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Biomedical subjects

W Hruby

Publications and source records attributed to W Hruby.

32 records · Page 2Linked to original sources
PubMed1988

[Behavior of contrast media in liver tumors in computerized tomography--correlation between pharmacokinetics and histological structure].

The characteristics of contrast medium in liver tumours were studied via CT in a prospective study in 247 patients. In 30 cases, dynamic CT was performed additionally. Analysis of the time density diagrams shows the pharmacokinetics of the lesion corresponding to the histological structure classified into 4 types according to Claussen and Lochner. We were able to prove that at a fast scan (15 slices in 3 minutes) the specific pharmacokinetics of a tumour can be determined. Classification in this way is possible in the majority of cases. Pharmacokinetics of tumours are related to histology, but a specific histological diagnosis cannot be made as yet.

Adenoma, Bile Duct↗
PubMed1987

[Is lymphadenectomy in stage I of non-seminomatous testicular cancer still justified?].

Testicular cancer is the tumour of the male genital tract which is most easily and successfully treated today. This very circumstance dictates that for ethical reasons we are more bound than ever to prevent unnecessary diagnostic and therapeutic procedures in these young patients. They should receive only the maximum necessary and not the maximum possible therapy. The difference between these two critical concepts determines the extent of treatment morbidity. Retroperitoneal lymphadenectomy (RLA) is only a diagnostic procedure in approximately 85% of cases. This is the reason for critically reviewing the necessity of this investigation in early non-seminomatous cancer of the testes. The prognostic impact of vascular invasion by the primary tumour is demonstrated in a retrospective study of 86 pathohistological specimens of germ cell tumours. We suggest the inclusion of vascular invasion basically as criterion for any prospective "wait and see" protocol in early non-seminomatous germ cell tumours.

Combined Modality Therapy↗
PubMed1987

Belt device for simplified CT-guided puncture and biopsy: a technical note.

A new radiolucent device for increased accuracy of CT-guided fine-needle punctures permits precise determination of the optimum angle, depth, and position of the fine needle, which can be preset from the data supplied on the CT monitor. Puncture and repeat scans for controlling the tip of the needle can be performed with the patient in a stationary position. The device is designed as a belt that holds a needle holder sheath and a goniometric scale, both of which can be moved to varying positions around the patient.

Biopsy, Needle↗
PubMed1987

Percutaneous nephrostomy--techniques.

Percutaneous nephrolithotripsy has become a widely accepted procedure, that permits the removal of up to 90% of all renal calculi with minimal morbidity and success rates of over 95%. Together with extracorporeal shock wave lithotripsy and the introduction of the ureterorenoscope it has revolutionised the surgical therapy of this clinical entity, and has reduced the need for open surgical interventions to approximately 5% of the numbers required before these methods became available. The success of percutaneous endoscopic surgery depends mainly on the correct position of the percutaneous nephrostomy, which must provide access to all renal calculi via a straight tract, yet should avoid significant trauma to the kidney or perirenal structures. This situation differs from the requirements for simple drainage of obstructed kidneys, as the collecting system of stone bearing kidneys is usually not dilated and the tract has to be adapted to the specific anatomical situation. Special techniques and material have been developed to meet these demands. The purpose of this article is to present our approach, based on percutaneous nephrolithotripsy in 2100 reno-ureteral units. Special reference is given to difficult anatomic situations, which frequently result in failure in inexperienced hands.

Dilatation↗
PubMed1987

[Long-term results using a nonionic contrast medium--a report of clinical experiences].

Between January 1982 and May 1986 more than 50,000 patients were examined radiologically with water-soluble (ionic and nonionic) contrast media at the Department of Radiology Rudolfsstiftung, Vienna. In 1983 only 2.2% of the contrast agents used were nonionic, in 1985 the share had increased to 53.3%. During this period the rate of drug-related side effects (DRSE) decreased from 6.9% (1983) to 3.3% (1985). From 1983 to 1985 DRSE were observed with 1952 patients after administration of ionic agents, whereas after application of nonionic media adverse reactions occurred in only 6 cases, so that DRSE rates of 6.98% respectively 0.07% resulted for ionic respectively nonionic contrast media. These results are discussed with regard to the physicochemical properties und physiological actions of ionic and nonionic contrast agents.

Angiography↗
PubMed1986

[Diagnosis and therapy of supravalvular aortic dissection (type A)--an interdisciplinary challenge].

Acute dissection of the ascending aorta is a life-threatening disease. Successful management requires close teamwork of internal medical specialist, radiologist and cardiovascular surgeon. The diagnostic and therapeutic approach is reviewed on the basis of 18 of our own cases - 15 men and 3 women aged from 42 to 88 years. Peculiarities of history, pain and ECG give valuable clues to the differentiation of aortic dissection from myocardial infarction and massive pulmonary embolism. As a non-invasive rapidly available diagnostic method echocardiography may yield decisive information about the aortic root and the presence of pericardial effusion. Definite confirmation of diagnosis is accomplished by aortography and/or computed tomography. Blood pressure and aortic flow must be decreased to the lowest level tolerated by the patient to prevent pericardial tamponade or rupture into the mediastinum. The urgency of surgical repair is underlined by a median survival time of 12 hours from onset of symptoms to death with conservative treatment. 7 of our patients were operated on. In 6 cases surgery was performed by means of extracorporeal circulation and the ascending aorta was replaced by a graft. 3 patients survived the operation (2 for over 2 years and three died in the postoperative period due to cerebral and pulmonary complications). In one case with inoperable dissection an axillo-femoral bypass was performed for relief of complete ischaemia of the left lower limb. Postoperatively, maintainance of the patient's blood pressure at the low normal level ist mandatory.

Adult↗
PubMed1985

Computed tomography in aortobifemoral Y grafts.

The fact that we have experience in assessing aortic aneurysms and the need for a noninvasive morphologic and hemodynamic method of examination for the follow-up of aortoiliac surgery motivated us to initiate a dynamic CT study of bifurcation prosthesis. Twenty-seven Y grafts (25 Dacron, 2 polytetrafluoroethylene) were studied by CT scan 1 month to 7 years postoperatively. There were normal CT findings in 16 patients, neointima formation in 6, graft occlusion (1 limb of the Y graft) in 3, and dilatation of the prosthesis in 2. Patent grafts showed enhancement of contrast medium. CT scans corresponded to clinical findings in all instances. Because of its noninvasiveness, assessment of perivascular changes, and semiquantitative measurements, dynamic CT may be applied in the follow-up of aortofemoral bifurcation grafts.

Aged↗
PubMed1985

Late sequelae of ultrasonic lithotripsy of renal calculi.

We examined 82 patients 12 to 43 (mean 22) months after renal calculi had been removed by ultrasonic lithotripsy. Recurrence was noted in 2 patients but this correlated to the previous stone-forming rate. Smaller fragments that had remained in 9 patients were passed in 2, removed percutaneously in 2 and unchanged in the remainder. There was no evidence of hypertension or urinary tract infection related to the procedure. There were 62 patients available for computerized tomography and 11 per cent of the kidneys showed minute calcifications not visible on plain films. Barely visible scarring was noted on the fibrous capsule posterior to the lower pole in 22 per cent of the cases and on the abdominal wall along the former nephrostomy tract in 46 per cent. However, a cortical scar was noted in only 1 kidney and no arteriovenous fistulas were found. On dimercapto-succinic acid scans it was impossible to localize the puncture site and serial 131iodine-hippurate renograms available in 18 patients showed a 7.6 plus or minus 2.8 per cent (mean plus or minus standard error of mean) increase in function. We conclude that percutaneous nephrolithotripsy with ultrasound is a safe and effective procedure with minimal late morbidity.

Adolescent↗
PubMed1985

Adrenal cortical carcinoma: preoperative demonstration of right atrial extension by sonography and computerized tomography.

We report a case of adrenal cortical carcinoma with tumor thrombus extending to the right atrium. Tumor extension was demonstrated preoperatively with sonography and computerized tomography. We recommend that both modalities be used when evaluating masses in the suprarenal space. The preoperative diagnosis of tumor extension via the adrenal vein into the inferior vena cava was confirmed at operation.

Adrenal Cortex Neoplasms↗
PubMed1985

[Pre- and postoperative diagnosis of an aortic aneurysm by dynamic computed tomography with omission of angiography].

A study which was prospective with regard to the method, showed 41 cases of aortic aneurysms in a collective of 3597 body-CT-examinations (1.14%). By means of CT and its possibility of reconstruction all morphological details of an aneurysm become visible. The course of the vessels to the bowel and to the kidneys are shown with the same excellence as in angiography. However, additional information which angiography cannot supply, is also given, like non-perfused lumen, changed wall structure and perivascular changes. Measurement of flow can be performed in the vessel and in the organ, the arterial supply of which is involved in aneurysmatic disease. The method is non-invasive. This is important for control after operation. Morphological changes of the vessel prosthesis are detected, as well as bleeding and infection. Functional parameters are determined semiquantitatively.

Adult↗
PubMed1985

[Venous diagnosis using duplex sonography].

Duplex sonography is an excellent alternative in sonographically accessible regions of the venous system if i.v. administration of contrast media for opacification is not possible for technical reasons or because of medical contraindications.

Adult↗
PubMed1979

[Responsibility of the radiologist in gastric studies].

The radiologist's responsibility for the investigation of the stomach. The most successful results in the gastro-intestinal examination is obtained by combination of ray-examination (double contrast method) with gastroendoscopy and biopsy. It is of main importance, that the X-ray examination is performed at the beginning of all diagnostic step. The radiologist is obliged to use the best examination method. Therefore an economic standardized process of diagnosis is recommended which can take place also at the radiologist's consulting room. The high accuracy which can be reached by the recommended proceeding justifies the little additional expenditure of time and material.

Biopsy↗
PubMed1979

[Problems concerning diagnosis and therapy of poorly vascularized malignant kidney tumors (author's transl)].

Clear directives for the indication of diagnostic and therapeutic procedures have as yet not been formulated. We postulate a solution using poorly vascularized and avascular tumors of the kidney verified by x-ray studies and surgical exploration. An attempt was made to achieve an exact diagnosis of poorly vascularized space occupying processes of the kidney (the available figures range from 3--10% among kidney tumors) using optimal economical standardized test methods. We suggest that the time between the first diagnosis and the surgical exploration be kept as short as medically responsible.

Aged↗