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Biomedical subjects

B Wimmer

Publications and source records attributed to B Wimmer.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Diagnosis and treatment of intra-abdominal abscesses].

Intraabdominal abscesses are life threatening complications of inflammatory processes or major surgery. Ultrasonography, computed tomography and scintigraphy are the diagnostic methods of choice. Diagnostic percutaneous puncture can be followed by therapeutic percutaneous drainage (PD). The diagnosis "intraabdominal abscess", however, is not sufficient for a rational therapeutic strategy. Therapy of intraabdominal abscesses (IAA) depends upon etiology and localization of the process and the individual situation of the patient.

Abdomen↗
PubMed1990

[The use of osteosynthesis screws in child mandibles. Anatomical and mechanical considerations].

Thirty seven child mandibular skeletons were analysed radiographically and computer tomographically to establish if there is enough room for osteosynthesis screws. The study demonstrated that in the primary and early mixed dentition there is not enough room in the canine or post-canine region to allow the installation of an osteosynthesis screw without damaging the inferior dental nerve or teeth buds. However, in the later stage of permanent tooth eruption the entire caudal portion of the mandibular body seems to provide sufficient room for osteosynthesis screws. SEM examinations of implant beds of 100 2 mm AO miniscrews inserted into the mandibles of eight fresh cadavers aged eight to twelve years showed cracks, as well as signs of squashing, crushing and shearing stress, regardless of whether the screws were pretapped or not. When, during screw insertion, the axis of the screw deviated by at least 10 degrees from the axis of the tap, two crossing thread courses resulted.

Bone Screws↗
PubMed1990

[Computed tomographic-guided fine-needle biopsy of the pancreas for histology determination].

Computed tomography-guided fine-needle biopsies of the pancreas were performed in 54 patients. In 46/54 biopsies, the material obtained permitted a histological diagnosis despite the small external needle diameter of only 0.95 mm. The only complication was due to laceration of an artery of the transverse mesocolon. The prevalence of malignant tumors was 67%. Adenocarcinoma was diagnosed in more than 80% of all biopsies; rare findings were malignant carcinoid or centroblastic lymphoma. Benign tumors included mucinous adenocystoma and serous microcystic adenoma. Within the group of patients where pathologic-anatomic evaluation was possible, the sensitivity of fine-needle biopsy for malignant tumors was 87% and the specificity 100%. A positive needle biopsy diagnosis for a malignant tumor reduces the number of exploratory laparotomies needed and is helpful in the planning of surgery.

Adenocarcinoma, Mucinous↗
PubMed1990

[Computed tomography of the wrist].

CT is a diagnostic tool that allows imaging of the wrist, wrist joint and distal radioulnar joint in the axial plane without superimposition. The differentiation of bone, joint space and soft tissue is possible in a single examination. This is helpful in the diagnosis of traumatic, degenerative or malignant lesions of bones together with the soft tissue reactions. Further information can be obtained by means of three-dimensional reconstructions.

Adult↗
PubMed1989

Computed tomography-osteoabsorptiometry for assessing the density distribution of subchondral bone as a measure of long-term mechanical adaptation in individual joints.

To estimate subchondral mineralisation patterns which represent the long-term loading history of individual joints, a method has been developed employing computed tomography (CT) which permits repeated examination of living joints. The method was tested on 5 knee, 3 sacroiliac, 3 ankle and 5 shoulder joints and then investigated with X-ray densitometry. A CT absorptiometric presentation and maps of the area distribution of the subchondral bone density areas were derived using an image analyser. Comparison of the results from both X-ray densitometry and CT-absorptiometry revealed almost identical pictures of distribution of the subchondral bone density. The method may be used to examine subchondral mineralisation as a measure of the mechanical adaptability of joints in the living subject.

Absorptiometry, Photon↗
PubMed1989

[Preoperative staging of rectal cancer: endosonography versus computerized tomography].

In a prospective study in 49 patients with rectal carcinoma the correlation of pre- and post-operative staging by CT and endorectal ultrasound (EU) was compared according to TNM-classification. With CT the pre/postoperative results correlated in T1 in 9/10, in T2 in 10/16, in T3 in 13/15 and in T4 in 6/8 patients. By EU identical results were found in all T1, in 10/12 T2, in 17/20 T3 and in 6/7 T4 stages. Overall, pre- and postoperative identical results were found by CT in 38 and by EU in 43/49 patients. Overestimation of the tumor stage was similar with both methods: 5 by CT and 4 by EU. Underestimation of the stage was more often by CT in 5 than by EU in 2 cases. (CT: accuracy 77.5%, sensitivity 88.3%, specificity 94.4%; ES: accuracy 87.7% sensitivity 91.5%, specificity 97.8%). Criteria for interpretation are discussed. In early tumor stages the depth of tumor invasion can be better evaluated by EU. In late stages both methods give important information for surgical strategy.

Adenocarcinoma↗
PubMed1989

Detection of biliary origin of acute pancreatitis. Comparison of laboratory tests, ultrasound, computed tomography, and ERCP.

Fifty consecutive patients with acute pancreatitis were assessed with respect to a biliary origin of the disease. Endoscopic retrograde cholangiopancreaticography, surgery, and autopsy were used to define biliary pancreatitis. Ultrasound, computed tomography, and several laboratory tests (SGOT, SGPT, alkaline phosphatase, and bilirubin) were analyzed for their ability to detect a biliary origin of the disease. Ultrasound and computed tomography could not reliably make the diagnosis in the 10 patients found to have biliary disease. Receiver-operator-characteristic curves revealed that none of the laboratory tests assessed had sufficient sensitivity and specificity to determine the diagnosis, although all tests showed higher mean values in biliary pancreatitis. SGPT gave the best discrimination (positive predictive value 53%, negative predictive value 94%, cut off 40 units/liter). Therefore, initial ERCP is suggested for a reliable diagnosis of biliary origin of acute pancreatitis.

Acute Disease↗
PubMed1989

[Sonography in acute pancreatitis--diagnosis, assessment of etiology and evaluating prognosis].

Fifty consecutive patients suffering from acute pancreatitis were studied prospectively with regard to the role of ultrasound (US) in diagnosis, in detection of a biliary origin, and in initial assessment of prognosis. In six patients the pancreas could not be visualised, whereas in 19 only partial examination was possible. In 34% no diagnostic abnormalities were found. US was superior to computed tomography (CT) in respect to the detection of small amounts of ascites, but less suitable than CT for the detection of necrosis. Compared to endoscopic retrograde cholangiography US was of little help in detecting bile duct stones. Neither a lethal outcome nor a severe course could be predicted with sufficient accuracy. The positive predictive value for the presence of necrosis was 33% and the negative predictive value 67%. The data demonstrate a limited role of US in diagnosis and staging in acute pancreatitis.

Acute Disease↗
PubMed1989

[Pseudolymphoma of the stomach].

Gastric pseudolymphoma is an uncommon benign lesion which poses a difficult problem in diagnosis and management. Lymphoid hyperplasia of the stomach, however, may occasionally precede true gastric lymphoma. Endoscopic, radiologic and pathological findings are not generally helpful in establishing the diagnosis preoperatively. Benign gastric lymphoid hyperplasia could be mistaken radiologically for ulcerated gastric carcinoma and pathologically for malignant lymphoma. Recognition of this condition is important to prevent unnecessary treatment by surgery or radiotherapy. About 140 case reports have been published to date. This paper describes the cases of two further patients.

Female↗
PubMed1989

[The anatomy of the pterygopalatine fossa in CT].

The pterygopalatine fossa represents a central space in the depth of the facial skull. Acting as a mediator between neighbouring compartments it is traversed by numerous neurovascular structures. High resolution CT is possible not only to depict all those canals and openings but also the soft tissue contents of the fossa itself can be visualised by CT. This paper presents the radioanatomic prerequisites for assessment of the pterygopalatine fossa that may be affected by a variety of pathologic conditions.

Contrast Media↗
PubMed1989

[Traction injuries of the brachial plexus: radiologic diagnosis using myelo-CT and MR].

The exact radiographic localisation of supraganglionic lesions of the brachial plexus provides important information for the prognosis and clinical management of these injuries. The authors report on the results of enhanced CT scanning and MRI of the cervical spine in five patients with surgically proven root avulsions caused by traction injuries. All lesions were correctly diagnosed by enhanced CT scanning. MRI, by comparison, identified only about 70% of the neural lesions.

Adult↗
PubMed1989

[Rare kidney tumors].

During the period from 1976 to 1986, a total of 518 kidney tumor patients were treated in the Department of Urology at the University of Freiburg, West Germany. In 34 cases (6.6%) the examination revealed a tumor that was neither a renal cell carcinoma nor a renal pelvic urothelial carcinoma (i.e., a rare renal tumor). Through diagnostic imaging procedures the presence of a tumor was correctly diagnosed in 97% of these 34 cases. Conservative treatment methods were used with 5 patients (4 with renal angiomyolipoma and 1 with hemangioma) whose conditions were clearly diagnosed. In these patients operative therapy was not indicated. The precise histological diagnosis found in 29 patients subjected to surgery was the same as the preoperative diagnosis in only 8 cases (27.6%). Histologically, 20 benign (4 epithelial, 16 mesenchymal) and 9 malignant (3 epithelial, 3 mesenchymal, 3 mixed) tumors were found. The operative methods for rare kidney tumors are the same as those used for the more common kidney tumors. Only in the presence of tumors that are clearly benign, such as angioma or angiomyolipoma, is a wait and see policy with frequent examinations recommended.

Angiography↗
PubMed1989

[The value of transrectal sonography and computerized tomography in the diagnosis of rectal cancer].

In a prospective study in 49 patients with rectal carcinoma the correlation of pre- and postoperative staging by CT and endorectal ultrasound was proven according to TNM-classification. With CT the pre/postoperative results correlated in T1 in 9/10, in T2 in 10/16, in T3 in 13/15 and in T4 in 6/8 patients. By endorectal ultrasound identical results were found in all T1, in 10/12 T2, in 17/20 T3 and in 6/7 T4 stages. Totally, pre- and postoperative identical results were found by CT in 38 and by endorectal ultrasound in 43/49 patients. Overestimation of the tumor stage was similar with both methods: 5 by CT and 4 by endorectal ultrasound. Underestimation of the stage was more often by CT with 5 than by endorectal ultrasound with 2 cases (CT: accuracy 77.5%, sensitivity 88.3%, specificity 94.4%; endorectal ultrasound: accuracy 87.7%, sensitivity 91.5%, specificity 97.8%). Criteria for interpretation are discussed. In early tumor stages the depth of tumor invasion can be better evaluated by endorectal ultrasound. In late stages both methods give important information for the surgical strategy.

Adult↗
PubMed1989

[Current diagnosis of dissecting aortic aneurysm].

The prerequisites for proper treatment of a dissecting aneurysm are for the diagnosis to be established quickly and for the location and extent to be identified precisely. For this purpose, various partially complementary methods of examination in addition to the history and clinical findings are at our disposal: plain chest roentgenography, abdominal sonography, transthoracic and transesophageal echocardiography, computed tomography, magnetic resonance imaging and angiography. Thirty-one of our patients have been studied to assess the reliability of the different methods. The advantages, diagnostic criteria and limitations of the methods are discussed.

Adult↗
PubMed1989

[Non-Hodgkin's lymphoma of the descending colon in a 6-year-old girl].

The most common site of non-Hodgkin lymphoma of the intestinal tract in children is the terminal ileum and the ileocecal region; boys are 5- to 10 times more frequently affected than girls, peak incidence is between 5 and 8 years of age. We present a 6-year-old girl with non-Hodgkin lymphoma of the descending colon.

Burkitt Lymphoma↗
PubMed1989

[Computed tomography of complications of cholecystitis].

In cases of acute cholecystitis, especially with cholecystolithiasis, the diagnosis is usually quickly made. In contrast, the symptoms in the presence of such complications as penetration, perforation and local abscess are often unspecific, and diagnostic procedures may be time-consuming, extending into weeks. One reason for this is the rareness of the entity. The same is true for emphysematous cholecystitis, although this presents with more acute symptoms. Computed tomography seems to be the most effective imaging method. Therefore, it should be used in cases of nonspecific problems in the upper abdomen.

Adult↗