Search PubMed⌕ Search

Biomedical subjects

G Bongartz

Publications and source records attributed to G Bongartz.

95 records · Page 6Linked to original sources

Massive pulmonary embolism: treatment with thrombus fragmentation and local fibrinolysis with recombinant human-tissue plasminogen activator.

PURPOSE: To report the results of thrombus fragmentation in combination with local fibrinolysis using recombinant human-tissue plasminogen activator (rtPA) in patients with massive pulmonary embolism. METHODS: Five patients with massive pulmonary embolism were treated with thrombus fragmentation followed by intrapulmonary injection of rtPA. Clot fragmentation was performed with a guidewire, angiographic catheter, and balloon catheter. Three patients had undergone recent surgery; one of them received a reduced dosage of rtPA. RESULTS: All patients survived and showed clinical improvement with a resultant significant (p < 0.05) decrease in the pulmonary blood pressure (mean systolic pulmonary blood pressure before treatment, 49 mmHg; 4 hr after treatment, 28 mmHg). Angiographic follow-up in three patients revealed a decrease in thrombus material and an increase in pulmonary perfusion. Two patients developed retroperitoneal hematomas requiring transfusion. CONCLUSION: Clot fragmentation and local fibrinolysis with rtPA was an effective therapy for massive pulmonary embolism. Bleeding at the puncture site was a frequent complication.

Angiography, Digital Subtraction↗

Degenerative cartilage lesions of the hip--magnetic resonance evaluation.

The capability of magnetic resonance imaging (MRI) to visualize early degenerative arthritis of the hip was investigated. The study was performed on 8 healthy students and 45 elderly volunteers. Images were obtained by using an electronically variable Helmholtz coil (switched-array coil, SAC). In order to diagnose degenerative lesions of the joint cartilage, FISP sequences with a flip angle of 70 degrees were found preferable to compared sequences. MRI-detectable signs of degenerative arthritis of the hip were narrowed joint space due to partially thinned cartilage layers, focal areas of either increased or decreased signal intensity in the hyaline cartilage, complete loss of cartilage, and signal variation in the bone marrow. MRI of the hip may be appropriate to detect early degenerative changes in the hips of young high-risk patients to facilitate therapy planning.

Aged↗

Anterior neopharyngeal pseudodiverticulum. A possible cause of dysphagia in laryngectomized patients.

Anterior neopharyngeal pseudodiverticula are out-pouchings of the neopharyngeal lumen in laryngectomized patients which can cause postoperative dysphagia. In this study 20 laryngectomized patients were examined endoscopically and with barium swallow to determine the frequency of pseudodiverticulum formation, the correlation with clinical symptoms, and to evaluate the best modality for diagnosis. In 12 patients an anterior neopharyngeal pseudodiverticulum was present. Of these patients eight complained of dysphagia. The barium swallow showed more clearly the pseudodiverticula than laryngoscopy and gave additional information on functional implications. All symptomatic patients were successfully operated on with endoscopic laser therapy.

Adult↗

Gene therapy study of cytokine-transfected xenogeneic cells (Vero-interleukin-2) in patients with metastatic solid tumors.

On the basis of compelling preclinical data in cats and dogs, we initiated a clinical gene therapy study in nine patients with advanced solid tumors using xenogeneic fibroblasts secreting human interleukin (IL)-2 (Vero-IL-2 cells). Cohorts of three successive patients with tumors accessible to computed tomography- or ultrasound-guided injection were treated repeatedly with 5 x 10(5), 5 x 10(6), or 5 x 10(7) Vero-IL-2 cells. The endpoints of the study were feasibility, toxicity, and the clinical and biological effects of this novel approach to immunotherapy of cancer. Histopathological, immunological, and molecular analyses were performed on biopsy specimens of tumors and blood samples before, during, and after treatment. Treatment was well tolerated, and toxicity consisted of transient fever in one patient and short-lived, mild itching and erythema in two others. One patient with soft-tissue sarcoma showed a reduction of >90% and >50% of the volume of two distant, noninjected metastases, lasting for 29+ and 26 months, respectively. Four other patients showed stabilization of their disease for 3-9 months; of these patients, one with melanoma developed marked vitiligo. We conclude that repeated injections of < or =5 x 10(7) Vero-IL-2 cells are feasible and safe in heavily pretreated patients with advanced solid tumors. An additional evaluation of an intratumoral application of Vero-IL-2 seems warranted.

Adult↗

[The value of magnetic resonance tomography (MRT) in inflammatory rheumatic diseases].

As compared to other imaging modalities, magnetic resonance imaging (MRI) is characterized by superior soft tissue contrast, multiplanar display, and lack of ionizing radiation and other hazards. Contrast media, including paramagnetic substances, (e.g., gadolinium-DTPA) are useful for further improvement of diagnostic capabilities of MRI. In this paper the results of MRI in rheumatoid arthritis and related disorders, as well as the potentials of its clinical use are discussed.

Bone and Bones↗