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J Haels

Publications and source records attributed to J Haels.

13 recordsLinked to original sources
PubMed1989

[Detection and assessment of cervical lymph node metastases in head-neck tumors. A comparison of methods].

From 1984 to 1987, seventy-two patients with squamous cell carcinomas involving oropharynx, hypopharynx, larynx and cervical lymph nodes, who underwent surgery, were examined to determine the value of computed tomography (CT), magnetic resonance (MR), high-resolution real-time sonography (US) and palpation in preoperative staging of cervical nodal metastases. The clinical staging was compared with the microscopic findings in the neck specimens and with operative reports. For the identification and description of cervical lymph node metastases, US and CT are more valuable than MR and palpation. In comparison to CT, however, US has advantages in most cervical areas as a dynamic method with variable representation of interesting regions. False positive errors are related to confusion with inflammatory nodes in all examinations. Metastatic infiltration of surrounding tissue especially of neck vessels, are best recognised by means of US and MR. However, the high rates of sensitivity and low rates of specificity of all methods point to the possibility of a great number of false positive errors in demonstrating tissue infiltration.

Angiography↗
PubMed1989

Radiological evaluation of temporal bone disease: high-resolution computed tomography versus conventional X-ray diagnosis.

Sixty-two patients with different temporal bone lesions were prospectively examined by high-resolution computed tomography (CT) and conventional plain radiography, including pluridirectional tomography. High-resolution CT enabled a clear diagnosis in 80% of cases, conventional radiology in 63%; 1.6-times more bone information was recorded by high-resolution CT which is clearly superior for imaging cholesteatomas, metastases and inflammatory processes and for evaluating osseous destruction. With regard to pathological soft tissue or effusions filling the tympanic cavities, conventional radiology shows poor sensitivity (0.61). High-resolution CT is the most sensitive method for the imaging and classification of temporal bone fractures, including labyrinthine damage and ossicular chain injuries. Only in cases of atypical fractures with an unfavourable relationship to the CT planes, can carefully directed tomography be more effective. In most cases high-resolution CT replaces conventional radiology and should be the method of choice for comprehensive radiological examination of the temporal bone.

Bone Diseases↗
PubMed1988

[Nuclear magnetic resonance tomography in diseases of the parotid gland].

The clinical experience with Magnetic Resonance Imaging in parotid gland diseases of 13 patients in discussed. An excellent visualization of the surrounding anatomy, the intrinsic structures of the gland. such as the facial nerve and the lesion, which can be achieved by MRI only, will provide more detailed information for the surgeon and thus for the prognosis. On the other hand, the differentiation of the diseases is not yet improved and MRI will certainly not replace the clinical examination including aspiration cytology.

Diagnosis, Differential↗
PubMed1987

[Detailed structural analysis of the petrous bone using high-resolution thin-layer computerized tomography. 1. Sensitivity of substructural demonstration using a standardized study technic].

High-resolution CT, using fine sections, is a valuable method for radiological examination of the petrous bone. A standardized method of examination using the orbitomeatal and coronary plane is adequate for detailed screening of the petrous bone and shows almost all structures with high accuracy. The sensitivity of the method for showing 35 sub-structures of the inner and middle ear was investigated by examining 40 petrous bones which were normal clinically and radiologically, using the orbito-meatal and coronary planes. The radiation dose to the lens is less than from pluri-directional tomography. For special problems and for demonstrating very small structures, cuts may have to be performed in other planes, suitable for the required topography.

Ear, Middle↗
PubMed1987

[Iatrogenic thrombosis of the jugular vein. A case report].

We report on a 52-year-old female patient who developed a thrombophlebitis with consecutive thrombosis of the internal jugular vein 14 days after hemicolectomy and prolonged central venous catheterisation. The tip of the polyethylene catheter was placed in the internal jugular vein. The pathophysiology of the thrombotic inflammation can be related to local alterations of the vessel wall due to mechanical irritation as well as hyperosmotic solutions on one side and bacterial infection on the other. The life threatening complications such as septicaemia, diffuse embolisation of other organs and the development of superior vena cava syndrome can be prevented only by instantaneous surgical removal of the jugular vein. Additionally, antibiotic and highdose heparine therapy are necessary. A review of the literature supports our experience.

Catheters, Indwelling↗
PubMed1986

[Nuclear magnetic resonance tomographic staging of tumors of the oral cavity, oro- and hypopharynx and the larynx. A comparison with computed tomography and sonography].

Thirty-six patients with tumours of the mouth, the oropharynx and hypopharynx and the larynx were examined by nuclear resonance tomography. The results were compared with the clinical findings of inspection and palpation and with CT and sonography, with respect to T and N classification. In seven patients the classification could be confirmed at operation. NMR provides very good anatomical detail and marked contrast between tumour and the surrounding tissues, particularly on T2 weighted images. NMR showed the best correlation with the clinical findings as regards the T classification and was the most accurate method, as confirmed by surgery. It is superior to CT and sonography for diseases in the oropharynx and hypopharynx. For the examination of the cervical lymphatics, sonography remains the recommended method.

Adult↗
PubMed1986

[Perioperative respiratory problems in patients pretreated with bleomycin].

We examined the incidence of an acute respiratory insufficiency in a retrospective study in 100 patients with carcinomas in the head and neck region who had received cytostatic pretreatment with bleomycin. All patients had been ventilated intraoperatively with 28% to 33% oxygen under precise control of blood gas analysis. In 93% of the patients, there were no respiratory problems in the postoperative course. The total lethality was 7%. Extrapulmonary causes were most prominent in five patients. In one patient, pre-existing pulmonary silicosis was suspected to be the cause of the acute respiratory insufficiency. Only in one patient was the acute respiratory insufficiency refractory to therapy very probably attributable to the synergistic toxic effect of bleomycin and oxygen on the lung parenchyma, as postulated by Goldiner and verified later in animal experiments. On the basis of these results, we do not consider that it is justifiable to reduce categorically the inspiratory oxygen concentration to 21% to 25% oxygen in bleomycin-pretreated patients with tumours in the head and neck region, as recommended by Goldiner. Since the majority are elderly patients with pre-existing cardiopulmonary stress, we recommend moderately reduced oxygen concentrations of 28% to a maximum of 33%. Further recommendations to prevent an acute respiratory insufficiency by those patients are discussed.

Adult↗
PubMed1986

[Nuclear magnetic resonance tomography in the diagnosis of head and neck tumors. A comparison of methods].

36 patients with carcinomas of different ENT regions were investigated by means of MRI, CT and B-mode ultrasonography (US). The images were evaluated by parameters of clinical importance: tumour detectability marginal appearance, internal architecture, regional extension, and artifact degradation. The results were compared with the clinical tumour staging in accordance with the TNM system. In MRI, a multiplanar imaging of tumour extension with horizontal, frontal and sagittal sections is possible. Together with a good contrasting of the tumour against the surrounding structures, these are major advantages over CT in the imaging of carcinomas of the tonsils, the hypopharynx and the larynx. For both methods, tumours of the tongue base and the floor of the mouth are a real challenge. Lymph node metastases can be visualised with MRI, but US is the method of choice for the evaluation of cervical lymph nodes.

Carcinoma, Squamous Cell↗
PubMed1986

[Ultrasound diagnosis of benign and malignant parotid tumors].

The value of high resolution real time ultrasound imaging in the preoperative differential diagnosis of focal disease of the parotid gland was evaluated in 35 cases. After description of the ultrasound imaging of the normal gland, the majority of benign and malignant tumours are demonstrated. Ultrasound patterns allow a good differentiation of mixed tumours, warthin's tumours and carcinomas. Differential diagnosis between mixed tumours on the one hand, mucoepidermoid and serous cell adenomas on the other can be difficult or even impossible. This holds true for pathologic lymphomas, too, whereas cysts can be distinguished very well. On the whole, the differentiation between benign and malignant tumours was correct in 28 out of 35 cases. Furthermore, in 21 cases the ultrasound pattern was in accordance with the result of the histologic examination. Compared with sialography, needle biopsy and CT scanning, ultrasonography is a reliable, safe and noninvasive method of high value in preoperative examination of parotid tumours.

Adenolymphoma↗
PubMed1986

[Nuclear magnetic resonance tomography in the diagnosis of parotid tumors. A comparison of methods].

The diagnostic value and the limitations of magnetic resonance imaging (MRI) in the management of large parotid masses were evaluated in a prospective clinical study. The results were compared with computed tomography (CT) and B-mode ultrasonography (US). MRI was performed using a Siemens 1.5 Tesla Magnetom with a RF head coil and surface RF coils. The images were evaluated by the following parameters of clinical importance: tumour detectability and marginal appearance, internal architecture, regional extension, and artifact degradation. MR imaging of parotid masses was superior to CT and US for the following reasons. The marginal appearance of the tumour was sharp and further enhanced in T2 weighted pictures. The extension of the tumour can be well seen by use of transaxial and frontal projections. This is an advantage especially when the mass extends to the retromandibular fossa or even to the pterygopalatine fossa. The position of the jaw, external ear canal, mastoid, skull base, and vessels of the neck are clearly shown without artifact degradation. Benign neoplasms can be well differentiated from malignant tumours which show local infiltration into the adjacent anatomical structures as well as irregularities of their internal structure. However, their appearance in MRI can be identical to that of an acute inflammation of the parotid gland. In summary MRI is the imaging technique of choice for extensive parotid masses, whereas US is effective for small tumours not situated in the retromandibular fossa.

Humans↗
PubMed1986

[Regulation of nasal resistance in children].

By means of active anterior rhinorheomanometry we searched for nasal cycles in children of 3-10 years of age. We measured the nasal air flow every 15 minutes for a period of 2 hours on both sides in relation to a pressure of 1 mbar. In the group of the 7-10 year old children we found nasal cycles in 79 per cent according to Hasegawa's and Kern's definition. In contrast to other authors nasal cycles were also ascertained in 50 per cent of the 3-6 year old children: Computing the correlation coefficient between the difference of one measurement from the right and left mean nasal air flow, we could demonstrate that the nasal cycle was actually subject to a regulatory mechanism. In contrast "solidary movements" showed no regulation in our challenge-controlled measurements.

Airway Resistance↗
PubMed1984

[Cervically-induced symptoms of the Klippel-Feil syndrome].

Klippel-Feil syndrome is a congenital deformity disease caused by disturbances of the growing together of the mesenchymal preliminary vertebrae which are mostly located in the regions of the cervical spine and shoulder. Short neck and wryneck (torticollis), as well as limited motion of the neck and reduced mobility of the cervical spine, are the most striking findings on clinical examination. Vertigo, disturbed sound conduction and perception, as well as combined loss of hearing, tinnitus and paralysis of the facial nerve can occur although otoscopic findings may be normal. Differential diagnosis is effected by means of the typical x-ray film of the cervical spine and the vertebrobasilar transition. Functional anomalies of the vertebral arteries are determined via x-ray angiography. Neuro-otological syndromes can be explained by congenital deformities of the middle ear, cochlea, peripheral vestibular organs and internal auditory canal; mainly, however, by a "vascular" cervical syndrome, which, in this particular case, explains the cochlea symptoms. Vertigo and dizziness can also be caused by a pathological irritation of cervical proprioceptive sensory organs through deformities of the skeleton.

Audiometry, Pure-Tone↗