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Biomedical subjects

E Gmelin

Publications and source records attributed to E Gmelin.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Percutaneous embolization with spirals in bleeding uterine cancer].

Percutaneous transcatheter embolization (PTE) in patients with life threatening bleeding carcinomas of the uterine cervix using stainless steel coils, proves to be an effective treating method. There is a low incidence of complications concerning the local cutis, nerves or arteries. PTE does not allow a causal therapy of the malignant disease, but in half of our patients (n = 13) embolization was the precondition for initial or further adequate therapeutic management.

Angiography↗
PubMed1989

[Follow-up of local lytic therapy of pulmonary emboli using DSA].

The series consisted of 30 patients with pulmonary emboli diagnosed by DSA. In 18 patients repeat DSA was performed using the central catheter which had been employed for the lytic therapy immediately after the end of treatment. Therapy was carried out from two to 14 days. Bleeding was observed in four of the patients. The final DSA showed complete recanalisation in five patients, partial recanalisation in 11 patients and no angiographic improvement in two.

Adult↗
PubMed1989

[Computed tomography and magnetic resonance tomography of the lower leg in chronic venous insufficiency].

Sixty-two lower limbs in 29 women and six men with chronic venous insufficiency (CVI) of grade II and III were examined by CT and eight of these additionally with MRI. The changes were compared with the findings in 21 patients of similar age, but without venous abnormalities. The most important findings were subcutaneous fibrosis with or without calcification, nonspecific infiltration of the extrafascial spaces and degeneration of the Achilles' tendon. The simultaneous occurrence of these changes can be regarded as typical of advanced CVI. CT was somewhat superior to MRI; its use can be justified as part of posttherapeutic follow-up and for special problems.

Adult↗
PubMed1989

[Analysis of dynamic CT curves in kidney transplants with rejection reaction and cyclosporin A poisoning].

The early differential diagnosis between transplant rejection and cyclosporin intoxication is often difficult, although it is important for treatment. We carried out dynamic CT on 48 occasions in patients with normal function, with acute tubular necrosis, rejection and cyclosporin A intoxication. Analysis of the time-density curve of the cortex showed significantly slower enhancement with cyclosporin A intoxication than during rejection. The peak and the arterial curve were also delayed in cyclosporin A intoxication. This evidence of reduced cortical perfusion during cyclosporin A intoxication can be explained by the results of modern pathophysiological studies. In principle, it is possible to distinguish between cyclosporin A intoxication and rejection by means of dynamic CT, but for its routine use the nephrotoxicity of the contrast medium must be taken into account.

Cyclosporins↗
PubMed1989

[The value of sonography in the pathologic evaluation of solid breast tumors].

Six hundred and twenty patients were examined clinically and by sonography and mammography; 113 tumours were found and a histological diagnosis was attempted on the basis of a previously determined diagnostic protocol. There were 51 solid tumours; 48 were shown by mammography and 46 by sonography. Mammography proved more accurate in diagnosing malignant tumours (72% against 67%), whereas ultrasound was more precise in diagnosing benign tumours. Sonography found ten out of twelve histologically proven axillary lymph node metastases and was better than palpation (seven out of twelve). Mammography and sonography combined increased the accuracy of the pre-operative diagnosis of solid breast tumours. Ultrasound of the axilla should be used routinely in addition to clinical examination in order to detect non palpable lymph node metastases.

Adenocarcinoma, Mucinous↗
PubMed1989

Insufficient hemodialysis access fistulas: late results of treatment with percutaneous balloon angioplasty.

Forty-six patients with malfunctioning hemodialysis access fistulas were treated with balloon angioplasty. The initial percutaneous transluminal angioplasty procedure was successful in 16 (89%) of 18 patients with stenoses and in 13 (46%) of 28 with occlusions. In ten patients (seven with stenoses and three with occlusions) repeated dilation (two to five times; mean, two times) became necessary due to recurrent malfunction 1-24 months (mean, 6 months) after the first intervention. In the 16 patients with stenoses, the patency rate after 6 months was 93%; after 1 year, 91%; and after 2 years, 57%. In the 12 patients with occlusions, the rates were 80%, 50%, and 14%, respectively. Dilation of stenoses in malfunctioning hemodialysis fistulas is the procedure of choice. If hemodialysis shunts malfunction, immediate dilation of stenotic lesions should be performed to prevent occlusion.

Angioplasty, Balloon↗
PubMed1989

Arterial bolus curve after intravenous injection of ionic and nonionic contrast media.

Studies of the intra-arterial bolus curve after intravenous contrast injection with dynamic computed tomography show that a higher bolus maximum can be obtained with a central injection than with a peripheral injection, other injection parameters remaining unchanged. In a singular venous injection ionic and nonionic contrast media show no different effects on the bolus curve. Due to the unfavorable effects of ionic contrast media with high osmolality, for the purposes of intravenous digital substraction angiography nonionic contrast media must be recommended. The subsequent injection of sodium chloride results in a higher bolus maximum.

Angiography↗
PubMed1989

Digital subtraction sialography, conventional sialography, high-resolution ultrasonography and computed tomography in the diagnosis of salivary gland diseases.

Forty-one patients with salivary gland disorders have been evaluated by digital subtraction sialography, conventional sialography, high-resolution ultrasonography and computed tomography, and the results compared with clinical, surgical and pathomorphological data. In the case of salivary gland masses, the sensitivity of ultrasonography, CT and digital subtraction sialography was 100%, 82% and 71%, respectively, while in the case of sialadenitis, the respective figures were 54%, 69% and 85%. The image quality of digital subtraction sialography was superior to that of conventional sialography in 80%, equal in 16%, and inferior in 3% of the examinations. We conclude that in all cases of salivary gland diseases ultrasound should be the first imaging procedure. If a tumour is not confirmed, digital subtraction sialography should be employed to visualise inflammatory changes, while in most cases of salivary gland masses no further imaging will be necessary.

Humans↗
PubMed1989

[Computerized tomography studies of the lower legs of patients with chronic venous insufficiency and arthrogenic venous stasis syndrome].

Transverse computed tomography of the lower legs in patients with chronic venous insufficiency reveals changes in the extravasal connective tissue. In the subcutaneous fat there is fibrosis - sometimes with ossification - that may extend to the periachilloregion and then embeds the Achilles tendon. The Achilles tendon has a reduced cross-section and reduced density with circumscribed, hypodense areas that are a sign of degeneration. In the muscles, areas of atrophy with lipomatous degeneration can be found as well. In the bones there are signs of increased osteoporosis; the periosteum shows osseous proliferation. The extent of these changes correlates with the degree of venous insufficiency and is most often seen in patients with the arthrogenic stasis syndrome.

Achilles Tendon↗
PubMed1989

[Comparison of 2 positive and 1 negative oral contrast media for abdominal CT diagnosis].

In a prospective randomised study three groups of 30 patients each were subjected to CT of the entire abdomen. The oral intestinal contrast media used were iodine solution (2%), barium suspension (1.5%) and paraffin emulsion (25%). The results were evaluated according to imaging, artifacts, ability to assess the intestinal wall, taste and side effects. All three contrast media are suitable for marking the gastrointestinal tract; paraffin shows advantages in the upper part of the tract and is the only medium that enables assessment of the wall, while causing the lowest rate of artifacts. Barium has a high acceptance and the best tolerance of all contrast agents.

Barium Sulfate↗
PubMed1988

Translumbar catheter angiography with a needle-sheath system.

Translumbar catheter angiography with a new needle-sheath system was used in 175 patients and proved to be a safe and simple technique. No complications related to aortic puncture or catheter manipulation were observed. The 5-F sheath allowed the introduction of 4-F catheters of different lengths and shapes. Results of computed tomography performed after the procedures in ten patients, and intraoperative findings obtained in 22 patients, showed only minimal hematomas in the retroperitoneal space.

Angiography↗
PubMed1987

[Is the increase in brain volume of abstinent alcoholics a sequela of rehydration?].

A group of 30 alcoholics as identified using the MALT score were examined both within the first 36 h of alcohol withdrawal and then again at the end of a 10-day treatment in hospital. We looked for clinical signs of dehydration, water and electrolyte imbalance, and concentration of steroid metabolites in the urine. Cranial computed tomography was also performed twice, again at the beginning and end of the 10-day period. The size of cerebrospinal fluid spaces was calculated through measuring the frontal interhemisphere distance, the width of cortical sulci, the ventricle III diameter, the Cella media index and also the number of vermal sulci. All patients had a brain atrophy which did not disappear within the 10 days. The neuroradiological parameters remained completely unchanged in the control examination. However, the laboratory parameters of the internal milieu had normalized. Therefore, it is submitted that the shrinkage of the brain of alcoholics cannot be due to a reversible intra- or extracellulary dehydration. There was also no proof of a hormonal cause for the brain shrinkage. As a consequence other etiological factors gain importance, such as malnutrition or a toxic alcohol effect.

Adult↗
PubMed1987

[Indications for percutaneous transluminal angioplasty in functional disorders of hemodialysis shunts].

With adequate indication, PTA is an effective technique for eliminating functional restrictions of hemodialysis shunts. PTA is indicated both in stenoses which occur above all at the venous shunt arm near to fistula and in occlusions over short distances. In thrombotic occlusions over long distances, PTA is indicated when prior thrombectomy did not produce any improvement of shunt function and dilatation should eliminate a causal stenosis. Stenoses of the arterial side of the shunt can also be successfully dilated: the dilation catheter should be introduced via the venous arm of the shunt in order to avoid damage to the proximal brachial artery. PTA is not indicated in all primarily insufficient shunts.

Angiography↗