions of the carpal bones - with the exception of those of the scaphoid bone - were discovered via the x-ray series of the os naviculare manus. For each individual wrist bone we recorded the incidence of fractures, clinical treatment and diagnoses, including any special x-ray takes that would be necessary for the detection of a particular fracture.

Carpal Bones↗