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Biomedical subjects

M Hold

Publications and source records attributed to M Hold.

16 recordsLinked to original sources
PubMed2001

[Aneurysm of the popliteal vein].

Venous aneurysms are a rare pathology. The possible complications are rupture, thrombosis and subsequently pulmonary embolism. The case of a 54-year-old male is reported, who was admitted on the suspicion of pulmonary embolism to our department. This suspicion was confirmed by scintigraphy and computed tomography. Further examination by colour coded duplex sonography showed an aneurysm of the popliteal vein in clinically asymptomatic legs, as a possible cause of the pulmonary embolism. The finding was confirmed phlebographically. After successful surgical treatment of the aneurysm the patient got an anticoagulation therapy for 6 months. In the case of thromboembolism the entire venous system can be affected. Therefore an examination of the peripheral veins should be carried out whenever there is an occurrence of pulmonary embolism.

Aneurysm↗
PubMed1999

Speech processing in radiology.

The goal of this study was to evaluate the recognition rate, learning potential and amount of time needed to complete a report with the Philips speech recognition system SP 6000 (Philips, Best, The Netherlands). Four radiologists dictated reports of interventional radiology, MRI examinations of the musculoskeletal system and CT examinations of the thorax and abdomen with the Philips system using the German language. The recognition rate of each report and improvement rate after each learning phase of the Philips system was assessed. The time needed to complete a report using the Philips system was then compared with the time needed to complete a report using the tape-based system via a time analysis. The average recognition rate for the four radiologists using the Philips system was 79.6 %, which improved to 92.5 % after the third adaptation. Initially, the average time demand to dictate and correct one report was approximately 16.8 min, but this time decreased to 8.1 min after the third adaptation. In contrast, only 3. 6 min were needed to dictate and correct one report using the tape-based system. However, with the speech recognition system, dictation, correction and transcription of the report can be completed within 15 min, whereas with the tape-based system, it takes nearly 1 day. With the Philips system, speech recognition can reach as high as 95 % since each adaptation of the system improves the recognition rate by approximately 5 %. While the Philips system is associated with longer dictation times than the tape-based system, turn-around time for a complete report is substantially shorter with the Philips system than the tape-based system.

Computer Communication Networks↗
PubMed1995

[Surgical treatment of infrarenal abdominal aortic aneurysm].

Results of surgical treatment of infrarenal abdominal aortic aneurysms (AAA) have improved in recent years. Through worldwide experience associated risk factors could be determined and reduced significantly. Therapy of associated diseases and profound morphologic knowledge about AAA are the most important factors to influence survival after surgery. Nowadays average mortality after elective surgery is 5%, 5-year survival rate 70%. By recognition of asymptomatic AAA on time the rupture rate with a mortality of more then 50% must be reduced in the near future. The purpose of this article is to represent, beyond the standard surgical technique, the possibilities to prevent ischemic complications from the myocardium, kidneys, colon and gluteal region during abdominal aortic surgery.

Anastomosis, Surgical↗
PubMed1992

Distal popliteal and tibioperoneal transluminal angioplasty: long-term follow-up.

The long-term efficacy of percutaneous transluminal angioplasty (PTA) for treatment of occlusive lesions involving arteries below the knee was evaluated in 168 consecutive patients. The procedure was preceded by intraarterial thrombolysis in 33 patients with failing femorodistal grafts. Indications were disabling claudication in 40 cases (24%), acute ischemia in 18 (11%), rest pain in 49 (29%), and tissue necrosis in 61 (36%). Angioplasty of tandem femoral and/or iliac lesions was performed in 58 cases (34.5%). Major complications were observed in 19 patients (11.3%) and minor complications in 12 others. Five patients died within 30 days (3%). Mean follow-up was 26.1 months (range, 4-72 months). Major amputation was required in 26 cases (15%). The cumulative clinical success at 3 years was 83% for a single stenosis, 76% for multilevel lesions, 44% following lytic therapy, 36% for segmental occlusions, and 14% for anastomotic stenoses. Infrapopliteal PTA is useful in selected patients. Factors associated with poor long-term patency include a single patent tibial artery (P = .039), acute ischemia (P = .03), anastomotic stenosis (P = .01), and, possibly, complete occlusion prior to treatment (P = .091).

Aged↗
PubMed1992

Blood viscoelasticity response during carotid endarterectomy.

As demonstrated in many studies ischemic brain injury causes microcirculatory disturbances which is reflected in changes in the rheological behavior of blood. This is caused by multifactorial interaction between blood cells and damaged endothelium in the capillary network with release of tissue metabolites and by-products of cellular injury with resulting increased cellular permeability producing a volume shift into the interstitium and, subsequently, a rise in the hematocrit density. Drop in perfusion pressure produces an increase in whole blood viscosity. By means of an oscillating capillary rheometer and densimeter, the viscous and elastic parts of the complex viscosity of whole blood and plasma were measured from the ipsilateral internal jugular vein in 17 patients with unilateral occlusive carotid lesions during different stages of carotid endarterectomy. Our results show that fluid characteristics deteriorated significantly during carotid clamping with increase in whole blood viscoelasticity and plasma density, although collateral circulation was judged sufficient in the angiogram and cerebral perfusion pressure. These parameters not only returned to their initial value, but a significant amelioration was observed after installation of an intraluminal indwelling shunt as a response to improved orthograde flow and an enhanced shear velocity. We conclude that an increase in whole blood viscosity does correlate with decreased cerebral blood flow. This response is immediate. Hematocrit density increases significantly as a result of fluid shift into the interstitium. These changes are reversible if blood flow is promptly restored.

Aged↗
PubMed1992

Deep venous thrombosis: results of thrombectomy versus medical therapy. Presented at the 5th European-American Symposium on Venous Diseases, Vienna, Austria, Nov. 7-11, 1990.

Between 1.1.1985 and 1.1.1988, 158 patients were referred because of acute deep venous thrombosis. They were 82 women (median age 48.5) and 76 men (median age 56.5). On admission, 4 patients had already a pulmonary embolism in 3 others embolism occurred during hospitalisation. The segment involved was the isolated iliac in 10, iliofemoral in 53, isolated femoral in 7, femorotibial in 47 and isolated tibial in 41 patients. Anticoagulation and compression therapy was undertaken in 102 and mortality was 21%. At follow-up 63% had at least 1 sign of venous insufficiency, in all 16% had no sequelae and were subjectively symptom-free. Thrombolytic therapy was carried out in 25, mortality was 8%. At follow-up, 72% had at least one sign of venous insufficiency. Venous thrombectomy was performed in 31, combined in 4 with balloon dilatation of an iliac spur. Mortality was low with 3%, 58% had at least one sign of venous insufficiency at follow-up and 39% were subjectively symptom-free. Our results show that an objective assessment is insofar difficult because subjective and clinical results do not correlate; 51% with clinically verified post-therapeutic venous insufficiency had normal venous drainage in strain-gauge plethysmography, whilst 41% without subjective discomforts demonstrated an insufficient drainage. Our results show that a full restitution is seldom achieved, thrombectomy does not prevent chronic venous insufficiency. Best results were observed in isolated iliac thrombosis. We conclude that thrombectomy should be restricted to the phlegmasia caerulea dolens form of DVT, while floating thrombus and ascending thrombus extending into the vena cava should be treated with a cava filter or ligation.

Adult↗
PubMed1990

Surgical management of perforating diverticular disease in Austria.

Perforated diverticulitis is a much feared complication of diverticular disease and requires immediate surgical therapy to limit the incipient peritonitis and its sequelae. The ensuing surgical approach which could best irradiate the septic focus as well as restore normal intestinal continuity with less morbidity and mortality has been a matter of controversy. In the last ten years primary resection and colostomy has replaced the three-stage procedure in most cases of peritonitis. Primary anastomosis, when peritoneal involvement is well confined, has been shown to give excellent results. To assess the surgical management of perforating diverticulitis in Austria, a questionnaire was sent to leading hospitals throughout the country and information of 241 patients with perforating diverticulitis was compiled. The overall peroperative mortality was 9%, and the highest rate of complication (37.9%) was observed after primary resection and anastomosis with temporary defunctioning proximal colostomy. The mortality, as expected, is directly proportional to the extent of peritonitis; it was significantly greater among patients with generalised peritonitis and lowest among cases of covered perforation.

Adult↗
PubMed1977

[Continuous monitoring of the pulmonary artery pressure in acute myocardial infarction (author's transl)].

The method of continuous pulmonary artery pressure (PAP) monitoring and its use in 66 patients with acute myocardial infarction is described. Measurement of PAP should be the first diagnostic step in hemodynamic monitoring and early recognition of left ventricular failure. In cases of elevated PAP and critical general state of the patient, monitoring should be extended by measuring pulmonary wedge pressure and cardiac output. Hemodynamic monitoring should be continued for 3 to 5 days, since some cases of acute myocardial infarction with increasing PAP up to the 4th day after the onset were recorded. With the safety precautions mentioned, neither threatening, arrhythmia, nor thromboembolic or septic complications were observed.

Acute Disease↗