Biomedical subjects

F Glaser

Publications and source records attributed to F Glaser.

53 records · Page 3Linked to original sources

PubMed1990

Influence of endorectal ultrasound on surgical treatment of rectal cancer.

Refined surgical treatment of carcinoma of the rectum, such as sphincter-preserving operations, pouch anal anastomosis, and pre-operative irradation require exact assessment of tumor and lymph-node involvement before therapy. To improve pre-operative staging we used endorectal ultrasound to determine the depth of tumor infiltration and the presence of lymph-node metastases. A 7.0 MHz transducer (Bruel and Kjaer, Denmark) was used in the pre-operative staging of 110 patients with rectal carcinomas. In 90% of the cases it was possible to perform a correct tumor staging pre-operatively in comparison with histopathology. Sensitivity for detection of perirectal fat infiltration was 96% and the negative predictive value was 96%. Lymph-node involvement was accurately identified in approximately 80% of the cases. Endorectal ultrasound is a highly accurate tool in the pre-operative staging of rectal carcinoma, as well as in the detection of lymph-node involvement. It will identify patients suitable for sphincter-saving procedures or local treatment and define those with a considerable risk of local recurrence, where combined surgery and radiotherapy may be considered.

Humans↗

PubMed1990

[Preoperative assessment of perirectal lymph nodes by ultrasound].

Endorectal ultrasound is a new technique which is having an increasing impact on the surgical community. Beyond the assessment of tumor penetration depth two kinds of lymph nodes are to be differentiated by ultrasound in the perirectal fat. 1) Inflammatory enlarged lymph nodes which appear hyperechoic, unsharply limited to the surrounding tissue and 2) lymph node metastases which are hypoechoic having the same density as the tumor. Sensitivity and specificity of endorectal ultrasound in the detection of lymph node metastases in 97 patients was 80%, the positive predictive value was 78%, the negative 82%. In an in vitro study we examined 27 lymph nodes of patients with either inflammatory or cancerous colon diseases by computerized B-scan texture analysis. An HP-77020 A realtime electronic sector-scanner was connected with HP-1000 microcomputer which permitted the selection and texture-analysis of a region of interest (ROI). Afterwards the lymph nodes were examined histologically. Independent of size and surrounding fat tissue there was a highly significant difference between inflammatory and cancerous enlarged lymph nodes concerning mean grey level and mean gradient. Tumor infiltrated lymph nodes are hypoechoic with poor contrast within the node whereas inflammatory enlarged nodes are more hyperechoic and show more contrast. Thus, we can state that it is possible by consideration of echogenity and contrast to distinguish sonographically between tumor infiltrated and inflammatory enlarged lymph nodes.

Diagnosis, Differential↗

PubMed1989

[The value of ultrasound in the diagnosis of capsule ligament injuries of the upper ankle joint].

Ankle ligament injuries are usually diagnosed by clinical and radiological examination. In this study we tried to determine the accuracy of dynamic sonography in the diagnosis of ankle ligament injuries. From 1 April 1987 to 1 July 1988, 72 patients with ligamentous injuries of the ankle were examined sonographically. The dynamic stability of the anterior talofibular ligament was determined by measuring the length of the ligaments under normal and stressed conditions. The anatomical course of the ligaments was used as the plane of section. Clinical and radiological examinations were used to determine whether an operation was indicated, and the results of these examinations were compared after the operation with the sonographic and intraoperative findings. Dynamic examination of the stability of the anterior talofibular ligament yielded findings compatible with the intraoperative findings in 64 of the 72 cases (88.8%). The mean difference in length between normal and stressed conditions was 7.4 mm, with a range of 6-12 mm in the case of rupture of the ligament. A high level of agreement between sonographic and intraoperative findings was also found for the calcaneofibular ligament. In 62 of the 72 cases (86.1%) a correct diagnosis was possible. The mean difference in length in this plane of section was 10.6 mm, with a range of 7-17 mm. The sensitivity and specificity of ultrasound in the diagnosis of rupture of the ligaments were between 80% and 90%, respectively, and the positive predictive value was about 95%. Sonography with a high-resolution scanner allows a correct diagnosis of ligamentous lesions at the ankle joint in 80-90% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

[Endosonography in preoperative assessment of rectal tumors].

Together with digital examination and rectoscopy, the endorectal ultrasound is of great value in the preoperative diagnostics of rectal carcinoma. In 90% of these patients it is possible to determine the depth of infiltration preoperatively. At the same time assessment of lymph node involvement can be made with a sensitivity and specificity of 78%. Thus, endorectal ultrasound gives decisive criteria for the therapeutic plan. Furthermore, endorectal ultrasound represents a fitting instrument for the postoperative follow-up of patients with anterior resection of the rectum. Intramural as well as extrarectal sited recurrences of the tumor can be detected. Whether endosonography will have an influence on the prognosis of rectal carcinoma, remains to be seen.

Adult↗

PubMed1988

Early recognition of postoperative hematoma formation.

Postoperative hematoma formation must be treated as a potential infection. One fourth of all postoperative hematomas are already contaminated. Ultrasonographical examination is an effective method for early recognition of such postoperative hematomas. Ultrasonic diagnosis on a routine basis is not necessary, but it should be carried out as soon as clinical symptoms appear. Our postoperative late results with only one early and one late infection after 100 postoperative treatments of the hip joint and femoral shaft emphasize the importance of early diagnosis of hematomas.

Femur↗

PubMed1988