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Biomedical subjects

R Janson

Publications and source records attributed to R Janson.

At least 37 records · Page 2Linked to original sources
PubMed1981

[On the treatment of carcinoma of the thyroid (author's transl)].

Treatment of carcinoma of the thyroid includes, in addition to possible total surgical removal of thyroid and tumour tissue, obligatory radio-iodine treatment as well as administration of thyroid hormone in high dosage. Patients with anaplastic carcinoma as well as those with differentiated carcinoma which has broken into vessels or capsule or metastasized, are additionally given percutaneous radiation treatment. Cumulative survival rate for papillary thyroid carcinoma, treated according to this schema, was for women 95% after three years, 83% after five and 53% after ten years. Corresponding survival rates in men were 93%, 78% and 20% respectively. Rates for follicular thyroid carcinoma in women were 87% at three years, 75% at five and 50% at ten years. In men corresponding figures were 94, 77 and 50%. Dividing patients with differentiated thyroid carcinoma (210) into various risk groups, those with papillary and follicular carcinoma manifesting at an age under 45 years had a better prognosis than that after 45 years. Worst prognosis was with anaplastic thyroid carcinoma, when survival rates at one, three and five years were 41, 28 and 18%, respectively.

Adenocarcinoma↗
PubMed1981

[Esophagus replacement by an isoperistaltic gastric tube (author's transl)].

In 20 patients the esophagus was replaced by an isoperistaltic gastric tube. Cervical esophagogastrostomy was performed. Postoperatively motility, histology, gastric secretion, and emptying time of the gastric tube were investigated. The esophageal replacement showed residual motility, pyloric motility, atrophic gastritis, decreased basal and stimulated secretion and normal emptying time, except in two patients. There were no essential drawbacks in function of the intrathoracic gastric tube. Patients with esophagectomy are comparable to patients with partial gastrectomy.

Esophagoplasty↗
PubMed1981

[CT diagnosis of chronic osteomyelitis (author's transl)].

The CT findings in 20 patients with chronic osteomyelitis, mostly of post-traumatic origin, were compared with conventional radiographs and operative findings. CT diagnosed rather more sequestra than the conventional method. An important advantage of CT is the ability to demonstrate lesions in the medulla and infections in the soft tissues, eg. abscesses. CT should be reserved for cases where conventional methods with tomography leave unsolved problems, and in the present of fistulae.

Adult↗
PubMed1981

[Radiological and clinical aspects of diaphragmatic injuries (author's transl)].

In experience of generally increasing frequency of diaphragmatic injuries, nowadays mostly caused by blunt body traumata in traffic accidents, a review is made about diagnostic and morphologic aspects outlining syndromal relations of 70 cases treated from 1950 until 1980 in the Department of Surgery of the Bonn University. Diaphragmatic tears following indirect (closed) trauma are surely more often associated with a transposition of abdominal organs (73%) than those secondary to direct (penetrating) wounds with an amount to 23%. In typical associated injuries like multiple rib fractures (29%, in relation to blunt injuries even 42%) and pelvic fractures (24% resp. 35%) diaphragmatic damage has to be investigated for if there is any doubtful abdominal or cardiorespiratory symptom. Especially in less symptomatic intervals roentgenographic methods come to use predominantly.

Accidents, Traffic↗
PubMed1981

[Mesentericocaval shunt after esophageal bleeding in patients with cirrhosis of the liver; results during a 10 year period (author's transl)].

54 patients with cirrhosis of the liver and relapsing esophageal bleeding received mesentericocaval dacron shunts between 1st January 1975 and 31st December 1979 and were followed up to the end of 1980. Patients were accepted for surgery under the following conditions: (1) liver function had to be compensated, (2) there had to be no signs and symptoms of hepatoportal encephalopathy, (3) there had to be no signs and symptoms of activity of cirrhosis of the liver, (4) liver volume had to be between 1 000 and 2 500 ml, (5) portal vein perfusion had to be 15-35%, (6) stenosis of liver arteries had to be excluded. Lethality during the hospital period and from hepatoportal encephalopathy was 7.4%, late lethality was 11%; this accounted for a 5-year survival rate of 70%. Residual perfusion of the portal vein could be demonstrated in many cases by intra- and postoperative measurements with different methods. The dacron prosthesis was implanted into the superior mesenteric vein in an acute angle (it had a diameter of 16 mm). The prosthesis was occluded by thrombosis in 3 out of the first 18 cases operated upon. This could be prevented in the following 36 patients by intra- and postoperative longterm heparinisation.

Adult↗
PubMed1980

Sensory pathways in Drosophila central nervous system.

We have analyzed the central projections of identified sensory neurons in wild type Drosophila and in the homeotic mutant bithorax postbithorax. The results indicate that: (i) the choice of a given pathway in the central nervous system of the adult depends on the developmental history of the neuron, namely on the type of sense organ of which it is part, and on the developmental compartment to which it belongs; (ii) the establishment of the projection involves the specific recognition of a preexisting "trail" in the central nervous system. Here we examine and rule out alternative explanations of our results, and conclude that the directed growth of an axon relies at least in part on a physical guidance mechanism to which specificity is conferred by programming the growing axon to recognize the appropriate guide. We speculate that the guides are preexisting, specifically marked nerve fibers and that the basic pattern of connectivity is largely laid down early during neurogenesis, at a time when a standard set of connections is relatively easy to specify.

Afferent Pathways↗
PubMed1980

[The value of computer tomography in the staging of primary lymph node neoplasms (author's transl)].

Staging was undertaken in 118 patients with primary lymph node neoplasms; the sensitivity of computer tomography in the paraaortic region was 80%, that of lymphography 89%. Specificity of computer tomography was 93%, of lymphography 95%. In the iliac region, sensitivity was 81% (CT) and 90% (lymphography), and specificity was 90% (CT) and 97% (Lymphography). The value of computer tomography should, however, be stressed, since it can demonstrate lymph nodes not shown by lymphography, including those in the mediastinum, as well as lesions in the spleen, liver and lungs.

Adolescent↗
PubMed1980

[Computer tomography in emergency diagnosis (author's transl)].

The results of 150 examinations by computed tomography in emergency situations are described (about 5% of all CT examinations). There were 80 examinations of the skull, 65 of the abdomen and five of the mediastinum. The results are shown in two tables and include the diagnosis of bleeding, infarcts and inflammatory lesions (abscesses, encephalitis, acute pancreatitis). The morphologic and densitometric findings are compared with the literature and with other imaging procedures. Computer tomography has assumed the most important place in the emergency diagnosis of the skull; as regards the abdomen, it reaches its limitations in the presence of acute vascular occlusion and diseases of the gastro-intestinal tract. In this situation other procedures (contrast studies, angiography) and endoscopy are to be preferred since these demonstrate the tubular organs longitudinally, unlike the transverse image produced by the CT scan. Acute diseases of the lungs can be demonstrated more quickly and simply by conventional radiography. CT is a non-invasive and rapid procedure, which can demonstrate haemorrhages, abscesses and exudates in the mediastinum and abdomen directly and also show their topography. The method is therefore essential for emergency diagnosis of conditions involving the trunk.

Adolescent↗
PubMed1980

[Computer tomographic and angiographic studies of histologically confirmed intrahepatic masses (author's transl)].

The computer tomographic and angiographic findings in 53 patients with intrahepatic masses were compared. The histological findings show that 17 were due to echinococcus, 12 were due to hepatic carcinoma, ten were metastases, five patients had focal nodular hyperplasia, three an alveolar echinococcus and there were three cases with an haemangioma of the liver and a further three liver abscesses. Computer tomography proved superior in peripherally situated lesions, and in those in the left lobe of the liver. Arteriography was better at demonstrating lesions below 2 cm in size, particularly vascular tumours. As a pre-operative measure, angiography is to be preferred since it is able to demonstrate anatomic anomalies and variations in the blood supply, as well as invasion of the portal vein or of the inferior vena cava.

Angiography↗
PubMed1980

[Focal nodular hyperplasia (author's transl)].

Focal nodular hyperplasia was diagnosed angiographically in 14 patients and confirmed histologically. Differentiation of this benign lesion from other space-occupying diseases of the liver can be very difficult, since focal nodular hyperplasia produces a variable angiographic appearance. The typical angiogram showing radial vessels in the arterial phase and sharply demarcated foci in the parenchyma phase is found in only one third of patients. Angiographic differential diagnosis includes adenomas and carcinomas of the liver. Resection of the tumours in case of malignant tumours is not indicated. Foci at the margin of the liver, or if they are pedunculated, should be removed in case of spontaneous perforation. Tumours in the centre of the liver should be observed (computer tomography). Oral contraceptives stimulate the growth of these foci. They may diminish in size after stopping these drugs. 70% of cases of focal nodular hyperplasia remain clinically silent and were discovered accidentally or at autopsy.

Adenoma↗
PubMed1980

[Extracranial arterial occlusive disease in arteriopathies with peripheral vascular disease (author's transl)].

Aortography and angiography of the aortic arch were carried out in 176 patients with peripheral arterial occlusive disease. In 63,6% there were haemodynamically relevant stenoses or occlusions of the supraaortic vessels, the carotid arteries with 39,2% and the vertebral arteries with 35,2%, being the most commonly involved. Peripheral arterial disease included haemodynamically relevant changes in the femoro-popliteal arteries in 83%, in the aorto-iliac region in 67,1% and in the calf vessels in 58,5%. There was a statistically significant correlation between the clinical severity of the cerebrovascular insufficiency and of the Frontaine stages with the angiographically demonstrable extent of the arteriosclerosis. In addition there was an increasing statistical risk of extracranial arterial occlusion if the disease affected more than one arterial level.

Aorta, Abdominal↗
PubMed1980

[Transjugular vena cava umbrella placement (author's transl)].

In order to prevent venous emboli originating from the veins of the lower extremities to pass through the inferior V. cava, its passage can be blocked without interrupting the blood stream. This is done by inserting an umbrella filter in the inferior V. cava above the entrance of the renal veins. 55 transjugular umbrella filters were inserted in the period from 1.8. 1972 to 31. 10. 1979. There were 4 cases of dislocation among them, which are described in detail.

Adult↗
PubMed1979

[Demonstration of left-ventricular contraction anomalies with the two-dimensional sector-scanner (author's transl)].

Echocardiographic findings were compared with those obtained by cardiac catheterisation in 134 patients. Echocardiography was performed in the standard plane of the long and short axes, as well as from the cardiac apex. After dividing the left ventricle into several segments wall movement was measured in them and compared with those obtained by ventricular angiography in the right and left anterior oblique positions. It was found that in patients with left-ventricular aneurysm, proven by left ventricular angio, there was complete conformity with regard to localisation and extent of the aneurysm between the two methods of investigation. In this group 79% of the demonstrated segments could be adequately assessed and, in 91%, agreed with the radiological findings. In the group of patients without aneurysm only 68% of the segments could be adequately assessed, and 77% correctly assessed wall movement when compared with the laevocardiogram. Tracing recorded from the cardiac apex gave especially good results in demonstrating the ventricle and its segments.

Adult↗