PubMed Health⌕ Search

Biomedical subjects

S Hancke

Publications and source records attributed to S Hancke.

At least 19 recordsLinked to original sources
PubMed2002

US-guided fine-needle aspiration biopsy of thyroid nodules.

PURPOSE: To determine which nodular areas provide most adequate and accurate material for cytology during US-guided fine-needle aspiration biopsy (FNAB) of thyroid nodules. MATERIAL AND METHODS: In a prospective multicentre study, US-guided FNAB (0.8 mm) was performed in 342 thyroid nodules (338 patients, 285 women, 18-83 years, 285 palpable). Histology was obtained in 169 nodules, revealing 75 neoplasms (44.4%) including 18 cancers (10.7%). In 206 solid nodules, 2 passes (central and peripheral) were compared. In 82 complex nodules, 2 passes (solid area and cystic area) were compared. RESULTS: The inadequacy rate was 16.4% and the false-negative rates were 2.2% and 28.1% for the diagnosis of cancer and neoplasm, respectively. In solid nodules, material was more adequate with peripheral passes compared to central passes, but the difference was not significant. In complex nodules, the inadequacy rate was much higher for passes in cystic areas (80.5%) compared to passes in solid areas (46.3%). CONCLUSION: Cystic areas due to degeneration seldom provided adequate material when aspirated. Aspiration should always be obtained from solid areas, at best using US-guidance. Adenomas and non-neoplastic nodules were difficult to distinguish.

Biopsy, Needle↗
PubMed1998

One-step endosonography-guided drainage of a pancreatic pseudocyst: a new technique of stent delivery through the echo endoscope.

We report here the first case of a one-step endosonography(EUS)-guided pseudocyst drainage. A prototype large channel curved array echo endoscope (Pentax FG-38 UX) and a prototype delivery system for placement of an endoprosthesis was used for the procedure. The delivery system (GIP MedicinTechnik GmbH/Medi-Globe Corporation) consists of a handle part with a piston, a metal ring sheath, a plastic catheter with a diathermy needle and a double pigtail endoprosthesis (8.5 Fr). When mounted on the endoscope the endoprosthesis can be advanced out of the distal end of the endoscope. The introduction of the stent as well as the stent release can be monitored entirely by ultrasound. The procedure was tested in a 76-year-old woman with a pseudocyst measuring 60 mm in diameter located in the tail of the pancreas. The procedure was well tolerated by the patient, and there were no procedural complications. The advantage of a large channel echo endoscope and our new prototype delivery system is that the endoprosthesis can be inserted in to a pancreatic cyst guided exclusively by EUS without exchange of endoscopes, catheters or guide wires. Further studies are warranted.

Aged↗
PubMed1996

[Percutaneous cysto-gastrostomy of chronic cysts in the pancreas. A nine-year clinical experience].

During the years 1984-1992 74 patients with chronic pancreatic cysts were treated with percutaneous cystogastrostomy. Forty-five patients (61%) were males, 29 females (39%). Pain was the indication for treatment in all patients. The catheter was successfully placed at the first attempt in 68 patients (92%). Immediate complications occurred in four patients (5.5%); they have not occurred since 1986. Abscess formation was seen in eight patients (10.8%). One patient died four days after the procedure from a myocardial infarction (mortality rate: 1.3%); no mortality has occurred since 1986. Pain disappeared or decreased in 90%, gain of weight was seen in 80%. The mean observation time was 27 months (range: 0-108 months). This method is less traumatizing than an operation, and mortality and complication rates compare favourably with those seen after surgery; the results are at least as good.

Adolescent↗
PubMed1996

Endoscopic ultrasonography and real-time guided fine-needle aspiration biopsy of solid lesions of the mediastinum suspected of malignancy.

STUDY OBJECTIVE: The study details our preliminary experience with endoscopic ultrasonography (EUS) guided fine-needle aspiration biopsy (FNAB) of mediastinal masses suspected of malignancy. DESIGN: Prospective uncontrolled study. PATIENTS: Nine patients had lesions suspected of malignancy ranging from 1 to 9 cm in diameter in various locations of the mediastinum. INTERVENTIONS: The EUS examination was performed with a gastroscope (Hitachi/Pentax FG-32 UA) equipped with an adjustable 5- or 7.5-MHz curved array ultrasonic transducer. The scanning plane is in the long axis of the endoscope allowing endosonographically guided biopsy to be performed. A 21-gauge (0.8 mm), full-length steel needle housed in a biopsy handle (type: Hancke/Vilmann; GIP-Medizin Technik; Grassau, Germany) was used for the biopsies. RESULTS: Nine patients had biopsy specimens taken from 13 lesions. The total number of needle passes was 18 (range, 1 to 3; median, 1.4). The cytologic diagnosis was conclusive for cancer in ten lesions and consistent with a benign lesion in three lesions. All ten malignant diagnoses and two benign diagnoses were confirmed either by operation or follow-up. In the last patient with lung cancer, a final diagnosis of the EUS-guided biopsy of an enlarged lymph node could not be obtained. No false-positive or negative biopsy diagnoses were recorded. The biopsy procedure was well tolerated by all patients, and there were no complications. CONCLUSIONS: EUS-guided aspiration biopsy is a significant advance in the differentiation between malignant and benign lesions of the mediastinum carrying a high diagnostic potential.

Aged↗
PubMed1996

Polycystic liver disease, complicated by Salmonella infection.

BACKGROUND: Polycystic liver disease is a relatively uncommon congenital condition. Infections of these cysts do occur, but there are no reports of salmonella as the aetiologic agent. Salmonellosis, complicating hydatid disease of the liver has been described. CASE: A patient with a long-standing polycystic liver disease suddenly developed an infection of one of the cysts, caused by Salmonella javiana. Under sonographic guidance a percutaneous drain was inserted into the cyst, followed by systemic antibiotic treatment and, later, intracystic instillation of tetracycline. CONCLUSION: The sclerosing treatment was successful, thus preventing laparotomy.

Aged↗
PubMed1995

Endoscopic ultrasound scanning of the upper gastrointestinal tract using a curved linear array transducer: "the linear anatomy".

During the last few years endoscopes with electronic array transducers have been introduced, making EUS-guided biopsy possible. However, only a few studies have been published with this kind of instrument. In this article, the EUS examination procedure and the normal anatomy of the upper gastrointestinal tract using a curved linear array transducer are described.

Digestive System↗
PubMed1994

Percutaneous cystogastrostomy for chronic pancreatic pseudocyst.

During the years 1984-1992, 74 patients of mean age 45 (range 6-71) years with chronic pancreatic pseudocyst were treated by percutaneous cystogastrostomy. They comprised 45 men and 29 women. A diagnosis of chronic pancreatitis was verified in 55 patients (74 per cent); pain was the indication for treatment in all cases. The catheter was successfully placed at the first attempt in 68 patients (92 per cent). Immediate complications occurred in four patients (5 per cent); there have been none since 1986. Abscess formation was seen in eight patients (11 per cent). One patient died 4 days after the procedure from myocardial infarction giving a mortality rate of 1 per cent; no death has occurred since 1986. The mean observation time was 27 (range 0-108) months. Pain disappeared or decreased in almost 90 per cent of patients and weight gain was seen in 80 per cent. The method described is less traumatic than operation, and mortality and complication rates compare favourably with those seen after surgery; the results are at least as good.

Adolescent↗
PubMed1993

Endosonographically-guided fine needle aspiration biopsy of malignant lesions in the upper gastrointestinal tract.

A new method of endoscopic ultrasound (EUS) guided fine needle aspiration using an ultrasonic endoscope with a curved array transducer mounted in front of the optic lens was developed. As a result of the sector shaped sound field and the direction of the scanning plane it was possible to visualise ultrasonically a needle inserted through the biopsy channel. EUS guided biopsy was performed in 37 patients (with 39 lesions) using three types of needles. Based upon initial testing of several prototype needles a 160 cm long, 0.8 mm diameter needle placed in a Teflon catheter was developed after preliminary results with the first two types were unsatisfactory (positive results for malignancy in 3/11 and 4/8 cases). The third prototype was tested in seven patients with malignant tumours of the upper GI tract. In these patients EUS guided biopsy was positive for malignancy in 7 of 8 solid lesions. Problems related to the technique and criteria for a successful outcome are discussed. The preliminary results show that it is possible to advance a needle into a malignant lesion inside or outside the GI wall during EUS examination and aspirate material for cytologic examination from various lesions. Controlled studies are needed to determine the indications for use and the accuracy of the technique.

Biopsy, Needle↗
PubMed1992

Hormonal and menstrual changes after laparoscopic sterilization by Falope-rings or Filshie-clips.

OBJECTIVE: To evaluate the influence of laparoscopic sterilization by Falope-rings (Cabot Medical Corp., Langhorne, PA) or Filshie-clips (Femcare, Nottingham, United Kingdom) on menstrual pattern and ovulatory function. DESIGN: A prospective, nonrandomized study of women sterilized by Falope-rings (n = 6) or Filshie-clips (n = 5). Menstrual charts were kept. Serum follicle-stimulating hormone (FSH), estradiol (E2) and progesterone (P) were measured by means of radioimmunoassay in one cycle before and 3, 6, and 12 months after the sterilization. Blood samples were drawn on day -6, -2, 0, +6, +10 of the menstrual cycle, ovulation corresponding to day 0. The women sterilized by Filshie-clips had abdominal ultrasonography of the ovaries measuring the leading follicle on day -6, -2, 0, +6 of the menstrual cycle. PATIENTS: Twelve women, 25 to 38 years old, with regular menstrual cycles and no use of oral contraceptives or intrauterine contraceptive device at least 6 months before sterilization. One woman was excluded. RESULTS: After the sterilization, all women reported unchanged menstrual pattern. The follicular rise in E2 unchanged, and FSH levels fell accordingly. Progesterone levels were ovulatory, but the midluteal P peak 3 months poststerilization was significantly decreased. Serial abdominal ultrasonography in women sterilized by Filshie-clips confirmed ovulation in all cycles except in one woman, who had an unruptured follicle in one cycle before and in the sixth cycle after sterilization. CONCLUSION: Laparoscopic sterilization by Falope-rings or Filshie-clips does not seem to interfere with menstrual pattern or ovulatory function.

Adult↗
PubMed1991

[Endoscopic ultrasound scanning of the upper gastrointestinal canal].

Endoscopic ultrasound scanning (EUL) of the upper gastro-intestinal canal has rendered apparently very meticulous assessment of pathological conditions in and around the oesophagus, stomach and the duodenum possible during recent years. On account of the close contact with the mucosa, high-frequent ultrasound transducer with great solubility capacity are employed. The wall of the gastrointestinal canal may thus be presented and subdivided into five layers. The ultrasound gastroscope most employed at present is lateral visualizing gastroscope with a mechanically rotating sector scanner mounted distal to the optic. On the basis of the literature, the technique of the examination and the hitherto employed indications for EUL are reviewed. International attention has been focussed on employment of EUL for preoperative subdivision of tumours in the oesophagus, stomach, pancreas and biliary passages into stages. Individual centres have reported promising results compared with existing forms of examination such as CT, conventional radiography, endoscopy and external ultrasound scanning. It is concluded that the necessary apparatus has not yet been fully developed. In addition, more numerous and more extensive prospective investigations are necessary before EUL may possibly be considered as a routine method of examination.

Duodenal Neoplasms↗
PubMed1991

[Endoscopic ultrasound scanning of the upper gastrointestinal tract. Preliminary results].

International interest in endoscopic ultrasonic scanning (EUL) for assessment of mural and extramural pathology in and around the upper gastrointestinal tract has increased during recent years. Since 1. February 1989, the surgical gastroenterological department D in cooperation with the ultrasonic laboratory in Gentofte Hospital has undertaken EUL on selected patients employing a recently developed Picker-Pentax ultrasonic gastroscope. The apparatus consists of a forward viewing fibreoptic gastroscope with a 5 MHz curved electronic ultrasonic transducer mounted immediately behind, the optic. The plans of scanning is longitudinal in the length of the gastroscope. On the basis of in vitro ultrasonic examinations and EUL in a total of 80 patients during a period of 12 months, the preliminary experience with the above mentioned apparatus is described. It is concluded that the 5 MHz transducer is not sufficiently high frequent for detailed examination of the mucosa and the walls of the gastrointestinal canal whereas deep penetration and imaging of the surrounding organs and structures is satisfactory. The method demands great endoscopic routine and extensive UL experience as the UL sectional image is unpredictable and difficult to define, one of the reasons being that the transducer is not visible through the gastroscope. The indications for employing the apparatus described here are not completely elucidated and assessment of the diagnostic certainty of the method requires more numerous and controlled investigations. The authors consider that EUL with linear array transducer as the most recent invention will result in increased diagnostic information in gastroenterology.

Adult↗
PubMed1991

Endoscopic ultrasound examination of the upper gastrointestinal tract using a curved-array transducer. A preliminary report.

Endoscopic ultrasound examination (EUS) of the upper gastrointestinal (GI) tract for the assessment of mural and extramural pathology has attracted growing international interest in recent years. Since February 1989, EUS has been performed on selected patients in our institution using a new Picker-Pentax fiber-optic ultrasound (US) gastroscope. The instrument consists of a forward-view fiber-optic gastroscope with a 5-MHz curved-array linear US transducer mounted directly behind the lens. The scanning plane lies in the long axis of the scope. Based on in vitro US examinations and EUS of 118 patients over an 18-month period, our preliminary experience with the instrument is described. Using EUS, various lesions in the esophageal wall as well as in the gastric and duodenal walls can be visualized. Furthermore, organs and structures outside the GI tract can be seen, and lesions such as enlarged lymph nodes in the mediastinum and abdomen; solid and cystic masses in the liver, pancreas and retroperitoneum; arterial aneurysms; esophageal varices; and gall stones and calcifications can be demonstrated. The 5-MHz transducer does not provide very detailed information on the GI wall. The direction of the ultrasound scanning planes is difficult to define, as the transducer cannot be seen through the optic lens. The method demands great expertise in endoscopy and ultrasound. Indications for EUS have not been definitively established. Evaluation of the diagnostic accuracy of this technique requires further controlled studies. We believe that EUS using a curved-array linear transducer will provide significant diagnostic information of clinical relevance to gastroenterology.

Aged↗
PubMed1991

Hematomas and subcutaneous suture techniques in total hip replacement. An ultrasound study.

Thirty-five patients undergoing total hip replacement due to primary arthrosis were randomized into two groups. In one group each subcutaneous suture included a stitch in the fascia; in the other group the fascia was not included in the suture. Ultrasonography examination showed no significant difference in the number of subcutaneous hematomas in each group. Nine subcutaneous and nine deep hematomas were diagnosed by ultrasound in 15 patients. Three patients had a clinical diagnosis of hematoma and in only one of these did ultrasonography support the diagnosis. It appears that the clinical diagnosis of hematomas, even subcutaneous hematomas, is unreliable. Careful hemostasis is recommended.

Aged↗
PubMed1991

Ultrasonically guided fine needle pyelography.

A method for ultrasonically guided fine needle pyelography is described. The procedure involves puncture of the renal pelvis with a long (150-200 mm) 0.8 mm needle which is subsequently bent and fixed to the skin. Puncture of the calyceal system can be performed even in cases of very mild dilatation and contrast medium for detailed radiologic investigation injected. The procedure is simple, safe and inexpensive and it has been performed on 49 patients without complications.

Humans↗