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Biomedical subjects

E Gmelin

Publications and source records attributed to E Gmelin.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Bolus geometry in various central and peripheral contrast medium applications: study with serial CT using non-ionic contrast media].

Measurements of concentration in 27 patients with a calibrated Serio-CT yielded for the intravasal contrast medium bolus maximum a value of approx. 23 mg I/ml for the a. carotis with central injection and approx. 14 mg I/ml for the a. iliaca with peripheral injection. 7 invasive measurements were performed at the bifurcation of the aorta, yielding a value of 12.5 mg I/ml with peripheral injection. In all these cases, 40 ml nonionic contrast medium (Iohexol) with an iodine content of 350 mg I/ml were applied. The average bolus half-life was 9.5 sec. measured at the carotid artery, 11.5 sec. at the a. iliaca, and 7 sec. at the bifurcation of the aorta. Differences in bolus geometry were not seen on comparing arterial injection with cava superior injection; likewise, there were no differences between peripheral injections at various speeds. Animal experiments reported in literature show that these observations can be mainly ascribed to vascular dilatation in the minor circulation produced by the contrast medium.

Carotid Arteries↗
PubMed1984

[The so-called inflammatory aneurysm of the abdominal aorta].

The computer tomographic appearances of four patients with the rare inflammatory aneurysm of the abdominal aorta are described. The condition, whose aetiology is not known, affects mostly men in the fifth, sixth and seventh decade. Computed tomography shows, in addition to the typical changes due to an aortic aneurysm, horse-shoe shaped, circular, homogeneous peri-aneurysmal masses, which enhance after intravenous contrast. Bolus injection of contrast is necessary in order to differentiate these from a dissection or retroperitoneal lymphoma. Distinction between these conditions is possible as a result of the various types of enhancement which occur in the aortic lumen, in fibrosis and in lymphoma.

Aged↗
PubMed1984

[Intra-arterial digital subtraction angiography of the femoral bifurcation as a supplement to conventional pelvic-leg arteriography].

In view of the fact that in prognosis and treatment of arterial occlusion, particular importance must be attached to the profunda femoris artery, and especially to the region of origin of this artery, it is imperative to achieve angiographic representation of the descent of the profunda femoris artery without any masking. The intra-arterial injection method employing digital subtraction angiography is the method of choice, since it requires a low amount of contrast agent, time, and film. In 90 per cent of the cases, ipsilateral anterior oblique projection will be most suitable to represent the femoral bifurcation, which depends on the course of the profunda femoris artery in anterior-posterior projection, the angle varying between 30 degrees 40 degrees. 50 to 70 per cent of the stenoses occurring in the descending part of the profunda femoris artery, can be recognised via oblique projection only.

Adult↗
PubMed1984

[Recent aspects in the diagnosis and therapy of inflammatory aneurysms of the abdominal aorta].

The so-called inflammatory infrarenal abdominal aneurysm is characterized by huge perianeurysmal retroperitoneal fibrosis, which may achieve a size of more than 1 to 2 cm. It impeats the surgical proceeding enormously. By means of computed tomography a diagnosis of this kind of aneurysm can already be given before the operation. A therapy of the fibrosis resp. the hereby caused complications especially in the urinary system is not an essential in the first place due to the fact that these complications tend to vanish spontaneously after the resection of the aneurysm.

Aged↗
PubMed1981

[Ultrasound misdiagnosis of gallbladder concrements in "phrygian cap" deformity (author's transl)].

Gallbladder septa, for example, in "phrygian cap" deformity, may in rare cases lead to a misdiagnosis of gallbladder stones when B-mode ultrasound with gray scale is used. Among 4,000 upper abdominal ultrasound examinations which included the gallbladder one such case was observed. In view of the frequency of septated gallbladders (about 15%) this, although very rare, cause of false-positive diagnosis of stone should be taken into consideration when interpreting ultrasound tracings.

Cholelithiasis↗
PubMed1981

[Accuracy of endoscopic retrograde pancreatico-cholangiography in the diagnosis of pancreatic disease: an analysis of three thousand investigations (author's transl)].

Endoscopic retrograde pancreatico-cholangiography (ERPC) gave the correct diagnosis in 83% of 269 cases of pancreatitis confirmed by operation, clinical features, laboratory findings and course. It provided the correct diagnosis in 85% of 82 cases of necrosis of the pancreas and pseudocysts confirmed at operation. ERPC is one of the most important methods of investigation in papillary stenosis, because it can demonstrate both ducts and can reveal functional changes, especially delayed emptying. The correct diagnosis of carcinoma of the pancreas, confirmed at operation or histologically, was made in 88% of 107 cases. Endoscopy correctly diagnosed 26 of 27 cases of papillary carcinoma. Biopsy with subsequent histological study and cytological analysis of pancreatic secretion further served to confirm the diagnoses established by ERPC.

Ampulla of Vater↗
PubMed1981

[A comparison of the diagnostic accuracy of ultrasound, computer tomography and ERPC in chronic pancreatitis and carcinoma of the pancreas (author's transl)].

A comparison of the diagnostic accuracy of ultrasound, computer tomography and ERPC in chronic or recurrent pancreatitis and pancreatic carcinoma has shown that ERPC is the most precise of the three methods. This was particularly important in the demonstration of the small, still operable, carcinomas of the pancreas. Sonography is most useful for serial observations of pancreatic pseudocysts due to chronic recurrent pancreatitis. In this situation, ERPC should only be used if sonography and computer tomography cannot localise the lesion. Where the computer tomogram has shown evidence of enlargement of the pancreas, sonography may show an area devoid of echos within the enlarged organ, suggesting the presence of a carcinoma. Computer tomography superior to ultrasonography in delineating the extent of extensive pancreatic disease and in showing the anatomical structures surrounding the pancreas.

Adult↗
PubMed1981

Tumours in the region of the papilla of Vater. Diagnosis via endoscopy, biopsy, brush cytology, ERPC and CT-scan.

Thirty-two cases of tumour in the region of papilla of Vater are reported including five benign lesions (papillitis, polyp, duodenitis) and 27 periampullary carcinomas. Duodenoscopy has a key position in the diagnosis of these lesions, since by judging the endoscopic appearance of the papilla a forceps biopsy and brush cytology can be performed. Accuracy of forceps biopsy is up to 66%, whereas diagnostic accuracy of brush cytology only reaches about 44%. Because of the possible false positive results, brush cytology should be regarded with reserve in the diagnosis of periampullary carcinomas. Retrograde filling of contrast medium of bile and/or pancreatic ducts mainly serves for delineation of tumour size and allows fine needle aspiration under fluoroscopy. Success rate of retrograde cannulation is rather low. CT-scans are of great importance in detecting metastases of liver and/or regional lymphnodes but are of little value in diagnosing the primary lesion.

Ampulla of Vater↗
PubMed1980

[Endoscopic retrograde cholangiography (ERC) in congenital cystic biliary anomalies (author's transl)].

Cystic anomalies of the bile duct are rare conditions found mostly in the younger age groups and four times more frequently in women than in men. The introduction of retrograde contrast filling of the bile ducts has led to a marked improvement in the pre-operative diagnosis. Precise demonstration of the anatomical relationships is of the utmost importance for surgical intervention. A number of variants of cystic bile duct anomalies must be differentiated from double gall bladders, bile duct fistulas, pancreatic cysts and pseudocysts; small cysts (type IV) must be distinguished from the autoimmune form of cholangitis-pericholangitis and from acquired generalised bile duct dilatation. The prognosis of cystic biliary anomalies is determined by the complications of these conditions. These include ascending cholangitis, stone formation and malignant change.

Adult↗
PubMed1980

[Radiation therapy of the eosinophilic granuloma of bone (author's transl)].

Fourteen patients are reported, 10 males and 4 females, who have been irradiated for eosinophilic granuloma of bone (8 of them for recurrences). Seven were aged between 1 and 30 years, seven were over 30 years old. In half of the patients, focal lesions from eosinophilic granuloma were localized in the region of the visceral and cerebral crane. Ratio of solitary eosinophilic granuloma to multifocal eosinophilic granuloma was 2.5 : 1. Of the 14 patients, 11 obtained remission (follow-up: 7 months until 17 years) after a dose generally amounting to 2000 or 3000 rad (20 to 30 Gy). In 3 patients aged between 30 and 57 years recurrences appeared following irradiation. None of the patients, however, died of his disease till now. The prognosis is good. If surgery or cytostatic therapy have been failing, cure of the disease is still possible with irradiation.

Adolescent↗
PubMed1978

Repeated phlebographic examination during and after fibrinolytic therapy with streptokinase and urokinase.

Forty-three patients with deep vein thrombosis were given fibrinolytic therapy with streptokinase and/or urokinase. In all patients the diagnosis was made phlebographically, and repeat phlebography was performed after termination of therapy. Sixty-four of 104 vein segments initially occluded (62%) were partially or completely recanalized. No vein segments particularly suitable for fibrinolytic therapy could be defined. The therapy was as successful in cases in which the thrombosis extended over several segments as in those in which the occlusions involved only one or two segments. Similarly, there was no difference in the success rate for thrombi that were still freely floating and for thrombi that occluded the veins completely. It is recommended that fibrinolytic therapy be given in suitable cases in which clinical symptoms have persisted up to two weeks; in some cases this limit may even be extended up to one month.

Adult↗
PubMed1978

[Rare arterial variations during upper abdominal and pancreatic angiography (author's transl)].

Selected cases showing rare variations of the arteries of the upper abdomen indicate how difficult the exact identification of individual vessels can be. In the presence of such variations, which usually involve several vessels, it is essential to find and demonstrate all vessels in the upper abdomen. Vessels which are not seen easily must also be specially searched for. In the presence of anomalous vessels, angiography may prevent the surgeon from ligating the incorrect arteries during operation on the pancreas, the liver, stomach, spleen or colon.

Abdomen↗
PubMed1977

[Complication with contrast medium in endoscopic retrograde cholangiopancreaticography (author's transl)].

After more than 2000 endoscopic retrograde cholangiopancreaticographies (ERCP) without contrast medium allergy, a case of severe allergic shock induced by contrast medium injected into the pancreatic duct is reported. The indication for ERCP in patients with known allergy to contrast media must therefore be restricted to those cases in which other examination procedures have given no useful results and yet diagnostic evaluation is vital to the interests of the patient.

Cholangiography↗
PubMedDate not supplied

Access-related venous stenoses and occlusions: treatment with percutaneous transluminal angioplasty and Dacron-covered stents.

PURPOSE: To determine the effectiveness of using Dacron-covered stents to treat access-related venous stenoses and occlusions. METHODS: Twenty-two Dacron-covered stents were placed in 20 patients: in the basilic or axillary vein (n = 2), cephalic vein (n = 3), subclavian vein (n = 5), and at the venous anastomosis of the polytetrafluoroethylene (PTFE) implant graft (n = 10). RESULTS: Initial technical success was 100%. The cumulative primary and secondary patency rates were 57% and 83% at 6 months, 29% and 64% at 12 months, and 29% and 53% at 18 months. A statistically significant difference in the stent patency was revealed by comparing the patients with stents in the subclavian vein and patients with upper arm stents. The secondary patency rates of the upper arm stents were 73% after 6, 12, and 18 months. CONCLUSIONS: Percutaneous placement of Dacron-covered stents is a safe and effective procedure for salvage of a dialysis fistula. First results are promising, with a tendency to prolongation of the time interval between reinterventions.

Angioplasty, Balloon↗