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Biomedical subjects

R Günther

Publications and source records attributed to R Günther.

At least 109 records · Page 6Linked to original sources
PubMed1983

Extrabiliary obstructive jaundice.

Extrabiliary obstructive jaundice is only encountered in biliary digestive anastomosis when the draining bowel itself is obstructed. In two patients, the cause of obstruction was a local tumour recurrence.

Adult↗
PubMed1983

[Microcystic pancreas adenoma].

The microcystic adenoma of the pancreas is a very rare benign pancreatic tumour. This tumour, which is usually large and grows slowly, results in displacement and compression of the adjacent organs. Angiography reveals hypervascularisation. The characteristic structure of the tumour can be recognized both in the sonogram and in the computer tomogram.

Aged↗
PubMed1983

[Computed tomography and preoperative staging of esophageal cancers].

Fifty-two patients with proven esophageal carcinoma underwent thoracic and abdominal computed tomography (CT) prior to treatment. The mediastinum, lungs and abdomen were studied for evidence of direct invasion or metastases. Correlation with surgical findings were available in 15 thoracic and 29 abdominal CT-scans. Results indicate that experience of the radiologist is the most important factor in evaluation and in accuracy of CT-scanning. The extent of mediastinal spread in 13 of 15 and intraabdominal metastases in 23 of 29 patients were correctly identified. All errors were caused by false-negative diagnoses. The ability of CT to reliably predict the extent of disease can help the surgeon to plan an optimal therapy.

Esophageal Neoplasms↗
PubMed1983

[Percutaneous transhepatic electroincision of stenosed biliodigestive anastomoses].

Percutaneous transhepatic electroincision is a new method for the treatment of stenoses after hepatico-jejunostomy. Using the percutaneous transhepatic approach the stenosis is cut with the aid of a papillotome by applying high frequency current. In all 5 patients treated the anastomis was patent. In one case multiple calculi in the intrahepatic bile ducts necessitated operative stone removal later on. In view of the problems of surgical correction percutaneous electroincision offers an attractive alternative to operation.

Bile Duct Diseases↗
PubMed1983

[Endoscopic retrograde cholangiography (ERG) with a double-lumen balloon catheter--an improvement on the conventional ERC technic].

We describe an improvement of the ERC-technique by use of a balloon catheter in order to hinder transpapillary contrast medium flow. The procedure was successful in patients presenting with choledochal stenosis or papillary insufficiency after previous endoscopic papillotomy. Two out of 11 cases in which the complete opacification of the biliary tree could not be achieved by standard ERC-technique are reported. The application of this technique will reduce the diagnostic indications for percutaneous transhepatic fine needle cholangiography which is still the method of choice in certain therapeutic indications.

Aged↗
PubMed1982

[Pathogenesis and clinical features of painful dysfunctions of the locomotor system].

In the pathogenesis of painful dysfunctions of the locomotor apparatus superficial pain, deep pain and compression pain as well as referred pain play a role. The development of this pain is discussed. The differential diagnosis of radicular and pseudoradicular forms of pain of the vertebral column is discussed. The most clinical important rheumatic pain syndromes, myalgia, arthritis and arthrosis as well as the development of pain in gout attacks are described according to the natural history and clinical presentation of the disease. Therapeutic indications are given. The importance of the differential diagnostic evaluation of pain syndrome is stressed, in particular if it seems, that there is no organic background.

Afferent Pathways↗
PubMed1982

[Imaging adrenergic tumours with 131J-meta-benzylguanidine].

Pheochromocytoma scanning using 131J-meta-benzylguanidine was done in one patient with metastasizing paraganglioma, one patient with multiple endocrine neoplasia type IIb. No activity of tumour tissue could be demonstrated in the patient with metastasizing paraganglioma, whereas the pheochromocytoma could be clearly defined in the patient with multiple endocrine neoplasia type IIa. The female with multiple endocrine neoplasia type IIb showed a suspect space-occupying lesion of the left adrenal using computed tomography. Pheochromocytoma could be excluded by 131J-benzylguanidine scanning, selective estimation of catecholamines in adrenal venous blood as well as the glucagon stimulation and clonidine suppression.

Adrenal Gland Neoplasms↗
PubMed1982

[Trends in surgery for chronic pancreatitis (author's transl)].

Improved preoperative assessment (ERCP, sonography, computer tomography) of pathological changes of the pancreas has impressively changed indications for surgery, timing of the operation and surgical methods used. Intraoperative diagnostics have lost ground due to newer techniques. The aim of surgical treatment is pain relief and the prevention of complications (cholestasis, duodenal stenosis, segmental portal hypertension). Introduction of endoscopic duct visualisation was followed by an increase of resecting techniques based on impressiveness of pathology of ductal changes. Non-invasive methods such as sonography and computer assisted tomography have improved definition of pathological changes and re-encouraged less radical surgery using drainage and anastomosing techniques. Therapeutic consequences of diagnostic progress are demonstrated in 503 cases treated surgically between 1964 and 1981.

Cholestasis↗
PubMed1982

[Diagnosis of the site of insulinomas: percutaneous transhepatic portal vein catheterisations with selective blood sampling for hormone determination (author's transl)].

Percutaneous transhepatic portal vein catheterisation with blood sampling from the various areas of drainage, especially the pancreatic veins, was undertaken in seven patients with insulinoma to diagnose its site. In six patients measurement of serum-insulin levels revealed an abrupt rise in the vascular area later found to drain the area of the insulinoma. Insulin measurement in one patient with insulinoma in the head of the pancreas falsely indicated an islet-cell tumour in the region of the tail of the pancreas. C-peptide concentration in serum followed the concentration of insulin, but did not show such a marked rise. The method of percutaneous transhepatic portal vein catheterisation with selective blood sampling for the measurement of hormonal concentration was superior to ultrasound, computer tomography or coeliacography for determining the site of the tumour.

Adenoma, Islet Cell↗
PubMed1982

[Reoperations for persistent and recurrent hyperparathyroidism (author's transl)].

The results of 26 reexplorations in 24 patients with primary hyperparathyroidism are reported. In 20 patients the disease was classified as persistent, in 3 as recurrent. The diagnosis was confirmed by measurement of calcium and phosphate in serum and urine and by serum-PTH. All patients were symptomatic. Localisation of the tumors was possible by following the embryology and topographical anatomy of the parathyroids during surgery; localization was not as successful in the various preoperative investigations used. Postoperatively, no patient was hypercalcemic. The success rate was 100% for 21 patients, with a follow-up time of more than 6 months. Use of cryopreservation and autotransplantation of the endocrine tissue proved very advantageous; this technique was performed successfully in two of ten hypocalcemic patients and still may be considered in another three patients.

Adenoma↗
PubMed1982

[The value of computer tomography in the diagnosis of local recurrences of carcinoma of the rectum (author's transl)].

The tendency of rectal carcinomas to recur makes it necessary to reexamine these patients repeatedly. The tissues remaining following resection of the rectum can only be examined directly by computer tomography. The value of this procedure in the diagnosis of local recurrences has so far not been established. The results of computer tomography must therefore be correlated with already established methods, particularly clinical examination and CEA measurements.

Adenocarcinoma↗