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Biomedical subjects

L Klühs

Publications and source records attributed to L Klühs.

9 recordsLinked to original sources
PubMed2003

[Accuracy of the sonographic determination of the splenic weight in comparison with the weight at autopsy].

PURPOSE: The weight of the spleen can be easily calculated from sonographic measurements. This study investigates the correlations between the weight of the spleen determined sonographically and the weight measured at autopsy or after splenectomy. MATERIALS AND METHODS: The splenic weight at autopsy or after splenectomy was correlated with the calculated sonographic splenic weight in 55 patients who had a sonographic examination within the preceding three weeks. RESULTS: A significant correlation (r = 0.978) was found between the sonographically calculated splenic weight (460.82 grams) and the measured weight of the removed spleen (average weight 463.18 grams). Spleens weighing more than 1 kg showed a slightly weaker correlation. CONCLUSION: This study proves that the simple formula of length x transverse diameter x vertical diameter x 0.6 provides a reliable calculation of the weight of the spleen.

Autopsy↗
PubMed2001

Anatomical variations in the internal jugular veins of cancer patients affecting central venous access. Anatomical variation of the internal jugular vein.

PURPOSE: Establishing a reliable central venous access is an important procedure in clinical haematology and oncology. The purpose of this study was to determine how anatomical variations in the internal jugular vein (IJV) and its position in relation to the common carotid artery (CCA) in cancer patients affects external landmark puncture. PATIENTS AND METHODS: In 113 patients with haematological or oncological diseases we examined sonographically potential target regions for placement of a central catheter via the IJV. RESULTS: 36% of our patients showed anatomical variations in the IJV and surrounding tissue. CONCLUSIONS: External landmark puncture may be difficult in a considerable number of patients since the IJV might not be situated in the presumed location anteriorly or laterally to the CCA, or a normal lumen may not be present in approximately 1/3 of cancer patients. This study supports the use of ultrasound-guided techniques for central venous catheters particularly in haematological and oncological patients.

Adult↗
PubMed2000

[Ultrasonographically guided puncture technique for central venous vessels as a one-person technique].

AIM: The traditional anatomic landmark technique usually allows a rapid and easy central venous access but this technique is not always successful and can be associated with severe complications. We developed an ultrasonically guided one-operator-catheterization technique whereas a second operator to place and hold the ultrasound transducer is not necessary. METHOD: The catheterisation technique consists of 3 functional components: the swivel arm, the ultrasound unit and the conventional Seldinger central venous catheterization technique. As swivel arm we used a device with a 300 mm column with a 700 mm span attached to ultrasound unit. There were 234 catheterizations of the internal jugular vein performed in the period of January 1999 to July 1999. The indication and complication rate for the catheterization procedure was documented. RESULTS: There were 2 plexus irritations and 1 hematoma observed in all performed catheterization procedures which remained without therapeutic consequences. CONCLUSION: Once the decision for central venous access has been made the safest technique should be applied. The ultrasonically guided catheterization technique allows a fast, safe and convenient central venous access for our patients.

Catheterization, Central Venous↗
PubMed1999

[Project graph technique for time management in abdominal ultrasound evaluations].

PURPOSE: German insurance companies are cutting down the time required for ultrasound examinations. To determine the minimal examination time to perform an ultrasound examination a project graph technique was applied. MATERIALS AND METHODS: Time measurements of abdominal ultrasound examinations were performed by two independent observers. The different jobs for the performance of an ultrasound examination were determined and the critical pathway method applied. The total available time for abdominal ultrasound examinations (leeway) was determined, the minimal time to perform each job was measured and the critical time required for the procedure was calculated. RESULTS: 14 different jobs were identified to complete one abdominal ultrasound examination. The project graph displayed the shortest possible time of 24 minutes to perform an ultrasound examination. The pure ultrasound exam without colour Doppler examination was 6 minutes ("hands on the ultrasound probe"). The jobs performed by the physician were fully within the critical period. In consequence, the physician had no leeway or time lag in relation to a total time of 24 minutes for an ultrasound examination, whereas by contrast the nurse has a total leeway of 7.5 minutes. CONCLUSIONS: The applied project graph technique is an effective instrument for the purpose of quality management for hospitals as well as in private practice. The workflow and actions necessary to perform a treatment or examination can be analysed. Human resources management and cost planning should be performed on the basis of project graphs.

Abdomen↗
PubMed1989

Computed tomography and endosonography in the preoperative staging of rectal carcinoma.

In 30 patients with rectal carcinoma the accuracy of computed tomography (CT) and endosonography (ES) was compared with the surgical specimen. Three cases were overstaged by ES and 4 cases were understaged by CT. The accuracy of ES was 84% and of CT only 76%. Both methods had advantages and limitations. An accurate staging of lymph node metastases was possible neither by ES nor by CT. - We advocate endosonography as the first imaging examination after proctoscopy. CT is recommended in endosonographic doubtful findings and in tight stenoses.

Adenocarcinoma↗