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Biomedical subjects

B Wimmer

Publications and source records attributed to B Wimmer.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Preoperative tumor staging in rectal cancer--a prospective study].

A precise preoperative tumor staging is the prerequisite of distinct treatment planning and subtle operative regimen. Diagnostic contribution of the various examination techniques especially of imaging modalities were determined in a prospective study and correlated to intra- and postoperative findings. The TNM classification of malignant tumors of the UICC, both in its present valid and the modified form to be introduced in January 1987, formed the basis of our clinical diagnostic staging. Diagnostic accuracy in tumor staging increased significantly from 63.4% to 83.9%, if digital rectal examination, rectoscopy and barium enema were accompanied by computed tomography. Staging prediction solely concerning the surgically important differentiation between tumors "organ limited" (T1/T2 stage) and "organ extended" (T3/T4 stage) achieved an accuracy of 91/4 (97.0%).

Adult↗
PubMed1986

[Diagnostic imaging potentialities of nuclear resonance tomography. Changes in vertebrae, ligaments and intervertebral disks in comparison with computed tomography].

This is a study of 49 patients with lesions of the spine excluding primary tumors of the spinal cord. All patients were examined by computed tomography and magnetic resonance imaging. Comparing both methods we observed slight diagnostic advantages for magnetic resonance imaging in inflammatory and neoplastic disease. Especially for evaluation of the spinal cord and subarachnoid space MR-imaging is far superior to computed tomography.

Adult↗
PubMed1985

[Value of computer tomography for evaluation of local operability and choice of surgical procedure in esophageal cancer].

The correlation of the preoperative staging by CT with the post-operative or postmortem staging was investigated in 74 patients with esophageal carcinoma. Criteria for the evaluation of local resectability were analyzed prospectively. According to TNM-classification, the pre- and post-operative staging showed identical results in T1 in 3/4, in T2 in 17/26 and in T3 in 42/44 patients. Thus, the preoperative staging turned out to be correct in 62/74 cases (83.7%). By conventional diagnostic methods identical results of pre- and postoperative staging were found in 28/74 patients (37.8%). The local resectability can be judged by the sagittal infiltration area and especially by the vertical extent of tumor infiltration of the aorta and/or trachea. Esophageal resection was not possible, if infiltration had been suspected in more than 4 tomograms (8 mm-CT-sections). Only palliative resection could be performed in cases with a 3 tomogram infiltration. A suspected infiltration up to 2 tomograms did not exclude a blind dissection of the esophagus without thoracotomy. The impression of the trachea with an irregular borderline of the lumen or tumor growth surrounding the trachea are additional infiltration signs in the CT. By the differentiated interpretation of local tumor growth the CT reached a central position planning surgical strategy.

Adult↗
PubMed1985

[Aneurysms of the abdominal aorta: possibilities and limits of sonography].

Sonography has proved successful as an excellent method to diagnose an aneurysm of the abdominal aorta with an accuracy of 98%. Diameter of the aneurysm can be determined via sonography with the same exactitude as with CT. The difficulties arising with sonography concern the exact determination of longitudinal spread. If an aneurysm starts on the level of the hilus of the kidney, the information supplied by sonography on an involvement of the renal arteries is not sufficiently safe, whereas the distal end of the aneurysm can often be determined correctly. The angiogram remains indispensable for assessing adjacent vascular regions in asymptomatic aneurysms. Sonography allows good identification of perforated and penetrating aneurysms. This fact emphasises the value of this method also in acute diagnostics.

Aortic Dissection↗
PubMed1985

[Diagnostic value of computed tomography in stomach cancer].

60 patients with gastric cancer were checked by computed tomography; 57 underwent surgery. Small tumors could not be demonstrated reliably. Double contrast studies and gastroscopy remain the leading diagnostic procedures. In advanced cases computed tomography informs the surgeon about extragastric tumor expansion and the existence and location of metastatic disease. Nearly all carcinomas with a diameter of more than 2 cm in computed tomography proved to be stage T4 (UICC). In selected cases diagnostic laparotomy could be avoided. Because of the lack of therapeutic alternatives the influence of computed tomography on the regimen is limited. Therefore CT-studies are not absolutely necessary in gastric cancer, but can be very helpful in selected cases.

Adult↗
PubMed1985

[The cutting biopsy cannula for histological diagnosis of abdominal and retroperitoneal masses. Sonographic or computed tomographic guided puncture?].

A new cutting biopsy needle has been used to obtain histologically useful material while causing the minimum of trauma. It permits biopsies of organs, but its small external diameter of 0.8 or 0.95 mm makes it possible to carry out transperitoneal puncture of the stomach, colon or liver and of the retroperitoneal space, using a ventral approach. Tissue samples were obtained in 96% of 63 patients. The risk of complications is no higher than for conventional needles used for cytology. The accuracy with which the material can be obtained is therefore the most important problem. The position of the area to be biopsied should determine whether the biopsy is to be aided by sonography or CT. Biopsies of organs can be appropriately carried out under ultrasound control, but processes in the pelvis and in retroperitoneal-paravertebral and extra-peritoneal positions are best biopsied under CT control.

Abdominal Neoplasms↗
PubMed1985

[Computed tomography in esophageal carcinoma. A prospective study].

In a prospective study, 83 patients with esophageal carcinoma were examined by computed tomography. The CT data were compared with intraoperative, postmortem and microscopical findings in 74 patients. The T stage as determined by computed tomography was confirmed by surgery or autopsy in 88% of the cases and by microscopical examination in 82%. Infiltration of surrounding structures could be proved with a sensitivity of 87%, a specificity of 91% and an accuracy of 89%. Suspected lymph nodes were detected by computed tomography in 68% of the patients with lymph node metastases. Computed tomography enabled additional information on localisation, length and diameter of the tumors and the existence of metastases in the liver, lung and pleura. Due to the very good correlation between pre- and postoperative staging, computed tomography gives important information on local tumor resectability. In this manner, operations and therapeutic strategy can be planned with greater accuracy, and diagnostic thoracotomy can be reduced to a minimum.

Adenocarcinoma↗
PubMed1985

[Temporary preoperative balloon catheter blockage of a traumatic giant aneurysm and of an a.v. fistula of the vertebral artery].

A new method of embolisation with a dilatation catheter is described as an example in a case with traumatic aneurysm and an a.v. fistula of the vertebral artery. The lesion was temporarily occluded with a conventional catheter for angioplasty and operated upon. The method is available for e.g. rapid management in case of imminent rupture of traumatic aneurysms, multiple lesions of vessels and for operative reconstruction of traumatised arteries.

Accidents, Home↗
PubMed1985

[Hernias in the computed tomogram of the abdomen].

Asymptomatic hernias may be accidental findings in abdominal computed tomography. The characteristic features in our own 47 own cases, and the results of other authors, are discussed. Suspected diaphragmatic hernias, with the exception of hernias, are a special indication for CT. The method may also be useful for the detection of rare abdominal and pelvic wall herniations.

Cicatrix↗
PubMed1985

Histological diagnosis of liver hemangiomas using ultrasound-guided fine needle biopsy.

Hemangiomas of the liver are a common fortuitous finding during ultrasonographic studies of the liver. Although they often present a characteristic ultrasonographic pattern, it is not always possible to exclude malignant disease. Diagnostic difficulties may arise when known malignant disease is present. Computed tomography and angiography do not exclude misinterpretations. In nine patients, six of whom had known malignant disease, liver tumors were detected at ultrasonography. Using a new type of fine needle and ultrasonographic control, biopsy provided the histological diagnosis of hemangioma in all cases. Complications were not observed.

Adult↗
PubMed1985

[Preoperative use of computed tomography for foreign bodies].

Computed tomography, with the possibility of density determination, makes possible the detection of foreign bodies that are not visible when using conventional techniques. The possibilities of localization are improved by the fact that tomograms are free of shadows and that distances can be measured exactly. These advantages provide important information in those cases in which surgical operation is planned.

Adult↗
PubMed1985

Computed tomographic findings in myogenic gastric tumors.

Computed tomographic findings in leiomyoma, leiomyosarcoma and benign leiomyoblastoma of the stomach are discussed. Gastroscopic biopsy was unsuccessful in every case, but CT was able to show the extragastric extension in all tumors. In one case, gastric leiomyoma and renal hypernephroma occurred simultaneously. Both tumors showed similar contrast medium enhancement, leading to a misdiagnosis.

Aged↗
PubMed1985

[Capillary embolization of a hemorrhaging kidney tumor. An unusual case report].

Experimental results of embolization of normal organs did not clarify the value of transcatheter vessel occlusion in the treatment of renal carcinoma. In experimental embolization of chemically induced renal rat tumors the concept of capillary embolization was developed and showed excellent results even in end-stage tumors. In consequence this concept was adapted and transferred to clinical tumor embolization. Of 30 patients, that have been embolized up to now using Ethibloc in combination with 40% glucose as occlusion medium, one case is reported herein with a very favourable outcome. The female patient had intensive venous infiltration of a renal carcinoma accompanied by severe hematuria (T3NxM0V2). Because a patient that seems to be practically cured 30 months after embolization demonstrating massive tumor shrinkage to less than 10% of the original size in CT-controls the use of transcatheter vessel occlusion should again be investigated in association with surgical alternatives.

Capillaries↗