Diagnosis of aortic dissection by transesophageal echocardiography.
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Aged↗
Biomedical subjects
B Braun
Publications and source records attributed to B Braun.
[Sonographic course control of chemotherapy in inoperable pancreatic cancer].
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Aged↗
Significance of the inner-surface structure of small-caliber prosthetic blood vessels in relation to the development, presence, and fate of a neo-intima. A morphological evaluation.
Microvascular prostheses with three different inner surface structures were examined morphologically 1-18 months after implantation to evaluate the presence and structure of the neo-intima. Fibrous polyurethane tubes (length: 5-10 mm, inner diameter: 1.5 mm) were implanted in the rat abdominal aorta in group A with a fibrillar inner structure (pore sizes 20-50 microns), and in group B the inner fibrillar structure was coated with an impermeable continuous silicon sheet. Expanded polytetrafluorethylene vascular prostheses (length: 40 mm, inner diameter: 4 mm) were implanted in the dog carotid artery (group C). The specimens were examined by light microscopy and scanning electron microscopy. A continuous and permanent neointima was only found in the prostheses with the porous fibrillar inner structure (group A). The thin new lining sheet was well attached to the prosthetic wall by cellular protrusions. In the silicon-coated prostheses (group B) also a continuous neo-intima had developed which, however, was irregular, thicker, and not anchored to the prosthetic wall. The expanded polytetrafluorethylene prostheses (group C) showed also after 1 year only incomplete lining with a neo-intima. Fresh blood cell deposits could be observed in the unlined prosthetic wall. It is concluded that a continuous lining of vascular grafts with a thin neo-intima is only achieved if the cells invading the prostheses from the anastomotic areas can anchor their cytoplasmic protrusions onto an appropriately structured inner surface. If these anchoring facilities are not provided, the unattached neo-intima will thicken, interfering with the patency of these microvascular prostheses, or fragments of the neo-intima or alternatively mural thrombi may constantly strip off and embolize.
Animals↗
Patency and neo-intima development in 10 cm-long microvascular polyurethane prostheses implanted into the rat aorta.
Microvascular fibrous polyurethane prostheses (inner diameter 1.5 mm, length 10 cm) were implanted in the abdominal aorta of rats. The prostheses were fixed in a loop. All rats (n = 37) were reoperated 6 weeks after implantation to verify the patency of the prostheses. Eight prostheses were obliterated from various causes. The remaining 29 prostheses were found to be patent 3 months after implantation, which gives a patency rate of 79%. Six weeks and 3 months after implantation 7 and 4 rats, respectively, with patent prostheses were sacrificed. The remaining 18 rats of this study are still alive, more than 4 months after implantation, and will be included in long-term observation studies. The prostheses were examined using both light and scanning electron microscopy. The patent prostheses exhibited macroscopically a clear and transparent inner surface. No obliterative processes could be found either macroscopically or microscopically. Neo-intima ingrowth had advanced +/- 10 mm into the prostheses over the anastomotic line from both ends 3 months after implantation, and was continued by a single endothelium layer for several centimeters. An acellular, stable fibrin film was found inbetween the cellular lining. The neo-intima was anchored at the prosthesis by cellular protrusions extending between the polyurethane fibers. Though 10 cm long prostheses were implanted under unfavorable hemodynamic conditions, a patency rate of 79% was achieved, both 6 weeks and 3 months after implantation. This patency rate could have been higher if evident technical failures had been avoided.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
[Diagnosis of cavernomatous transformation of the portal vein].
In 10 patients at the age of 17 to 59 years the diagnosis of a cavernomatous transformation of the portal vein primarily was made by sonography and was confirmed by computer tomography and angiography, respectively. These findings were seen by chance when an abdominal ultrasound was performed in order to clarify splenomegaly or esophageal varices. The characteristics of the disease are the positive proof of a convoluted agglomeration of racemose venous structures that have replaced the normal single portal vein and signs of portal hypertension. The sonographic figures are so typical that ultrasound is the decisive procedure in its diagnosis and that direct or indirect splenoportography is not necessary. The present results show that clinical manifestations of cavernomatous transformation of the portal vein are delayed sometimes in to adolescence and that invasive diagnostic methods are only necessary when shunt operation is planned.
Adolescent↗
[Sonographic findings in analgesic nephropathy].
Demonstration of circular papillary calcifications in renal sonography, frequently combined with urinary retention and reduction of kidney size, can be used as evidence of analgesic nephropathy. This previously not described sonomorphologic pattern was observed in 8 out of 10 patients on dialysis treatment with previously known abuse of analgesics and in 5 out of 8 patients with compensated reduction of renal function and established abuse of analgesics. In addition, this sonographic pattern was also reported in 6 patients with increased serum creatinine concentration of unknown origin. This resulted in detection of a previously unknown abuse of analgesics.
Analgesics↗
[Sonographic diagnosis of Budd-Chiari syndrome].
In a 28-year-old female patient a diagnosis of Budd-Chiari syndrome was established post partum on the basis of characteristic ultrasonographic findings. The results permit establishment of the syndrome in the early phase of the disease. Early diagnosis of hepatic vein occlusion is particularly important because directed therapeutic regimes may lead to revascularisation of hepatic veins and may thus prevent liver cell necrosis and subsequent hepatic failure.
Adult↗
[CEA determination to differentiate between pheochromocytoma with ectopic calcitonin formation and type-II multiple endocrine neoplasms].
Plasma levels of calcitonin and carcinoembryonic antigen (CEA) were determined pre-operatively and two months postoperatively in ten patients with C-cell carcinoma as part of multiple endocrine neoplasia type II. In addition, CEA was measured in extracts from 20 different phaeochromocytomas (five from patients with multiple endocrine neoplasia type II, 15 from patients with sporadic phaeochromocytoma). In comparison, CEA concentration was determined in extracts from five C-cell carcinomas of patients with multiple endocrine neoplasia type II. When correlating pre- and postoperative calcitonin and CEA levels, there was a significant linear relationship (P less than 0.001). CEA concentration in extracts from phaeochromocytomas was at the lower level of sensitivity (4.7 +/- 12.2 pg/mg tumour wet-weight). In extracts from C-cell carcinomas they were much higher (6402 +/- 4570 pg/mg tumour wet-weight). The results suggest that it is possible, in patients with phaeochromocytoma and high calcitonin levels, to differentiate by additional CEA determination between C-cell carcinoma in the course of multiple endocrine neoplasia type II and sporadic phaeochromocytoma with ectopic calcitonin liberation.
Adrenal Gland Neoplasms↗
[Calcifying liver metastases].
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Calcinosis↗
Evaluation of the patency rate of fibrous microvascular polyurethane prostheses after implantation in the rat aorta.
Two types of fibrous polyurethane prostheses with different compliances were implanted into the rat aorta with interrupted sutures and a running suture line. Excluding two technical failures, one unexplained death, and three infected prostheses, both groups (n = 21) showed a patency rate of 100%, up to 6 months after implantation. Rapid reendothelialisation occurred, and a stable neo-intima was formed. Compliance of the prostheses, as well as the suture technique used, has proven to be an unimportant factor in the rat aorta model, probably due to the low magnitude of the pulsations of the rat aorta. The experience of the surgeon with microsurgical techniques seems to be an underestimated factor in determining patency rates of microvascular prostheses.
Animals↗
Ultrasonic findings in analgesic nephropathy.
Thirty-four patients with analgesic nephropathy (AN) were investigated by realtime ultrasonography. In 11 of 14 dialysis patients and in 16 of 20 patients with renal insufficiency calcified renal papillae were documented surrounding the internal echo in a typical garland pattern. Incomplete garland pattern of papillary calcifications or development of hydronephrosis occurred in patients with a history of renal colic due to detachment of necrotic papillae. Moreover, AN was assumed in 10 patients with renal insufficiency of unknown origin after detection of typical ultrasonic signs of AN and confirmed by a hitherto unknown history of analgesic abuse.
Humans↗
Diagnosis and therapy of liver abscess by ultrasonographic imaging, puncture and drainage.
Liver abscesses in 19 patients were primarily diagnosed by real-time ultrasound. Characteristic features and changes in the course of disease are described. Fine needle puncture under ultrasonographic guidance confirmed the diagnosis and permitted bacteriologic examination. Ultrasonographically guided abscess drainage dramatically improved the clinical condition, and can be recommended as an alternative to surgical drainage.
Drainage↗
Changes in gallbladder motor function during the female cycle--a risk factor leading to gallstone formation?
The gallbladder volume of eight women with stable cycles was determined by sonography. Furthermore, gallbladder contraction--following an orally administered fatty meal and the spontaneous refilling of the empty gallbladder--was quantitatively examined. The formula of a rotation ellipsoid, which has been proven to be adequately accurate in in vitro studies, was used for calculating the gallbladder volume. In the gestagen phase (21st or 22nd day) the intraindividual studies showed greater fasting volumes, higher residual volumes after contraction, slower gallbladder emptying, and retarded refilling of the empty gallbladder as compared to the estrogen phase (12th or 13th day). The hormonally modified contraction behavior and the differing course of gallbladder filling may play a major role in the pathogenesis of gallstone formation.
Cholelithiasis↗
[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↗
[The influence of sonography and computer tomography on the operative treatment of acute pancreatitis (author's transl)].
Adequate stage-depending therapy of acute pancreatitis includes basic conservative treatment, intensive care measurements, and operative interventions depending on the grade of severity. Prerequisites are early diagnosis and accurate clinical assessment of the stage of severity. Beside clinical and laboratory findings, as well as the development of acute pancreatitis under conservative treatment, sonography and computed tomography allow a better prediction of the underlying morphological changes, thus leading to an exact staging of the patient's individual situation. Sonography is regarded a screening procedure of high accuracy in mild forms of acute pancreatitis. Computed tomography is the method of choice in all severe forms of this disease. The indication for immediate or delayed operative treatment of hemorrhagic-necrotising pancreatitis, heretofore depending on clinical findings solely, is supported by these new-invasive diagnostic modalities.
Acute Disease↗
Sucrose polyester and covert caloric dilution.
Total daily caloric intake was measured in 10 obese subjects when sucrose polyester (SPE), a nonabsorbable synthetic fat, covertly replaced conventional fats in a single crossover study consisting of three periods: a period of 7 to 14 days to determine baseline caloric intake and two 20-day study periods. An average of 60 g SPE/day replaced conventional fat in one of the two study periods. During both study periods, 60% of the base line caloric intake was "required intake" at mealtime; an additional 60% of base line caloric intake was allowed as "free choice" foods at a specified snacktime. It was thus possible during both study periods to consume more than 100% of the base line caloric intake. In the SPE study period, 40 g SPE replaced 40 g conventional fat for every 1200 kcal of required intake, resulting in a 30% reduction in mealtime caloric intake. Mean total caloric intake (meal and snack) fell 23% during the SPE period (p less than 0.05), despite an average daily weight loss of 0.18 kg. Snack caloric intake did not increase significantly to compensate for caloric dilution of the meals during the SPE period. These results indicate that the obese may not detect or may not compensate for covert dilution of fat calories with SPE. In addition, during the SPE period, there was a 10% reduction in total plasma cholesterol, a 14% reduction in low-density lipoprotein cholesterol, and a 10% reduction in triglyceride concentration. Thus, fat replacement with SPE may benefit weight reduction regimens in obese subjects by facilitating decreased caloric intake and by improving the circulating lipoprotein profile as well.
Adult↗
Aneurysm of the superior mesenteric vein.
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Aneurysm↗
[Possibilities and limits of ultrasonography in gastrointestinal diseases (author's transl)].
Sonography has become a widely accepted method for noninvasive imaging of abdominal viscera. This report demonstrates the value of ultrasonography in comparison with other methods in diagnosing gastrointestinal diseases. The sonographic demonstration of an abdominal tumor by ultrasound enables to get informations about the extent, and in connection with sonographically guided fine needle aspiration biopsy about the malignancy of the tumor. In cases of clinically suspected gallstones, biliary obstruction or pancreatic pseudocysts sonography allows the definitive diagnosis and determines the further therapeutical proceeding. In the differential diagnosis of cholestasis ultrasonography should be the initial technique. The differentiation between obstructive and "internal" jaundice can be achieved in most cases, through the cause can not be obtained in all cases. The sonographic findings, however, reduce the differential diagnostic possibilities so that further diagnostics can be abbreviated and coordinated in the right and the patient considerate way. In many clinical situations sonography has to be interpreted in connection with clinical and biochemical findings and the results of other investigations.
Biliary Tract Diseases↗