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Biomedical subjects

D Kühne

Publications and source records attributed to D Kühne.

At least 73 records · Page 4Linked to original sources
PubMed1982

Embolization with "Ethibloc" of vascular tumors and arteriovenous malformations in the head and neck.

"Ethibloc" has been used almost exclusively until now for embolization of tumors and bleeding vessels in the liver and kidney. Unlike with Gelfoam-particles, there is no recanalization. The resorption occurs so slowly that there is no interference with the necrosis of the embolized tumor. Due to its low viscosity, it passes catheters with thin lumina and fills the capillary bed of the tumor without danger danger of reaching the venous vessels. In this paper we describe a new technic of percutaneous catheter-embolization with Ethibloc using a coaxial catheter which we believe enhances safety and effectiveness. It has been successfully used in five patients. In the meantime two more patients have been treated successfully.

Adult↗
PubMed1982

[Computer tomography in malformations, inflammatory and degenerative changes in the spine].

Technical improvements and the use of intrathecal Metrizamide have made computer tomography of the spine a valuable diagnostic method. The value of CT in demonstrating morphological changes in the spine was investigated in 77 examinations of congenital malformation or inflammatory and degenerative disease. Measurements of the spinal canal provide more accurate information than conventional radiology and these are discussed. Intradural injection of contrast medium makes it possible to diagnose abnormalities of the cord by means of CT. Inflammatory changes in the spine and in the paraspinal soft tissues are shown at an early stage. A diagnosis of tumour can be confirmed by CT-controlled needle biopsy. It is usually possible to demonstrate disc prolapse without the use of contrast medium. On the other hand, the investigation of pain following disc operations remains a difficult problem.

Abscess↗
PubMed1982

[Advantages of linear tomography in plain roentgenography of small intrasellar space-occupying processes (author's transl)].

Diagnosis of small intrasellar space-occupying processes, known as microadenomas, requires a subtle study of the structural conditions of the floor and anterior wall of the sella. The intended aim cannot be achieved by means of processes of measurement technology. Linear tomography, nowadays hardly used in the skull region, has been found useful for diagnosis. If the region under investigation is placed at right angles to the scanning plane, the thicker image supplied by the linear tomogram supplies better information on the extent of the changes. The advantages of this tomographic technique, which is employed as an assisting measure, are demonstrated by means of several representative cases.

Adenoma↗
PubMed1981

Contrast bolus technique with rapid CT scanning. A reliable diagnostic tool for the determination of brain death.

Twenty-three patients complying with the clinical criteria for brain death were studied by contrast-enhanced CT. In all but one, the great intracranial vessels escaped visualization; accordingly, angiography demonstrated cerebral circulatory arrest. In the remaining case, faint enhancement of the circle of Willis corresponded to angiographic demonstration of the proximal segments of cerebral arteries. Neither in normal brain nor in dead brain did slow CT scanning disclose any postcontrast increase in parenchymal attenuation. An improved technique is proposed to demonstrate the transit of the contrast bolus by rapid CT with image splitting. If cerebral blood flow is preserved, the grey and white matter will enhance significantly following administration of contrast medium. Vice versa, the absence of enhancement confirms brain death, even in instances in which the great cerebral vessels are obscured by hemorrhage or other extensive lesions. Two additional cases of brain death were evaluated by rapid CT scanning. As to brain death, the technique obviates the need for angiography or radionuclide angiography, usually applied in prospective organ donors, because its informative content is superior to that of either method. The CT technique described affords a reliable and safe diagnosis of brain death, and can be interpreted easily.

Brain↗
PubMed1981

An improved balloon catheter technique for the occlusion of carotid-cavernous sinus fistulas (CCF).

By means of a case report a shortcoming of balloon catheter techniques for intravascular occlusion of CCF is demonstrated: the procedure by which the balloon is detached from the filling catheter is unreliable and may further traumatise the vessel wall. We describe a new technique that allows careful, gentle, and effortless detachment of the balloon by means of a melting-off technic.

Adolescent↗
PubMed1981

Neuronal ceroidlipofuscinosis: CCT findings in fourteen patients.

CCT was performed in 14 children/adolescents with juvenile ceroid lipofuscinosis (JNCL) at different stages of the disease. CCT was normal in 7 patients; mildly abnormal in 3, clearly abnormal in another 3 and severely abnormal in 1 patient. Characteristic findings were symmetrical enlargement of subarachnoid spaces and of the lateral and third ventricles. White matter showed no changes in density. In later stages also the fourth ventricle was enlarged and cerebellar atrophy was seen. CCT findings were not closely correlated with onset and/or severity of the neurological abnormalities. CCT findings were positively correlated with age of the patients: CCT was usually normal if patients were less than 10 years old, and usually abnormal if patients were more than 14 years old.

Adolescent↗
PubMed1979

Cranial computed tomography (CCT) findings in children treated with ACTH and dexamethasone: first results.

8 children with different petit mal epilepsies were systematically treated with ACTH and dexamethasone. CCT examinations were performed before, during and after treatment. In all children severe cerebral changes. enlargement of ventricles and subarachnoid space developed during the initial phase of treatment with Depot-ACTH. Similar changes, but to a less severe degree, could be demonstrated during the phase of dexamethasone therapy thereafter. In all patients cerebral changes disappeared after hormonal treatment had ended. At this point many children had a developmental spurt, developmental relapses could not be observed. It is suggested that these reversible changes seen on CCT scans represent a form of morphological plasticity of brain structures. These results bear certain consequences as to the therapy of cerebral edema.

Adrenocorticotropic Hormone↗
PubMed1978

[Brain atrophy in chronic alcoholism. Clinical and computer tomographic study].

Fifty chronic alcoholics (37 men and 13 women, ages 26--55, mean age 39.9 years) with different clinical syndromes (alcoholic psychosis, alcoholic encephalopathies) were studied by computerized cranial tomography. Cerebral atrophy was detected in 96% of all cases. Combined cortical and subcortical signs were encountered in almost all cases. Cortical atrophy seemed to be detectable more easily by CT than by pneumencephalography. The computerized tomographic findings were studied in their relations to age, sex, duration of abuse, clinical syndromes, frequency of relapse (and seizures, too), etc. Cerebral atrophy was correlated primarily with the subjects' age and the duration, and less with the intensity of alcoholism. The most distinct changes were found in delirium syndromes and, in cases with relapse of psychosis, especially in combination with seizures. Wernicke-Korsakow encephalopathies showed the widest third ventricles when combined with repeated syndromes of withdrawal in their case histories. Computerized tomographic examinations of ten patients during acute psychosis as well as 4 weeks later showed identical findings; transitory changes, e.g., cerebral edema, were not detected. Computerized cranial tomography appears to be extremely useful to study the numerous open questions concerning the pathogenetic role of age, duration, and severity of abuse with cerebral atrophy.

Adult↗
PubMed1978

Findings in computerized axial tomography after intrathecal methotrexate and radiation.

Medulloblastoma and acute lymphocytic leukemia patients treated by intrathecal methotrexate and radiation were investigated by means of computerized axial tomography. More than 50% of them turned out to have acquired encephalopathy. Only gross morphologic brain defects, as visualized by computerized tomography, caused manifest clinical signs of brain dysfunction, such as epilepsy, mental retardation, paresis, and apallic syndrome. Mild morphologic changes were found even in asymptomatic children. The preferred site of defects in brain substance was the paraventricular white matter.

Brain↗
PubMed1978

[Meningioma of the tentorium cerebelli: computer tomographic and angiographic aspects (author's transl)].

The relationship of a meningioma to the tentorium is of great significance for the choice of treatment. In order to evaluate the role of computer tomography and angiography for elucidating this problem, 21 cases were examined (all had angiograms, 13 had computer tomography). In most cases the tumour was attached to the tentorium. In 18 patients it was possible to compare the results of radiology with operative findings. It was found that computer tomography and angiography are complementary; indirect involvement of the tentorium by tumour passing through the tentorial hiatus can nearly always be demonstrated by computer tomography, whereas demonstration of direct involvement is best achieved by selective or super selective angiography. Extension of tumour to both sides of the tentorium is accomplished most easily by computer tomography or angiography, if the meningioma is in the mid-line.

Adult↗
PubMed1978

[A clinical and angiographic study of occlusions of the posterior cerebral artery with special reference to the pathogenetic role of oral contraceptives and nicotine-abuse (author's transl)].

A series of 13 cases of occlusions of the posterior cerebral artery are presented as verified by angiography. 9 of these were between the age of 20 and 39. The symptoms and clinical courses are compared with the angiographic findings, especially with the collateral circulation. On the basis of our observations and similar cases reported in the literature the factors, disposing to vascular occlusions are discussed in detail particularly the role of oral contraceptives and nicotine-abuse.

Adult↗
PubMed1978

[Spontaneous intracerebral hematomas. New aspects since the introduction of computer tomography].

Computed tomography has extended the diagnostic possibilities in intracerebral haemorrhages in a decisive manner. Owing to the more exact computer-tomographical diagnosis, especially with regard to the extension and localisation of the haemorrhage as well as the experience gained with simultaneous cerebral pressure measurement, surgical treatment of the haemorrhage can in most cases be carried out through a drilled hole in local anaesthesia. The prognosis of intracerebral haemorrhages is by no means unfavourable from the first, in case of haemorrhages of an unknown etiology in young adults it is even very good. That is why the operation should be carried out in good time. But even patients in a bad condition and cases with additional massive intraventricular bleeding are as such no contraindications.

Adult↗