The recognition of MHC molecules by gamma delta T cells.
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Amino Acid Sequence↗
Biomedical subjects
H Schild
Publications and source records attributed to H Schild.
[Carbon dioxide--contrast medium for digital subtraction angiography].
UNLABELLED: Fundamental considerations: Despite appreciable improvements in conventional iodine-containing contrast media, vascular studies involving patients with renal insufficiency, hyperthyroidism or known allergic reaction to conventional contrast media continue to pose a problem. Own study: Testing the investigation of the possibility of visualizing vessels using carbon dioxide as a gaseous contrast medium. In 30 patients, angiography of the pelvis and legs (DSA) employing conventional iodine-containing media and/or CO2 were carried out simultaneously. RESULTS, handling and toleration were compared. In two further patients, percutaneous transluminal angioplasty and stent implantation, respectively, were successfully performed under CO2 control. RESULTS: All the findings obtained with "normal" DSA were also obtainable with CO2. The CO2 examination, however, was often plagued by incomplete contrasting of the blood vessels, with interruption of the contrast medium column, which made assessment more difficult. In two of the 30 patients undergoing angiography of the pelvis and legs, the investigation had to be abandoned on account of persistent intensive lower abdominal pain under CO2 injection.
Angiography, Digital Subtraction↗
[Angiography in infancy and childhood].
Between 1973 and 1991 we performed 160 percutaneous angiograms (130 arteriograms, 30 phlebograms) in children and infants; 12 patients were less than one year and 52 less than ten years old. 44 of the examinations were done by a DSA technique. The examinations were carried out under general anaesthesia except in 8 cases. In 50.7% an arteriogram was carried out for the investigation of a suspected or known tumour, in 9.3% an arteriogram was required following trauma. The most common phlebographic examination was for the demonstration of the spermatic vein; in 27 patients this was done for cryptorchidism or a varicocele. The only complication following a diagnostic angiogram was perforation of one spermatic vein. There were no other complications requiring treatment, such as thromboembolic events. With a total complication rate of 0.6%, angiography in childhood is a relatively safe diagnostic method.
Anesthesia, General↗
[Spiral CT with three-dimensional (3D) surface reconstruction in assessing solitary pulmonary foci].
Recently it has been thought possible to characterise a pulmonary lesion by its vascular involvement. The complex vascular relationships are difficult to demonstrate by the "normal" technique of transverse CT sections. Spiral CT with 3D-surface reconstruction makes it possible to evaluate the vessels accurately and simulates the appearances one would have by looking into the thorax with a demonstration of all vessels lying within the pulmonary space examined by CT. Venous involvement was shown in every one of 18 malignant lesions but was also found in 4 out of 11 benign lesions, arterial involvement occurred in 14 out of 18 malignant and in 2 benign lesions. CT evidence of vascular involvement is in favour of a malignant tumour but is no absolute proof.
Computer Graphics↗
[Selective blood sampling from the sinus petrosus inferior: a comparison of CRF and TRH stimulation].
In 10 patients with hypophyseal Cushing microadenomas, selective bilateral sampling from the inferior petrosal sinuses was performed and the effect of stimulation by iv TRH and CRF was compared. On the side of the microadenoma. ACTH concentration rose from 650 +/- 242 pg/ml to 2712 +/- 843 pg/ml following injection of CRF and 2025 +/- 242 pg/ml after TRH. Contralateral values were 165 +/- 79 pg/ml, 490 +/- 200 pg/ml and 165 +/- 72 pg/ml respectively. Prolactin concentration on the side of the adenoma was 98 +/- 49 ng/ml before stimulation, 236 +/- 62 ng/ml after CRF and 747 +/- 168 ng/ml after TRH. Contralateral concentration was 22 +/- 10 ng/ml, 64 +/- 19 ng/ml respectively. Sampling localised all adenomas correctly, whereas contrast-enhanced MRT diagnosed only four adenomas.
Adenoma↗
[Computed tomography following extracorporeal shockwave lithotripsy of the kidneys. III. A prospective CT study of 105 patients and a 3-year follow-up of 23 patients using CT and 99mTc-MAG3 clearance].
In 105 patients CT studies were done prospectively after renal ESWL with a second generation lithotripter. 33 (31%) of the patients had renal oedema (n = 8), renal (n = 20) or extrarenal (n = 31) bleeding. Three of the 23 patients who had a three year follow-up had chronic renal changes, 10 had renal stones. As blunt renal trauma can be the cause of renal hypertension a longterm follow-up is necessary in ESWL patients, particularly if there was renal bleeding after treatment. Further studies are needed to determine the exact risk of renal hypertension after ESWL.
Adult↗
[Detection of chronic recurrent pulmonary emboli using spiral-CT].
Chronic recurrent pulmonary emboli may lead, in rare cases, to progressive pulmonary arterial hypertension which cannot be treated medically. These patients may be helped by bilateral pulmonary thrombendarterectomy. The value of spiral CT in the diagnosis of this condition was demonstrated in 31 patients. In 12 patients, thrombi could be shown to be the cause of the pulmonary arterial hypertension. Indirect criteria were vascular occlusions, changes in calibre and mural irregularities which were shown in varying degrees in all patients. In 22 of 31 patients there was non-homogeneity of perfusion with greater opacification of the perfused lung parenchyma. In 11 patients scars related to pleural surfaces were seen. Typical changes of right heart insufficiency (cardiomegaly, widened central pulmonary arteries) were shown in all patients by CT.
Adult↗
[Percutaneous removal of an intraperitoneal foreign body].
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Aged↗
[The safety belt: effects on injury patterns of automobile passengers].
Since 1984 the law concerning safety belts has been implemented; this paper deals with the findings in 386 victims of motor accidents who were x-rayed between 1981 and 1989. Minor injuries have been ignored. The number of passengers wearing belts increased by 30% after 1984. The number of passenger injuries did not decrease. Injuries directly caused by the belts included a small number of fractures of clavicles, the sternum and ribs and one pelvic fracture, one serious abdominal injury with tearing of the mesenteric artery and one ruptured spleen. An indirect result of wearing seat belts was a marked increase in cervical whiplash injuries and some increase in thoracic vertebral fractures. None of the belt induced injuries proved fatal. Amongst those using seat belts there was a significantly lower fatality rate and injuries causing prolonged disability. In particular, using seat belts, serious injuries to the skull and brain were reduced by 80%. Similarly injuries to the abdomen, the odontoid, pelvis and hip joint were greatly reduced. The advantages of wearing a seat belt greatly outweigh the disadvantages.
Accidents, Traffic↗
[MRT for surgical planning in anal atresia].
We evaluated in this study the value of preoperative examinations of anal atresia with an optimised MRI strategy. 13 patients with anorectal anomalies, most of them younger than one year, underwent an MRI examination of the pelvis. 10 of these patients were operated afterwards. Compared with the situs shown by the operation the results of the MRI examination were very exact in all cases in respect of the level of atresia and the development of the striated muscle complex. Fistulas could be completely described in most cases. MRI demonstrated additional lesions in some patients which were of great importance for planning the further treatment of the patients. As a consequence MRI can give valid information on anal atresia for planning the operative treatment.
Anal Canal↗
Percutaneous ultrasonic angioplasty: initial results of an in-vitro study on normal and atherosclerotic human vessel segments.
The aim of the present study was to assess the efficacy and safety of a new ultrasound catheter system in vitro before employing it in humans. Ultrasound energy was applied to 141 normal and atherosclerotic human vessel segments, obtained at autopsy. Macroscopical and histological examination of the treated vessel segments revealed that ultrasound energy is atraumatic to the normal vessel wall. In atherosclerotic vessel segments, there was macroscopically significant reduction in the size of plaques. In 7/10 completely occluded femoral arterial segments, recanalization could be achieved. The resulting lumen approximated the diameter of the wire probe. Therefore, ultrasound energy is an appealing form of energy for recanalization of completely obstructed atherosclerotic vessels and for disintegration of atherosclerotic plaques. Clinically, ultrasonic angioplasty may become an adjunctive modality to balloon angioplasty.
Angioplasty, Balloon↗
[Computed tomography of the digestive tract].
Computed tomography (CT) of the gastrointestinal tract is mostly employed in the staging of malignant lesions. Additionally, the application of CT in the diagnostic work-up of unclear abdominal complaints becomes more and more widespread. These different indications require adequate and standardised examination procedures. In this publication the general principles of gastrointestinal CT are presented, and the characteristic CT features of malignant and benign diseases are illustrated. The advantages, limitations and common pitfalls are pointed out.
Digestive System Diseases↗
[Injuries of the thoracic skeleton].
Injuries of the thoracic skeleton are an important indicator of other, relevant traumatic changes after a polytrauma. Most fractures occur in the ribs, followed by fractures of the clavicle, the scapula and the sternum. Because of their high kinetic energy, car accidents are the main reason for thoracic fractures. The basic radiologic tool is the a.p. projection of the thorax in supine position; in addition, other conventional x-ray examinations or computed tomography are performed. Most thoracic fractures are treated conservatively, only in few cases (instability of the thorax, risk of pseudoarthrosis, incongruence of joint surfaces) surgical procedures are used.
Clavicle↗
[Galeazzi's fracture in the x-ray picture].
Galeazzi's fracture represents the rather rare association of a fracture of the radial shaft with disruption of the distal radio-ulnar joint (13). The assessment of 19 galeazzi's fractures revealed the typical displacement of the distal radial fragment with a concomitant contraction in 7 and a lateral dislocation to the ulnar and/or volar side in 7 cases. The characteristic dorsal and/or lateral dislocation of the ulna following the disruption of the distal radio-ulnar joint was seen in 16 patients. Besides this dislocation additional radiographic signs of the rupture of the capsule and ligaments were a widening of the joint space of the distal radio-ulnar articulation shown on the ap-projection in 10, a pathological shortening of the radius or ulnae in 7 and the avulsion of the ulnar styloid process in 10 patients.
Adolescent↗
[Percutaneous endoscopic gastrostomy].
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Gastroscopy↗
[The computed tomographic staging of gastrointestinal tumors].
During a period of six years 131 patients had CT for gastrointestinal tumours or inflammatory bowel disease; the results were analysed retrospectively according to standard criteria. The preoperative CT appearances were compared with the surgical and histological findings. Confirmation of the diagnosis was obtained at surgery and from pathological studies carried out within six weeks of the CT. There were 93 malignant and 8 benign tumours and 30 inflammatory lesions. The reliability of CT for determining tumour extent and the presence of metastases can be improved by standardising the method of examination. Altogether a sensitivity of 75-85%, a specificity of 89-96% and an accuracy of 83-86% was obtained, depending on the anatomical lesion. Correct findings of all three staging parameters T, N and M for carcinomas was, however, obtained in only 56%. Differentiation between malignant and benign tumours and from inflammatory lesions was possible in the presence of specific CT patterns.
Adult↗
[Intercostal arterial embolization following thoracic trauma].
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Adult↗
[The value of the x-ray findings in the follow-up of the adult respiratory distress syndrome. A retrospective analysis].
Serial chest x-rays of 23 ARDS patients, taken in an 24 hour interval, were retrospectively analysed. Radiographic patterns of ARDS were divided into five stages and were related to corresponding parameters of respiratory status. Characteristic findings on chest x-ray films occurred after a short latency period following the clinical onset of ARDS. There was a close relationship between the time of maximum radiographic changes and maximum loss of lung function. The progression through successive radiologic stages was in many cases accompanied by a significant deterioration of functional parameters. Distinction between survivors and non-survivors was achieved while considering maximum radiographic abnormalities. The results suggest significance of serial chest x-rays in diagnosis and course estimation of ARDS.
Follow-Up Studies↗