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Biomedical subjects

G Lechner

Publications and source records attributed to G Lechner.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Standardized sonographic measurement of the width of the extrahepatic bile ducts].

As there are no exact data available which part of the bile duct should be measured, the hepatoduodenal ligament was examined in 20 cadavers. The constant anatomic relationship between the right hepatic artery and the common hepatic duct is shown. A right hepatic artery properly originating from the hepatic artery passes to 85% dorsally and to 15% ventrally of the common hepatic duct, but remains ventrally to the portal vein. If the right hepatic artery is shown dorsal to the portal vein (20%), an accessory right hepatic artery should be suggested. To maintain uniformity of measurement, the size of the common hepatic duct should be recorded immediately caudal to the right hepatic artery.

Arteries↗
PubMed1989

[Sonographic staging of pancreatic cancer. Report of 100 cases].

The ultrasound studies of 100 patients with proven pancreatic carcinoma were reviewed and correlated with the intraoperative and pathoanatomic findings. Ultrasound had a sensitivity of 87% in detecting the malignant lesion. The extension of the tumour and the infiltration of peripancreatic structures and visceral vessels was interpreted correctly in 85% of the cases. The sensitivity for liver metastases was 90.9%, whereas for lymph node involvement it was 78.3%. 19 patients had carcinosis peritonei. Ultrasonography could only detect the carcinosis in two cases. Malignant ascites was found in 15% (sensitivity of US 88.2%). 31% of the pancreatic carcinomas were resectable.

Adult↗
PubMed1989

[Sonography of gallbladder carcinoma. Correlation with surgical findings in 60 cases].

60 patients with carcinoma of the gallbladder were staged preoperatively by sonography (staging scheme by Nevin and TNM scheme of the UICC). This was correlated with the operative and histopathological findings. The tumour was diagnosed by sonography in 70% of the patients, 15% were diagnosed at operation and 15% histopathologically. The criterion for malignancy was tumour invasion into the liver (94.7% Sensitivity) and/or into adjacent tissues (36.8% Sensitivity). Most tumours were in an advanced stage (98.5%) and only one early carcinoma (1.5%) was found histopathologically. No improvement in the diagnosis of early carcinomas was achieved by ultrasound in our series.

Adult↗
PubMed1989

[Ultrasonic diagnosis following liver transplantation].

Realtime and duplex sonography were used routinely for the postoperative and long-term follow-up of liver transplantation patients. In the early postoperative period 90 patients exhibited diffuse (67.7%) and focal (33.3%) alterations of the liver parenchyma; in 53% of patients various liquid lesions were diagnosed in the abdominal cavity. In case of diffuse alterations of the liver parenchyma, no correlation could be established between sonomorphology and histopathologic findings; especially rejection could not be diagnosed by using sonography. In case of focal intrahepatic lesions highly echogenic areas of infarction could be differentiated from poorly echogenic changes such as necrosis, haematoma and abscess--these entities had to be further distinguished by means of CT or needle biopsy. 20 patients showed biliary pathology (biliomas: 5, cholangiectasis: 15). In 73.3% of cholangiectasis the cause of obstruction could be demonstrated sonographically (biliary thrombus, stenosis of the anastomosis of the common bile duct, recurrence of tumour). In 13 patients major vascular complications were diagnosed predominantly by means of duplex sonography (hepatic artery occlusion: 4, hepatic artery stenosis: 1, portal vein occlusion: 1, partial thrombosis of portal vein: 2, portal vein stenosis: 2, stenosis with incomplete thrombosis of the inferior vena cava: 3, VCI stenosis: 1). 13 patients developed recurrent malignancy in the late postoperative period.

Adolescent↗
PubMed1989

Dislocated Atkinson tubes: removal and repositioning with a balloon catheter.

Atkinson tubes are inserted endoscopically for palliation of obstructing esophageal carcinoma. A technique was developed to reposition or remove dislocated tubes that involves the use of a dilation balloon catheter. The technique was successful in treating three partially dislocated tubes and one of two completely dislocated tubes (tubes completely dislodged into the stomach). The only complication occurred in two patients who coughed up a small amount of blood.

Aged↗
PubMed1988

The relationship between the common femoral artery, the inguinal crease, and the inguinal ligament: a guide to accurate angiographic puncture.

The variability of the extraperitoneal puncture space between the inguinal ligament and the inguinal crease was evaluated in 100 patients. The distance between the inguinal crease and the inguinal ligament varied from 0 to 11 cm (average 6.7 cm +/- 1.9 SD), the average value for women (7.5 cm +/- 1.9 SD) being significantly greater than that for men (6.3 cm +/- 1.9 SD, p = 0.0128). The bifurcation of the common femoral artery was found below the inguinal crease in 20%, at the same level in 3.5%, and above it in 76.5% of cases. Consideration of these results will help avoid intraperitoneal puncture and improve the rate of successful antegrade puncture of the femoral artery.

Biometry↗
PubMed1987

[Sonography of acute cholecystitis. A report on 58 cases with a correlation of pathomorphological and histological findings].

Sonography has become the method of choice for evaluating acute diseases of the right upper quadrant. Prior to the ultrasound the diagnosis of acute cholecystitis was based on clinical and laboratory data. The pathohistomorphology of 58 opertively and histologically proven cases of acute cholecystitis has been correlated with preoperative sonography. An acute cholecystitis can be diagnosed based on the following sonographic criteria: Thickening of the wall of the gallbladder to more than 4 mm, sonolucent areas in or around the wall of the gallbladder, an increased ap. diameter of more than 4 cm as well as gallstones. A hyperechoic content of the gallbladder correlating to an empyema of the gallbladder was found in 31% and a perforation in 27.6% of the cases.

Acute Disease↗
PubMed1987

[Functional choledochus diagnosis following cholecystectomy].

50 patients after cholecystectomy and right upper quadrant pain have been examined by ultrasound for obstructive biliary disease. The value of dynamic changes of the common hepatic duct after a fatty meal in the evaluation of bile duct obstruction was investigated. The accuracy of a negative test in the group of patients with normal bile ducts (n = 27) was 100%. However in patients with dilated bile ducts (n = 23) the value of this test is limited. In this group 3 false negatives in patients with multiple small moveable stones occurred resulting in an accuracy of 86.9%.

Cholangiography↗
PubMed1987

[Percutaneous gastro-enterostomy].

Percutaneous gastrostomies or gastroenterostomies serve for temporary or permanent enteric feeding in patients with obstruction or functional derangement of the esophagus or hypopharynx. In addition, this radiological procedure may be indicated for small bowel decompression. The authors present their experience in 71 patients. Insufflation of air through a nasogastric tube or catheter is the preferred method for gastric distension. The inferior margin of the left lobe of the liver and the transverse colon are localized sonographically and fluoroscopically prior to puncture. Either Seldinger or Trocar-techniques have proven effective in establishing access to the stomach. The feeding tube is advanced into the proximal jejunum to reduce the likelihood of gastroesophageal reflux and possible aspiration. Complications were encountered in four patients and included catheter dislocation in three and respiratory distress in one patient.

Female↗
PubMed1987

[Comparison of the value of general and oblique images and whole lung tomography in a high kilovoltage technic in the detection of pulmonary coin lesions].

The ranking of high kvp pa. and lateral chest x-ray, left and right oblique films and whole lung tomography in the detection of pulmonary coin-shaped lesions is compared. Out of a total number of 327 coin lesions in 115 patients detected by high kvp whole lung tomography, only 52% were found on pa and lateral chest films. Additional oblique films improved the score to 64%. Oblique films proved to be especially helpful in detecting pleural lesions. Although CT has a higher sensitivity in detecting nodules (with decreasing specificity) whole lung tomography will continue to play an important role in the management of tumour patients.

Diagnosis, Differential↗
PubMed1986

The angiographic response of osteosarcoma following pre-operative chemotherapy.

The prognosis of osteosarcoma has improved significantly with recent advances in chemotherapy. Evaluation of the effect of chemotherapy is important for optimal timing of surgery, for selecting an alternative drug regimen in instances of poor response to chemotherapy and for testing combinations of new drugs. The purpose of this paper is to define the value of plain radiographs and angiography in assessing tumor response to chemotherapy. Studies were obtained before and after chemotherapy. The radiographic results were correlated with histologic evaluation of the resected specimen. Patients with less than 10% residual viable tumor in the resected bone were designated "responders" and patients with more than 10% of remaining viable tumor were "nonresponders". Angiographic appearances correctly separated 15 patients with good response to chemotherapy from seven patients who were not responsive. Conversely, comparison of plain radiographs obtained before and after chemotherapy did not allow a reliable differentiation between patients with good, poor, or no response to chemotherapy. The current role of angiography in the management of patients with osteosarcoma is discussed. It is concluded that - in contrast to plain film radiography - angiography is an accurate method for assessing the response of osteosarcoma to chemotherapy.

Adolescent↗
PubMed1986

[The accuracy of ultrasound in the diagnosis of intra-abdominal abscess formations].

During the last two years 73 patients with a total number of 84 abdominal abscesses have been investigated by ultrasound. Two thirds of the patients (67%) had postoperative abscesses. Spontaneous abscesses occurred in the remaining 33%. Multiple abscesses occurred in the postoperative group only (7 patients). The overall sensitivity in detecting an abscess was 84%. The sensitivity was much better with spontaneous abscesses (92%) than with postoperative abscesses (80%). One third of the patients have also been investigated by computed tomography. The diagnosis was confirmed either by needle aspiration or by operative drainage. Ultrasound was most useful in detecting abscesses in the right and left upper quadrant and in the pelvis, while CT was superior in the mid-abdomen and when dealing with multiple abscesses.

Abdomen↗
PubMed1984

[Real-time sonography in breast diagnosis. Indication and value].

With improvement in ultrasound technique, sonography is gaining increasing importance in the evaluation of breast lesions. The following conclusions are drawn on the basis of experience in the use of real-time sonography in 200 patients. Palpable masses are most suitable for examination by sonography, whereas the diagnostic yield in diffuse breast disease is relatively low. The most important task is the differentiation between benign cystic and solid masses. Differential diagnosis of solid tumours may be difficult or even impossible and biopsy should not be carried out solely on the basis of a sonographic examination. Palpation and mammography must still be considered as basic methods of examination, which may be successfully complemented by sonography.

Adenocarcinoma, Mucinous↗