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Biomedical subjects

M Lütolf

Publications and source records attributed to M Lütolf.

10 recordsLinked to original sources
PubMed2003

[Venous stents].

The continuous development of stents in the past 20 years has facilitated the widespread use of stents in the arterial and venous system. The idea of stents is tightly related to the name of Charles Dotter, the inventor of percutaneous transluminal angioplasty (PTA). Stents can be placed for various causes of obstruction, both benign and malignant, throughout the venous system either, primarily, in combination with fibrinolysis, or as adjunct to PTA or surgical intervention. Stent placement is a minimal invasive method associated with a low complication rate and a high clinical success mainly due to differences of the properties and of the pressure between veins and arteries. Special cases of veinous stents are hemodialysis shunts, where patency rates are not improved but critical situations can be managed, and transjugular intrahepatic porto-systemic shunts (TIPS), which have high rates of complication and restenosis requiring frequent reinterventions.

Adult↗
PubMed2001

[Modern imaging for detection and localization of distant metastases].

Imaging and staging of malignant tumors is an essential part of the practice of radiology and also an important focus of clinical radiological research. There are many different modalities for tumor imaging and the efficient use requires profound knowledge of their advantages and limitations. CT, ultrasound (US) and magnetic resonance (MRI) can provide images with high morphological details but often fail to detect minimal tumor agglomerations (micrometastases). New techniques such as positron emission tomography (PET) and the development of specific contrast agents can reveal changes at the physiological, cellular or molecular levels. In this review the advantages and limitations of the current imaging modalities are discussed and their application in the evaluation of the most common sites of metastasis described.

Bone Neoplasms↗
PubMed1994

Screening for sinus disease in patients with asthma: a computed tomography-controlled comparison of A-mode ultrasonography and standard radiography.

BACKGROUND: Paranasal sinus disease and bronchial asthma are frequently associated. Patients with asthma often have chronic inflammatory changes of the paranasal mucosa rather than acute bacterial sinusitis. Our aim was to compare the rankings of A-mode ultrasonography and standard radiography as routine screening procedures in the diagnostic workup of these patients. METHODS: We compared the evaluation of the maxillary sinuses by A-mode ultrasonography and standard radiographs. Computed tomography served as a gold standard in 19 patients with asthma who had no history of sinus surgery. RESULTS: Computed tomography showed at least some minimal mucosal thickening in any of the paranasal sinuses in 74% and of the maxillary sinuses in 61% of the patients. Compared with the results of computed tomography, plain-view radiography gave a specificity of 86.7% for the maxillary sinuses. Although all cases of severe mucosal thickening were detected, sensitivity for minimal mucosal hyperplasia was low, at 52.2%. In contrast, A-mode ultrasonography demonstrated a sensitivity of 70% but a specificity of only 22%. CONCLUSIONS: Even symptom-free patients with asthma show a high prevalence of at least limited mucosal thickening in the paranasal sinuses. Acute sinusitis is not a common finding. A-mode ultrasonography does not allow sufficient evaluation of this mucosal hyperplasia and is therefore not suitable for initial screening in these patients. It may prove helpful as a follow-up in selected patients with known anatomic characteristics, however, especially when antral fluid is involved. For routine screening in patients with asthma, a conventional Waters' view radiograph should be used in conjunction with direct visualization of the ostial-meatal area by fiberoptic or rigid rhinoscopy. This combination provides information about the degree of mucosal hyperplasia as well as mucosal inflammation and secretion.

Adult↗
PubMed1994

[The primary cruciate ligament suture--is the method outdated? Results in follow-up of 58 patients].

In the present study 58 out of 105 patients, who had been operated on for anterior cruciate ligament rupture from 1980-1992 by the same experienced surgeon, were followed up clinically and by X-ray examination. Most of them were sports accidents, above all skiing and soccer. In 11 patients an isolated rupture of the anterior cruciate ligament was found, the remaining 47 had sustained additional injuries (mainly the medial collateral ligament and the medial meniscus). In 52 cases the operation was performed with primary repair of the anterior cruciate ligament. For chronic instability 4 patients (7%) had to be treated with secondary anterior cruciate ligament reconstruction. In the follow-up study 60% of all patients achieved a Lysholm-score of 95-100 points, 19% of 84-94 points. The remaining 21% achieved less than 84 points. In the side to side comparison the Lachman Test was equal or showed a slightly diminished stability of the operated knee in 91% of 54 patients without secondary reconstruction. The anterior stability with 90 degrees flexed knee in neutral position was within a similar scope, the anterior medial stability was a little worse. In 48% of all patients we found radiological signs of osteoarthritis (stage II and III according to the classification of Jäger and Wirth).

Adolescent↗
PubMed1992

[Temporary balloon catheter occlusion for control of bleeding of a blunt injury of the proximal axillary artery. Case report and review of the literature].

We describe the successful placement of an intra-arterial balloon catheter by a femoral approach in order to occlude the proximal arterial end and to control massive bleeding in a patient with rupture of the left axillary artery after blunt scapulo-thoracic dissociation. To our knowledge this technique has so far not been reported in Europe. It allows rapid control of bleeding, minimizes blood loss and markedly facilitates pre- and perioperative management in selected cases. The authors review the relevant literature dealing with this topic.

Adult↗
PubMed1988

[Morbid obesity. Our results with the appetite-depressing stomach balloon].

Morbid obesity still remains a controversial topic with varied therapeutic approaches. In cases of unsuccessful conservative management we implant a gastric balloon or bubble. 30 balloons have been introduced in 24 patients with a mean age of 43 years (26-68 y.) and a mean body weight of 115 kg (87-160 kg). Mean overweight was 47 kg. The balloons were introduced immediately after gastroscopy performed to identify possible contraindications. Except in the initial 3 patients this procedure was carried out in the outpatient clinic. 25 silicon mammary prostheses were implanted until a special balloon (Ballobes-Balloon) became available for the last 5 cases. Implantation and follow-up has been uneventful in all cases. Our data suggest that a combination of this approach with close dietary management provides more efficient and rapid weight reduction than any diet alone.

Adult↗