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Biomedical subjects

G Alzen

Publications and source records attributed to G Alzen.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Extensive acute pulmonary embolism: fragmentation treatment with a rotatable pigtail catheter].

A 58-year-old patient with extensive pulmonary embolism complicated by cardiogenic shock and contraindications to thrombolysis was treated by mechanical embolus fragmentation using a rotatable pigtail catheter system. Considerable recanalization of the left pulmonary arteries was rapidly achieved with relative ease of instrumentation. Subsequently, the hemodynamic condition stabilized.

Acute Disease↗
PubMed1996

[Catheterization of the nasolacrimal duct].

A technique is described for passing a guide wire through the lacrimal duct into the nose following catheterisation of the duct. The wire is passed into the pharynx, a 7 F feeding tube is passed through the nose into the pharynx and these are then pulled out of the mouth with a Magill forceps. The tip of the feeding tube is then cut off and the guide wire introduced into a side hole of the catheter. By removing the catheter, the tip of the guide wire is pulled along and can be removed from the nose.

Catheterization↗
PubMed1996

Persisting unilateral lung hypoperfusion after resection of a subcarinal bronchogenic cyst.

As a rare malformation with a wide variety of clinical modes of presentation, the bronchogenic cyst remains a diagnostic challenge. We report a case with a subcarinal bronchogenic cyst and stenosis of the left main bronchus presenting as "unilateral hyperlucent lung". Hypoplasia of the ipsilateral pulmonary vascular system persisted after surgical restitution of ventilation and is most likely due to an associated vascular malformation. Alternatively, anatomical fixation of pulmonary reflex vasoconstriction can be discussed.

Adolescent↗
PubMed1995

Venous stenosis and occlusion in hemodialysis shunts: follow-up results of stent placement in 65 patients.

PURPOSE: To provide follow-up data on the use of self-expanding stents in hemodialysis fistulas to improve the technical success of balloon angioplasty. MATERIALS AND METHODS: Ninety-two self-expanding vascular stents were placed in 65 patients (29 men and 36 women 25-79 years of age; mean, 57.6 years) with failing hemodialysis fistulas or shunts. RESULTS: Stent placement was successful in all patients, but rethrombosis of the shunt occurred in six patients (10%) within 1 week. There were 96 episodes of reobstruction. In 87 cases, percutaneous or combined surgical and percutaneous repeat intervention was performed. The cumulative shunt function rate was 88% after 6 months, 86% after 1 year, and 77% after 2 years. CONCLUSION: Stent placement in hemodialysis fistulas helps treat lesions that cannot be adequately treated with percutaneous transluminal angioplasty (PTA) alone but has a follow-up patency rate similar to that of PTA. Standard central venous stents have a better patency rate than after PTA.

Adult↗
PubMed1995

[Diagnostic imaging in the traumatized child].

The value of different radiological procedures in the acute care of injured children is described. Newly developed techniques, e.g., digital luminescent radiography, are discussed. The indications for modern scanning procedures in traumatology and their influence on the examination strategy are shown. The handy use of ultrasound in abdominal injuries is essential if a laparotomy is necessary. Additionally, CT is useful in equivocal cases. Conversely, angiography and MRT are less useful in an emergency situation because of the longer duration of these procedures. Special problems of medical-legal reports are demonstrated. Injuries in the infant and adolescent skeletal system can result in growth delay. In contrast to adults, the growing skeletal system of children has the ability to correct deformations in time.

Battered Child Syndrome↗
PubMed1995

[Efficiency and efficacy of radiologic diagnosis in skeletal trauma in childhood and adolescence].

In a retrospective analysis, 2,006 X-ray examinations of the skeleton obtained after trauma in 1,386 children were examined; 354 fractures were diagnosed. X-ray films of the skull were requested in 596 (29.7%); fractures were diagnosed in only 13 patients (2.2%). The radiological result changed the medical management in none of these cases. On the other hand, X-ray after trauma in the extremities is indispensable, except for the knee region. Examinations of the lower arm showed a fracture in 54.9%, X-ray of the shoulder 47.7%.

Adolescent↗
PubMed1995

[A new concept for rational emergency diagnosis of polytrauma patients].

To optimize the emergency care of patients with multiple injuries, a special emergency room with integrated radiological equipment has been developed. It consists of a linear array of a computed tomography system, a mobile C-arm with an integrated scattered radiation grid for conventional films and a C-arm fluorographic system. The intent is to avoid delay caused by transport and repositioning of the patient. It enables all necessary diagnostic procedures to be performed within a minimal amount of time. If there are no emergency patients, the room can be divided by a sliding door and the equipment can be used separately.

Emergency Service, Hospital↗
PubMed1995

Chronic venous occlusions in haemodialysis shunts: efficacy of percutaneous treatment.

PURPOSE: The efficacy of percutaneous treatment of chronic venous occlusions in haemodialysis fistulae was retrospectively analysed. MATERIALS AND METHOD: In 33 cases, percutaneous treatment of chronic venous occlusions was attempted. The type of shunt was an autologous arteriovenous fistula in 23 cases and a PTFE implant graft in 10 cases. The lesion involved forearm veins in six cases, an upper arm vein in 15 cases, and a central vein in 12 cases. The mean length of the occlusion was 7.4 +/- 5 cm with a range from 2 to 25 cm. Fresh thrombus material in addition to the chronic occlusion was present in five cases. The patients were referred for chronic shunt dysfunction in 29 cases and with acute shunt thrombosis with an underlying chronic venous occlusion in four cases. RESULTS: Mechanical recanalization succeeded in 27 of 33 occlusions (82%). In one further patient, direct recanalization failed but an alternative improved drainage was created by detouring the main venous outflow tract by the use of a stent. Immediate clinical success was therefore 85%. Simple balloon dilatation was used in 11 of 27 cases (41%). Additional stent implantation became necessary in 16 of 27 cases (59%). In 15 patients an event of reobstruction occurred during follow-up. Mean primary cumulative patency was 85% after treatment, 41% after 6 months, and 24% after 2 years. By use of reintervention shunt function was maintained at 74% up to 2 years. CONCLUSIONS: Percutaneous treatment of chronic venous occlusions is technically feasible with a success similar to treatment of stenotic lesions. Follow-up results do not show impaired follow-up data for that type of obstruction.

Aged↗
PubMed1992

[Radiographic examination of injuries in children. Clinical and legal considerations about indications].

X-ray films of the skeleton obtained after trauma in 1,386 children and adolescents (until the end of their 18th year) were analysed retrospectively. Among a total of 2,006 examinations 354 fractures were diagnosed, an average diagnostic yield of 17.2%. Classifying the results by skeletal region, X-ray films of the skull were the most frequently requested examination (29.7%), but fractures were diagnosed in only 2.2%. On the other hand, X-rays of the lower arm provided the highest fracture yield, at 54.9%, followed by the shoulder with 47.7%.- In view of the large discrepancy between clinical suspicion and radiological confirmation of fractures, X-ray examinations should be undertaken in case of trivial injuries in children only if strictly indicated. Although the doctor is legally bound to detailed documentation of each case, this does not necessarily imply that he must perform an X-ray.

Adolescent↗
PubMed1992

Pediatric craniofacial surgery: comparison of milling and stereolithography for 3D model manufacturing.

To improve the planning phase for pediatric craniofacial surgery, 3D reconstructions of CT image series were performed on a personal computer. For construction of true models of the surgical site, two concepts were pursued. CT image data of six patients were used for model manufacturing by a conventional 2 1/2 axis milling system. The material used was polyurethane foam. Alternatively, in one patient a stereolithography was produced on the basis of the 3D reconstructed CT data. This new manufacturing device uses a photocurable monomer, hardened by a UV-laser. The spatial resolution of the system is about 0.1 mm. 3D-reconstructions were performed on a personal computer. Data were then transferred into a surface oriented structure to control a stereolithographic modeling device. Time for transfer was 70 min. The production of the modelled cranium took a total time of 59 h. Accuracy was found to be much higher in stereolithography than in milled models. The model served for surgical planning. The long time for production was caused by inadequate computer capacities, which are configured for much less complex objects in computer aided design. Furthermore the programs for the machine control are optimized for technical purposes. If these conditions are improved, stereolithography could be an attractive alternative to milling of medical models.

Child↗
PubMed1992

[Diagnosis of complications of ventriculo-peritoneal and ventriculo-atrial shunts].

The value of imaging (cranial CT, cranial and abdominal sonography, plain film surveys) was examined retrospectively in 28 shunted children in whom 82 instances of suspected dysfunction arose. There were 23 obstructions, 12 dislocations, 1 disconnection, 6 infections, 3 overdrainages and 5 slit ventricle syndromes. Impaired absorption with ascites, a peritoneal liquor cyst and a seroma occurred in the peritoneal part of the shunt. Progressive dilatation of the ventricle system shown by CCT (89%) or ultrasound was the most sensitive sign of high-pressure hydrocephalus. Periventricular hypodensity and flattening of the gyri (15%) were found less often. An examination strategy in suspected shunt dysfunction is suggested on the basis of these findings.

Cerebrospinal Fluid Shunts↗
PubMed1991

Comparative examination of various rectal tubes and contrast media for the reduction of intussusceptions.

The hydrodynamic influence of different rectal tube sizes, contrast media, and heights of the fluid column on hydrostatic reduction of intussusception was analyzed in vitro. Enemas were performed in dead rabbits to compare the filling speed of bowel with a liquid and a gaseous contrast medium. For hydrostatic reduction, tubing and rectal tube with a large caliber and a low viscosity contrast medium achieved a higher filling speed of colon and are expected to provide a higher force of reduction on the intussusceptum. A rectal tube with a large caliber can be more useful than an increase of the column height. Filling bowel with carbon dioxide was approximately 7 times faster than with meglumine sodium diatrizoate. Theoretical considerations allow the hypothesis that a gaseous medium provides a faster and steadier reduction than a liquid.

Animals↗
PubMed1991

[Transfemoral extraction of a knotted Swan-Ganz catheter using an F24 dilator].

We report on the successful transfemoral extraction of a Swan-Ganz catheter twice knotted in a patient's heart. The extraction was performed with a Dormia basket and removed via a 24F dilatator which was placed in the femoral vein. The Swan-Ganz catheter had been placed in a 67-year old patient after Whipple's operation. The technical procedure of the catheter removal is described and the advantages are discussed.

Aged↗
PubMed1991

[The renaissance of simultaneous tomography with the fluorescent-film storage system].

The handling, technical and exposure details of digital simultaneous tomography are explained, while particular emphasis is placed on image quality. Selected case reports demonstrate the application of this technique by using the digital storage fluorescent system (Fa. Siemens, Erlangen). Simultaneous tomography with storage fluorescent screens is particularly suitable to demonstrate or exclude osseous findings at the skull, the column and large joints.

Adult↗
PubMed1990

[Common channel syndrome--2 case reports].

The common channel syndrome is a disease mostly of young girls. To demonstrate the problems of diagnosis and therapy we report on 2 cases operated on in 1987 and 1989. The long delay of several years between the onset of symptoms and the diagnosis might be shortened by improved diagnostic possibilities (Ultrasound, ERCP). In any case of hyperamylasemia or chronic pancreatitis in childhood an obstruction of the biliary tract should be excluded. The common channel syndrome can be treated by means of sphincteroplasty or a bilidigestive anastomosis.

Amylases↗