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Biomedical subjects

F Spelsberg

Publications and source records attributed to F Spelsberg.

At least 55 records · Page 3Linked to original sources
PubMed1981

[Sonographic diagnosis of enlarged parathyroid glands in hyperparathyroidism (author's transl)].

Fifty-nine patients suspected clinically of having primary or tertiary hyperparathyroidism have been examined since 1978 in order to localize enlarged parathyroid glands. With glands larger than 5 mm. this proved successful in about 90% of those situated in the neck. The sonographic features of enlarged parathyroid glands are poor echoes, smooth margins and the typical position on the medial and posterior surface of the thyroid gland. A requirement for diagnostic success is the use of modern compound apparatus with digital convertors and focussed high resolution probes.

Adenoma↗
PubMed1981

[Preoperative ultrasonic diagnosis and localization of enlarged parathyroid glands in suspected hyperparathyroidism].

Since August 1978, the neck of 68 patients with the clinical diagnosis of hyperparathyroidism was examined by ultrasound. The accuracy of the method increased from 61% during the first period of investigation to 82% using a newly-developed ultrasound scanner. These results are comparable with those obtained by invasive methods like angiography or selective venous blood sampling for the assay of parathyroid hormone. Positive preoperative localization of enlarged parathyroid glands confirmed the diagnosis of HPT. Cases involving acute HPT preoperative localization of enlarged parathyroid glands requires prompt surgical management. Preoperative localization of an adenoma allows direct removal of the enlarged gland and exploration of the others within the immediate section from microscopic examination under surgery.

Diagnosis, Differential↗
PubMed1980

[The angiographic diagnosis of islet cell tumours. Results in 34 patients (author's transl)].

Between 1965 and 1979, 34 patients with organic hyperinsulinism were examined angiographically. By observing the following points it should be possible to diagnose tumours greater than 1 cm, whatever their position in the pancreas: 1) Use of high performance generators and tubes which permit one to employ fine focus, low kv and high mAs. 2) Optimum imaging systems (carbon fibre table top, high intensity screens). 3) Selective catheterisation, large quantities of contrast per unit time and adequate duration of the filming sequence. 4) Pharmacoangiography and subtractions may be valuable in some cases.

Adenoma, Islet Cell↗
PubMed1980

[Disease picture and operative therapy in multiple endocrine adenomatoses (MEA sydrome)].

We have outlined the symptoms, diagnostic procedures and operative treatment of "multiple endocrine adenomatosis" (MEA I, IIa und IIb). The priority of the operative procedure whenever two or more clinical syndromes in a patient with MEA are present and the possibility of multiple tumors has to be considered carefully. When there is a tumor of an endocrine organ, it should always bethought about the MEA-syndrome. We report about 9 patients seen in our hospital.

Adrenal Gland Neoplasms↗
PubMed1980

Primary malignant tumours in the small bowel. (A report about 43 of our own cases and 1134 cases from literature).

From 1953 until May 1975 6553 patients with malignant tumours of the gastrointestinal-tract were operated on the University Hospital for Surgery in Minich, and in 43 cases (0,67%) a primary small bowel neoplasm was found. In the available literature we gathered a few more than 2000 cases it was possible to compare the data of symptoms and clinical findings with our results. We came to the following conclusion: 1. The main symptoms are abdominal pains in 71% in the literature (83% in our own cases), changing of peristaltic in 52% (33%), melena in 48% (62%), weight loss in 47% (67%), nausea and vomiting in 34% (22%). 2. The Benzidine examination for blood in the stool was in 70 to 90% the cases positive, in 33% we found an aneamia and in 29% a palpable tumour mass. The X-ray contrast exploration is the simplest and best routine method to find the lesion. Recently the selective angiography and the endoscopy are a valuable aid for the diagnostic in the small bowell. 3. The prognosis of these tumours is one of the poorest of the whole tumour surgery. In 60% (81%) of the patients there were a metastazisation at the time of operation; the five year survival ranged from 5 to 32% (12,7% in our own cases). Only with greater awareness of the vague symptoms will it become possible to diagnose the small bowel tumour at an early stage.

Adult↗
PubMed1979

[Carcinoid of the digestive tract. Diagnostic possibilities (author's transl)].

Special features which enable preoperative differential diagnosis are dealt with in detail with reference to 44 patient with carcinoid of the digestive tract. Carcinoid of the appendix becomes noticable early with signs of acute or chronic appendicitis and in 94% of cases is operated on in good time. Angiography of the superior mesenteric artery shows a characteristic stellate figure in the mesenterium in carcinoid of the small intestine. In contrast to the primary tumor, liver metastases show intense vascularization in the angiogram. A rise in urinary excretion of 5-hydroxyindole acetic acid is pathognomonic for carcinoid, its determination permits the checking of operative radicality and shows the appearance of metastases early.

Adult↗
PubMed1979

[Unrecognized traumatic rupture of the diaphragm (author's transl)].

20 cases of rupture of the diaphragm (one due to direct trauma, the other 19 due to indirect trauma) which were not recognized at the time of the accident are described. The reasons for the delay in diagnosing the true nature of the condition and the misleading complaints caused by the unrecognized injury are reviewed. Essential diagnostic measures are discussed and guide-lines are suggested to ensure the early diagnosis of rupture of the diaphragm.

Diagnostic Errors↗
PubMed1978

[Clinical aspects, diagnosis and treatment of organic hyperinsulinism. Experience with 46 operated patients (author's transl)].

The clinical picture of organic hyperinsulinism is presented with reference to experience in 46 operated patients. For the recognition of disease, a careful history is a decisive contribution. The hunger test showed a characteristic hypoglycemic reaction in 100%; the tolbutamide test gave a positive result in 92%. Insulinomas could be localized angiographically in 71%; in one patient this could only be done with an ERCT. The treatment of choice is operation as soon as possible. If possible, enucleation is to be given preference over pancreas resection because of the low complication rate. A search for ectopic (2%) and multiple (12%) adenomas is important. A cure was achieved in 76% of all those operated on. The hospital mortality was about 4%.

Adenoma↗