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Biomedical subjects

H Schild

Publications and source records attributed to H Schild.

At least 235 records · Page 13Linked to original sources
PubMed1989

[The supinator fat pad in fractures of the elbow joint].

The position of the supinator fat pad is regarded as a valuable sign in fractures of the elbow. In our patients the pad was visible in 277 out of 337 cases (82%). The sign was positive in only 27 out of 55 proximal fractures of the radius (sensitivity 0.49). There was no correlation between the severity of the fracture and the sign. There was marked variation in the distance between the pad and the radius, depending on age, build and projection. Our results indicate that the sign is not suitable for the diagnosis of fracture of the elbow.

Adipose Tissue↗
PubMed1989

[Pseudarthrosis of the scaphoid: frequency, pathogenesis and course].

Eight-three scaphoid pseudo-arthroses were found amongst 1.104 scaphoid examinations. Sixty-seven were present at the first examination and 16 pseudoarthroses developed amongst 252 scaphoid fractures. Men were affected predominantly, particularly in the 20 to 40-year old group. Fractures in the proximal third of the scaphoid and vertical oblique fractures had a particular tendency to pseudo-arthrosis formation. The operative treatment of choice is a Matti-Russe bone graft. Only one patient in seven with definite scaphoid pseudo-arthrosis showed firm fusion.

Adult↗
PubMed1989

[The results and complications of 616 percutaneous transhepatic biliary drainages].

During nine years, percutaneous transhepatic biliary drainage was carried out 616 times on 563 patients in the Department of Radiology, University of Mainz Medical School. 50.3% were pre-operative and 39% were palliative. More than 80% were necessitated by malignant lesions. Subsequent improvements in biochemical measurements were observed in 82.4% of patients. Complications of the procedure led to the death of five patients (0.8%) and required surgery in nine patients (1.5%). The following complications were observed: biliary peritonitis in 0.6%, sepsis in 1.9%, bleeding in 1.9% and fever higher than 38 degrees C in 16.2%.

Biliary Tract↗
PubMed1989

[Transpenile venous occlusion in the treatment of erectile impotence].

In 15 of 18 patients, 2 of them with previous surgery, transpenile venoablation was performed for treatment of erectile dysfunction due to cavernous leakage. In 4 this was combined with retrograde venooclusion via the internal iliac vein. In 4 patients normal erectile status could be obtained. In 3 other patients erections became possible with use of intracavernous vasoactive agents. In two only mild amelioration, and in two others no change of erectile dysfunction were obtained. Follow-up studies are yet missing in 3 patients. Complications of the procedure were not observed.

Adult↗
PubMed1989

[Percutaneous removal of a pacemaker electrode].

The large number of pace-makers introduced transvenously has resulted in increasing the number of complications, amongst which infections and dislocations are prominent. It is usually necessary to remove the electrode, which can be attempted percutaneously by using a Dormia basket, a loop or forceps. Amongst the complications of this procedure are tears to the myocardium, with the risk of pericardial tamponade, or tears of the tricuspid valve leading to tricuspid insufficiency. Consequently, thoracic surgical intervention should be available if necessary. Four successful procedures are described.

Aged↗
PubMed1989

Initial clinical experience with an endoluminal spiral prosthesis for treating complicated venous thrombosis and preventing pulmonary embolism.

Fourteen patients with complicated venous thrombosis or recurrent pulmonary embolism were treated by implantation of an endoluminal spiral prosthesis subsequent to balloon angioplasty, surgical thrombectomy or embolectomy, a combination of these, or, in 2 cases, no other treatment. The patients were divided into 2 groups, based on their primary diagnosis and the purpose of the prosthesis. Group I included 8 patients with extensive iliofemoral or caval thrombosis, caused by congenital caval stenosis (1 case) or extravascular compression or retraction (7 cases); 7 of these patients had had previous operations, and the remaining patient had undergone thrombolysis, which failed. The current treatment consisted of balloon angioplasty and surgical thrombectomy or embolectomy, and implantation of an endoluminal spiral stent to prevent elastic recoil of the vessel. In 4 cases, an arteriovenous fistula was constructed and was taken down 3 months later; in 1 additional patient, a bilateral arteriovenous fistula was created. Group II comprised 6 patients with recurrent pulmonary embolism (4 cases), massive pulmonary embolism (1 case), or paradoxical bilateral carotid artery embolism (1 case). Four of these patients underwent surgical thrombectomy or embolectomy, while 2 had no treatment other than filter implantation. All 6 underwent transluminal implantation of a helix caval filter (a modification of the endoluminal spiral stent). All but 1 implantation was accomplished by means of either a transfemoral or a transjugular cutdown; the remaining implantation was performed transatrially after a pulmonary embolectomy. The only device-related complication was a retroperitoneal hematoma in Group I, resulting from perforation of the inferior vena cava by the guidewire during device implantation. This complication necessitated an emergency laparotomy and takedown of the arteriovenous fistula, which resulted in rethrombosis of the left iliofemoral vein. The other 7 stented veins were patent at early phlebographic follow-up, as were all 5 of those studied later. One Group-I patient died 4 months after surgery, due to tumor progression and without signs of caval restenosis. Twelve months postoperatively, 1 Group-II patient died of urosepsis without a recurrence of pulmonary embolism. Four of the 6 Group-II patients were studied late postoperatively, and all of their stented vessels were patent. There was no operative mortality or postoperative embolism. On the basis of these results, we conclude that endoluminal stenting with an expandable spiral prosthesis is a promising method for remote venous reconstruction. Moreover, it appears that the modified stent, or helix caval filter, compares favorably with commercially available filters.

Journal Article↗
PubMed1989

[Computed tomography of pancreatic carcinoma].

The ductal adenocarcinoma is the most frequent tumour of the pancreas. So far, imaging methods did not enable early diagnosis of the tumour, since in most cases it cannot be detected before it has grown to a size of 2-3 cm diameter. CT findings of the carcinoma of the pancreas as well as problems connected with the diagnosis and with staging of the tumour are presented in a concise review.

Carcinoma, Intraductal, Noninfiltrating↗
PubMed1989

[Computed tomographic diagnosis of liver metastases].

Detailed CT diagnosis of liver metastases requires besides plain CT also computed tomography using a contrast medium which can be applied by different methods and routes of application. The problems associated with plain CT and with CT using water-soluble and fat-soluble contrast media are presented in a concise manner.

Contrast Media↗
PubMed1989

[Spontaneous arterial recanalization--a case report].

Spontaneous thrombolysis with recanalisation of peripheral arterial vessels is a well-known, albeit rare phenomenon. The probable mechanisms of this phenomenon is the activation of local fibrinolytic processes by local mediators of the vascular endothelial cells. Vascular stenoses of atherosclerotic origin are also subject to regression, depending on the plasma LDL level. Reangiography is indicated for determining further therapy planning if there is a change in clinical signs towards either improvement or deterioration. Reangiography is imperative if the previous angiography was performed before more than three months.

Arterial Occlusive Diseases↗
PubMed1989

[The 4 mm plasma-tetrafluoroethylene prosthesis as a coronary vessel replacement in the animal experiment].

For coronary artery revascularisation the availibility of a prosthesis may be useful, which in case of insufficient or inadequate veins may be used as a biocompatible substitute. The new 4 mm Plasma TFE prosthesis consisting of a woven fiber of polyethylenteraphtalate (PET) coated with an ultrathin layer of Tetrafluoroethylene (TFE) has shown to be highly non thrombogenic in vitro and was therefore regarded as being promising. In an experimental study 10 beagle dogs underwent aortocoronary bypass grafting in order to evaluate the in vivo behavior of the prosthesis. In group 15 dogs received a Plasma TFE prosthesis of 7 cm length. To overcome the problems of inadequate caliber at the distal side of the anastomosis another 5 dogs in group II received a composite sequential graft composed of a 4 cm proximal Plasma TFE prosthesis and a 3 cm distal autologous saphenous vein. Treatment with antiplatelet drugs (Aspirin) was started during the operation and continued by daily doses of 500 mg p. os. Control-angiography 1 week after the operation demonstrated patency of 1 out of 5 grafts in group I and 4 out of 5 grafts in group II. Half a year later the only graft from group I was still patent, whereas in group II all grafts had thrombosed. Histological examinations showed the graft coated with a layer of 50-250 microns fibrous tissue mear the aortic anastomosis, while more distally the prosthesis was completely occluded. In conclusion the 4 mm Plasma TFE prosthesis though promising from in vitro experiments has proven to be not suitable as a substitute for aortocoronary artery bypass grafting in the dog.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

[Traumatology and diagnosis of scaphoid fracture].

In 9 years, 1,104 patients had one or more roentgenological studies of the scaphoid; 252 fractures of the scaphoid were found. The most reported traumatic mechanism was a fall on the extended wrist. The form of fracture most seen was transverse fracture of the scaphoid; most of the fractures were found in the middle third of the scaphoid. The primary radiodiagnostic procedure should contain pictures of the wrist in two planes and four special pictures of the scaphoid. The "fat-pad sign" seems to be an unreliable indicator of fracture, but nearly two-thirds of fractures of the scaphoid showed a swelling of the soft tissues in the X-ray picture.

Accidental Falls↗
PubMed1989

[Diagnosis of unusual fractures of the wrist bones].

Fractures of the navicular bone are the most frequent fractures in the region of the wrist bone. Injuries of the other carpal bones are often primarily overlooked, since the examiner commands over less routine in diagnosing these rare fractures and the carpal bones are often superimposed over one another. We examined 9.723 x-ray films of the hand performed because of suspected fracture of the os naviculare, in order to find out how often lesions of the carpal bones - with the exception of those of the scaphoid bone - were discovered via the x-ray series of the os naviculare manus. For each individual wrist bone we recorded the incidence of fractures, clinical treatment and diagnoses, including any special x-ray takes that would be necessary for the detection of a particular fracture.

Carpal Bones↗
PubMed1988

[Assessment of fluid content of the lung by thoracic radiography. Comparison of extravascular lung water measurement and results of radiological estimation methods].

Extravascular lung water (EVLW) was determined with the thermal-dye double-indicator method (119 individual measurements) in 23 patients in an intensive-care unit, and the results were compared with estimates made from largely standardized portable chest X-ray films, using the staging method of Sibbald as well as that of Halperin. There was a significant correlation with the measured EVLW for both methods. Radiologically "normal" films corresponded to a mean EVLW value of 8.4 ml/kg body-weight. Radiologically judged adjacent stages did not in all cases compare with corresponding measured EVLW values. But when EVLW values were clearly abnormal, the X-ray films always demonstrated massive interstitial or alveolar infiltrations. Measurement of EVLW enables one accurately to judge the fluid contents of the lung and is superior to the assessment of the chest X-ray film.

Adult↗
PubMed1988

Percutaneous transhepatic biliary drainage: experience with 311 procedures.

Percutaneous biliary drainage was performed in 296 patients on 311 occasions using a fine-needle puncture technique. In 59%, the procedure served as postoperative decompression, and in 35% for palliation of obstruction, particularly in malignant disease. Postoperative drainage for the management of postoperative complication accounted for 2.5%. In more than 80% of the patients treated, the underlying disease was malignant obstructive jaundice. In 257 retrospectively evaluated patients the following complications were observed: cholangitis (6.6%), sepsis (3.1%), bile leakage (1.6%) with two deaths (0.7%), and subcapsular hematoma and hematoma in the hepatoduodenal ligament (1.2%). Catheter dislocations accounted for 8.5% and were eliminated by the use of self-retaining catheters. In 51 prospectively studied patients pain was encountered in 55% and cholangitis in 11.8%. The procedure is most valuable for complicated biliary obstruction, palliative drainage, and endobiliary manipulations.

Biliary Tract Neoplasms↗
PubMed1988

[Oncocytoma of the kidney. 1. Computed tomography].

The computer tomograms of 22 patients with renal oncocytomas were analysed retrospectively. Characteristic findings were: 1. solid round space-occupying lesions (22/22), 2. sharp demarcation from the kidney (20/22), 3. smooth margin (20/22), 4. hypodensity after intravenous contrast (20/20), 5. enhancement (19/19), 6. central hypodense nidus (16/22), 7. homogeneous beyond the nidus (11/22). In the presence of these criteria, the diagnosis of an oncocytoma may be suspected. Safe differentiation from a renal cell carcinoma may not always be possible.

Adenoma↗
PubMed1988

[Vascular recanalization using an electric thermal cauterizing catheter--in vitro experiences with a new catheter system].

Recanalisation of arteriosclerotic occlusions by means of laser angioplasty, Kensey catheter and the "hot tip" catheter is undergoing early, successful clinical trials. The thermo-cautery catheter described in this paper uses the well known technique of cutting with high frequency electric currents in order to achieve vascular recanalisation. Seven attempts were made to recanalise occlusions at post mortem; four were successful, but perforation occurred in three. Histologically we found a narrow rim of carbonisation of tissues surrounded by a zone of homogenisation and a transitional zone.

Angioplasty, Balloon↗
PubMed1988

Does velocity of dilatation influence the result of dilatation? A postmortem study.

We evaluated the influence of velocity of dilatation on the success of and the vascular damage produced by dilatation. Nonatheroslerotic segments of distal superficial femoral arteries were dilated "fast" (n = 69) or "slow" (n = 45) under standard conditions with balloon catheters. The arterial wall was overstretched between 1% and more than 60%. The success of dilatation rose continuously with increasing overstretching during dilatation. The damage to the arterial wall by dilatation increased discontinuously with increasing overstretching. Dilatation success and damage patterns did not differ in the "slow" and "fast" groups.

Angioplasty, Balloon↗