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Biomedical subjects

J M Friedrich

Publications and source records attributed to J M Friedrich.

At least 91 records · Page 5Linked to original sources
PubMed1990

[Scintigraphy using erythrocytes labeled in vivo with 99mTc. Detection of an intestinal hemorrhage following a duodenum-preserving resection of the pancreas head].

Following resection of the head of the pancreas while preserving the duodenum a gastrointestinal haemorrhage was localised by red blood cells labeled in vivo with technetium-99m. The previously performed endoscopy and angiography were normal. The haemorrhage in the region of the pancreatico-jejunal anastomosis was confirmed intraoperatively. If intermittent bleedings are suspected, scintigraphy should be performed as a routine measure besides endoscopy and angiography.

Chronic Disease↗
PubMed1990

[Drug modification of double-contrast imaging of the small intestine].

The intravenous use of metoclopramid (paspertin) and ceruletid (Takus) reduces the time required for fractionated double contrast examinations of the small bowel. It also improves visualisation of individual sections of the small bowel, particularly the terminal ileum. The value of these drugs has been assessed in a prospective study in 48 patients with suspected Crohn's disease.

Barium Sulfate↗
PubMed1990

[The use of sonography in the diagnosis of fresh talofibular ligamentous lesions].

Sonography of the ankle joint is a simple method of exploring articular soft tissue. 100 patients with acute injury of the lateral ligaments were examined with a 7.5 MHz linear array transducer. Diagnostic criteria were haematoma and capsular deformation. Sonographic findings were assessed by stress films (n = 94), arthrography (n = 29) and operative evaluation (n = 28). In 94 of 100 joints, acute injury could be demonstrated with sonography. In most cases sonography was able to differentiate the site of the lesion: anterior talofibular or fibulocalcaneal ligament. The positive predictive value in relation to the operative findings is 100% for talofibular ligament and 96% for fibulocalcaneal ligament.

Adult↗
PubMed1990

[Percutaneous transhepatic lysis of gallstones].

The present study reports on morphological findings obtained from 15 patients who were submitted to percutaneous transhepatic contact dissolution of gallbladder concrements with methyl-tert.-butyl ether (MTBE) and--in case of slightly calcified gallstones (n = 10)--with ethylene diamine tetraacetic acid (EDTA). At a maximum intracystic catheter placement time of four days complete lysis was obtained in 12 patients. As could be depicted by CT, the solvents induced significant regional or disseminated chemical cholecystitis in the majority of all cases. However, these changes proved to be completely reversible within about five weeks. It is concluded that with certain types of gallstones contact dissolution can be an effective alternative therapeutic technique which, however, requires meticulous morphological controlling in view of the time-consuming treatment of calcified concrements.

Adult↗
PubMed1990

[Colorectal invagination in adults following removal of a sigmoid polyp].

A unusual case of colorectal intussusception after transanal surgery of a polyp of the sigmoid colon is presented. Clinical Signs consisted of transanal bleeding and mucous diarrhoe. The diagnosis was established after an enema with water-soluble contrast media and computed tomography of the pelvis. The radiological appearance was similar to that of intussusception at other sites of the large bowel: The enema showed a sharply outlined filling defect whereas CT demonstrated a target-like intraluminal mass.

Colonic Diseases↗
PubMed1990

[Use of imaging procedures in gallstone ileus].

Gallstone ileus is a rare complication of cholecystolithiasis with a high mortality and a high rate of postoperative complications caused by the advanced age of the patients and the often delayed diagnosis. The article shows that the consistent use of conventional radiological methods helps to reduce the high incidence of undetected gallstone ileus. A plain film of the abdomen is mandatory because it yields important information on the presence of an ileus and allows to diagnose gallstone ileus if air in the biliary tree and an aberrantly located gallstone is visible. Signs of an ileus are a frequent finding on abdominal scout films (9 of 9 cases) while the additional signs are often absent (5 of 9 cases). Contrast x-ray studies of the intestine, especially the upper gastrointestinal series with water-soluble contrast media, are of importance because they can help in detecting biliary enteric fistulas or gallstones located in the intestine. Hence, the consistent use of this roentgenologic routine methods can promote the accuracy of correct preoperative diagnosis (4 of 7 cases).

Aged↗
PubMed1989

[Venous occlusions distant to the shunt as malfunction factors during hemodialysis].

On 78 patients with dysfunction of haemodialysis vascular access (predominantly poor flow) systematic radiographic evaluation was performed. In all cases arteriography was carried out, followed by venous angiography in patients exhibiting occlusion of the arteriovenous fistula or the graft, respectively. In 11 cases (14%) occlusion or significant stenosis of far proximal venous vessels (axillary and/or subclavian vein) could be detected. It is suggested that consecutive deterioration of central venous runoff may induce or aggravate malfunctioning of the shunt and, moreover, may contribute to recurrent thrombosis of arteriovenous fistulae or grafts.

Arm↗
PubMed1989

[Intra-arterial DSA of the hand arteries in the diagnosis of inflammatory connective tissue diseases].

Seventy-five patients with suspected rheumatic diseases underwent intraarterial DSA of the hand arteries. In 81% of the patients we were able to establish the diagnosis of vasculitis according to angiographic criteria. Neither clinical nor chemical or immunological features allowed the diagnosis of an inflammatory disease of joint and perivascular tissue at this time. However, histological examination and immunofluorescence microscopy confirmed the angiographic findings and showed signs of an immune complex vasculitis. A strong predictor for an abnormal angiogram of the hand arteries is the presence of Sicca's and Raynaud's Syndrome in addition to rheumatoid joint pain.

Adult↗
PubMed1989

[Aneurysmic transformation of the venous system in venous angiodysplasias of the limbs].

Based on a retrospective evaluation of 107 patients with congenital venous angiodysplasia of the Type Klippel-Trenaunay (n = 76) and Type Servelle-Martorell (n = 31) the frequency and pathogenesis of aneurysm formation in the venous system has been analysed. The vascular patterns include both cylindric ectasias and fusiform aneurysms with an incidence of approximately 40%. Preferred locations are subcutaneous drainage veins, the popliteal, external iliac vein and atypic communicating veins between the superficial and the deep venous system. Complications of the aneurysm such as local thrombosis, recurrent pulmonary embolism or bleeding from rupture were not observed. From a pathogenetic point of view the aneurysm formation in venous angiodysplasias results probably from two causative factors, i.e., a congenital weakness of the venous wall (inborn error?) and an abnormal hemodynamical stress situation. The latter is caused by concomitant malformations of the deep venous system (avalvulia, hypo- and/or aplasia). The persistent intermittent venous hypertension associated with a more or less pronounced increase of the venous volume in the affected venous system of the limb results in a deep venous insufficiency respectively venous reflux disease. Surgery is indicated under two conditions: a) in the presence of aneurysm complications or b) for the elimination of a pathological short circuit flow in some drainage veins. Antireflux surgery, e.g., venous valve transfer form the brachial vein, is up to recently still in a stage of experimental-clinical investigation. The therapy of choice is predominantly conservative, i.e., external compression bandages or stockings to reduce the deleterious effects of a chronic deep venous insufficiency respectively venous reflux disease.

Adolescent↗
PubMed1989

[An arterio-cutaneous fistula following attempted thrombolysis and amputation].

This report demonstrates an exceptional case of arteriocutaneous fistula developing after local thrombolysis. The arterial catheter was left in situ for four days and was removed after failure of lumen restoration. A complete ischemia of the lower leg persisted. Following above knee amputation, the patient developed a fistula at the medial side of the stump. Fistulography proved a direct communication with the lumen of the partially recanalized superficial femoral artery. At operation, a suppurative arteritis was found. After complete extirpation of the superficial femoral artery including the transcutaneous fistula, a complete healing could be achieved.

Aged↗
PubMed1988

[X-ray diagnosis of intimal ruptures of the internal carotid artery. A pathologico-anatomic controlled study].

In a prospective study to determine the accuracy of intravenous DSA in the diagnosis of ulcerative lesions of the internal carotid artery, preoperative findings obtained from DSA in patients with suspected cerebrovascular disease were reviewed and compared with thrombendarterectomy specimen (n = 74). The radiological parameters employed for the assessment of ulcerations were excavations of the vascular contour, ill defined vessel walls and steep plaque surfaces. Overall sensitivity of DSA was 66%, specificity 52%. The depth of excavations proved to be the most accurate sign in detecting ulcerative lesions (sensitivity 83%). However, in rare cases mural recesses with the angiographic appearance of ulceration corresponded to re-endothelialized cavities. Small intimal disruptions with a depth of 0.1 to 1 mm. could not be detected by intravenous DSA.

Arteriosclerosis↗
PubMed1988

[Radiological diagnosis of intraosseous lipoma].

Intraosseous lipomas exhibit a very characteristic radiological appearance. Diagnosis can be derived exclusively from x-ray examinations if a sharply defined cystic lesion with dense central sclerosis and fat-equivalent CT values is detected. When the latter criterion is not markedly pronounced the occurrence of a lipoma-derived, e.g. myxomatous, process can be discussed.

Bone Neoplasms↗
PubMed1988

[Bone lesions in chronic pancreatitis].

Case reports of 4 patients with combined pancreatic and bone marrow disease are presented. 3 of them were alcoholics and suffered from chronic pancreatitis and bacterial osteomyelitis, one showed lipolytic lesions of the bone marrow following an acute exacerbation of a chronic lithogenic pancreatitis. X-ray examination of the left hand, both feet and tibiae showed evidence of multifocal small osteolytic defects accompanied by periosteal reaction in the case of lipolytic bone lesions. The appearance resembles that of an osteomyelitis, however, lacking the extensive destruction and sclerotic reaction. These bone lesions were associated with neurological symptoms and subcutaneous nodules. In one patient histological investigation of the bone lesions showed osteomyelitic and lipolytic changes so that there might be an association between both diseases.

Adult↗
PubMed1988

[Modification of the imaging quality of the small intestine by using methylcellulose of different classes of viscosity].

In certain diseases originating from the small intestine the peroral application of contrast medium can complete with enteroclysis. The use of methylcellulose MH 1000 proved to be a good compromise between viscosity ans stability of mucosal coating. It allowed good image quality in all segments of the small bowel particularly in the distal ileum. Therefore, this method is clearly indicated in Crohn's disease. Good results were also obtained in delineating tumours, radiation enteritis and ischaemic enteritis. With few patients exhibiting reduced small bowel mobility and/or who are incapable of drinking adequate volumes of contrast medium the results of the oral method are rather unfavourable.

Adolescent↗