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Biomedical subjects

M Helmer

Publications and source records attributed to M Helmer.

15 recordsLinked to original sources

[Carotid and vertebral artery circulation in forearm choke holds in Doppler sonography].

By means of continuous wave doppler the effect of two choke holds (Carotid sleeper, Nami-juji-jime) on the carotid and vertebral arteries was investigated. For both choke holds, which are characterized by pressure on lateral parts of the neck, we found an obstruction up to a complete stop of flow. The degree of obstruction depended on the direction of force. The vertebral artery can be compressed between the subclavian artery and the foramina transversaria, therefore it was most effective to press on the lower neck. Tensing the neck muscles can reduce the effect of choking.

Asphyxia↗

Sonography versus palpation in the detection of regional lymph-node metastases in patients with malignant melanoma.

High-resolution real-time sonography was done in 217 patients with malignant melanoma to compare its value in detecting regional lymph-node metastases with that of palpation. Lymph-node metastases were found in 29 patients by ultrasound whereas, by palpation, metastases were detected in 15 patients only. The presence of metastases was proven by histopathology after surgical lymphadenectomy in these ultrasound positive cases. Thus sonography was superior to palpation, and in addition permitted distinction between metastatic changes and inflammatory lymph-node enlargement. Ultrasound is recommended for preoperative staging as well as in postoperative monitoring of patients with malignant melanoma.

Adult↗

Diagnostic imaging of tumor invasion of the mandible.

Several imaging techniques, such as conventional radiography, sonography, computed tomography, isotope scanning and magnetic resonance tomography are used for evaluation of malignant tumors in the region of the floor of the mouth and the tongue. At present, conventional radiography, as well as computed tomography and isotope scanning are the techniques preferred for examination of the mandible. In this study, the results of conventional radiographic examination, computed tomography, ultrasound and Tc scanning in detecting tumor invasion of the mandibular bone, are documented and correlated to surgical and histological findings. The results suggest that ultrasound--our primary diagnostic imaging technique for evaluation of tumors of the floor of the mouth and the tongue--not only provides excellent imaging of tumor extension in soft tissue but also allows accurate diagnosis of osteodestructions of the mandible. In most regions ultrasound had the same accuracy in detecting tumor invasion of the mandible. In the alveolar process, however, sonography was superior to other imaging techniques. The lingual surface of the mandibular ramus can not be screened by the extraoral sonography.

Carcinoma, Squamous Cell↗

[Sonography in malignant tonsillar tumors].

In this retrospective study the value of sonography in the preoperative staging of malignant tumours of the tonsils was evaluated in 36 patients. According to our results sonography is indicated in small tumours. In greater tumours, especially if bone destruction could be expected, MR or CT should be performed additionally to sonography. Good results were achieved in assessing the infiltration of the tongue with or without crossing the midline (accuracy 92 to 97%) and the detection of cervical lymph node metastasis (accuracy 94%).

Adult↗

Invasion of the carotid artery and jugular vein by lymph node metastases: detection with sonography.

Knowledge of invasion of the walls of the cervical vessels by tumor is of great clinical importance before surgery. We performed sonography on 83 patients with palpable cervical lymph node metastases in the region of the carotid bifurcation to determine the relationship of the metastases to the carotid artery and jugular vein. In all patients, the sonographic results were proved by surgery. The wall of the carotid artery was hypo-echogenic in 11 of 12 patients with surgically proved tumor invasion of the artery. Four results were false-positive. Palpation or swallowing during real-time scanning showed mobility of the tumor relative to the wall of the artery in 47 patients (57%). In these patients, tumor invasion could be excluded. Bilateral compression or invasion of the internal jugular vein was identified correctly with sonography in all five patients in whom this was confirmed surgically. These results suggest that real-time sonography is a valuable method for determining the relationship between cervical lymph node metastases and the carotid artery and jugular vein.

Carcinoma, Squamous Cell↗

[Sonographic detection of osteodestruction of the mandible].

32 patients with osseous destruction of the mandible were examined sonographically. The results were compared with those of plain radiographs. In 30 patients, discontinuation of the cortex was clearly evident. Sonography could detect osteolytic lesions in the corpus region, in the angle and on the buccal side of the rami of the mandible. 2 cases of osteodestruction on the lingual side could not be seen.

Aged↗

[Duplex sonography after femoro-distal vascular reconstruction using umbilical veins].

In 34 patients femoro-distal reconstructions with umbilical vein grafts were assessed by means of pulsed Duplex sonography. Dilatations of the grafts and aneurysms were diagnosed easily by means of DS, likewise thrombotic plaques and perivascular pathologies. Haemodynamically significant stenoses can be quantified due to the increased velocity measured by pulsed Doppler. It can be concluded that DS is the method of choice for the postoperative follow-up of umbilical vein grafts of the femoro-distal vascular system.

Aged↗

[Primary lymph node metastases in malignant melanoma studied via high-resolution real-time sonography--its value and indications].

To detect regional lymph node metastases 217 patients with melanoma were examined both sonographically and clinically. Metastases were found in 15 patients by means of palpation, and in 26 patients via ultrasound. Sonography was evidently superior and enabled differentiation between metastatic changes and inflammatory enlargements of lymph nodes. Because of its excellent accuracy ultrasound examination should be performed both in preoperative tumour staging and in posttherapeutic monitoring.

Adult↗

Sonography and computed tomography in deep cervical lipomas and lipomatosis of the neck.

Nineteen deep cervical lipomas and five patients with cervical lipomatosis were examined with computed tomography (CT) and Sonography. By means of CT, which is the imaging method of choice for both diseases, it is possible to differentiate between circumscribed lipomas and infiltrating intramuscular lipomas. In addition, an exact localization in parenchymatous organs is possible. Cervical lipomatosis is also clearly delineated. Sonography is the first imaging method in cervical swelling or lesions; therefore, knowledge of the sonomorphology of fatty tumors is mandatory. Cervical lipomas have a fairly typical sonomorphology, but it is not as pathognomonic as the density values are by means of CT. In cervical lipomatosis, an adequate pretherapeutic assessment of the depth of infiltration is not possible sonographically. Only the cervical vessels can be clearly differentiated in this condition.

Head and Neck Neoplasms↗

[Tuberculosis of the female breast: diagnostic clarification].

Modern therapeutic possibilities made tuberculosis of the breast a rare entity which, however, still exists and usually mimicks a malignancy. It represents a secondary organ manifestation and should be considered in differential diagnosis in all cases of primary lung tuberculosis and when fine needle biopsy fails to yield the expected tumour cells. We demonstrate such a case of breast tuberculosis and stress the cytologist's option to restain any cytological slide according to Ziehl-Neelsen. In our case, this renewed staining established the correct diagnosis.

Biopsy, Needle↗