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Biomedical subjects

H Strunk

Publications and source records attributed to H Strunk.

At least 55 records · Page 3Linked to original sources
PubMed1997

[The diagnosis of intra-abdominal hemorrhages with CO2 as the contrast medium].

PURPOSE: Evaluation of carbon dioxide (CO2) as contrast medium for detection of intraabdominal haemorrhage. METHOD: We performed in 5 patients 7 DSA examinations (one with upper and three with lower gastrointestinal bleeding, one traumatic spleen rupture) using an iodinated contrast-medium and CO2 for the localisation of haemorrhage. RESULTS: With iodinated contrast medium it was possible to localise the haemorrhage in three of 5 patients. With CO2 the localisation was possible in all cases. There were no side effects. CONCLUSION: CO2 is useful for detection of intraabdominal bleeding. Even in cases with negative angiographic results with iodinated contrast medium, CO2 may enable localisation of the bleeding vessel. Because of this, we use CO2 and iodinated contrast media in all cases of intraabdominal haemorrhage. Further studies are required.

Angiography, Digital Subtraction↗
PubMed1997

[Carbon dioxide (CO2) as contrast medium for the new installation and follow-up of a TIPS].

PURPOSE: To determine the efficacy of CO2 as negative contrast medium compared with iodinated contrast medium in creation and control of TIPS. MATERIAL AND METHODS: CO2 was used during TIPS procedures in 33 patients. In 21 patients a wedged hepatic venography was obtained for planning the shunt tract. Additional TIPS-control DSA was performed in 42 cases by direct portal venography to verify the TIPS function and patency. In all cases CO2 gas was used in addition to iodinated contrast medium. RESULTS: CO2 produced excellent wedged hepatic venographies in all patients. Visualisation of the portal veins and collaterals was superior to iodinated contrast medium. The TIPS-control DSA performed with CO2 were comparable to those performed with iodinated contrast medium. Complications were not observed in our study. CONCLUSION: CO2 is an effective contrast medium for TIPS procedures. In particular the visualisation of portal veins performed by CO2-wedged hepatic venography is superior to iodinated contrast medium.

Adult↗
PubMed1997

[The typical radiological findings and course of invasive pulmonary aspergillosis in the immunosuppressed patient].

PURPOSE: This retrospective study was designed to show whether invasive pulmonary aspergillosis, which is often difficult to diagnose by bronchoscopy or serology, can be diagnosed at an early stage by typical radiological findings on conventional radiographs or by CT, specially high resolution CT (HR-CT). PATIENTS AND METHODS: In 19 Patients with 20 disease episodes, 20 thorax radiographs and eight spiral CT examinations were performed and in four cases HR-CT was also available. The earliest pathological findings and the course of the disease were analysed and the results of the various examinations were compared. RESULTS: 90% of chest examinations, including CT and HR-CT, showed the following lesions as part of the earliest changes: round or wedge-shaped opacities or the so-called "halo" sign. CT or HR-CT always demonstrated more lesions than plain chest radiographs; 75% of lesions appeared typical and thereby contributed to the diagnosis. CONCLUSION: The typical radiological findings of round or wedge-shaped opacities and the so-called "halo" sign are additional criteria for the diagnosis of invasive pulmonary aspergillosis. The superiority of CT or HR-CT in the demonstration of pathological changes suggests that these should be used early in the investigation of patients who are specially at risk.

Adult↗
PubMed1997

[CO2 cholangiography].

PURPOSE: Evaluation of the benefit of carbon dioxide (CO2) as contrast medium to reduce intraductal manipulations in biliary drainage. METHOD: In 8 patients with biliary occlusion demonstrated by cholangiography with iodinated contrast medium, percutaneous CO2 cholangiography was performed by manual injection of 30-50 ml CO2 using the same approach. Capability of CO2 to pass the obstruction and delineate distal parts of the common bile duct was evaluated. RESULTS: In 5 of 8 patients CO2 visualised additional segments of the occluded bile duct. In 4 patients the poststenotic bile duct was demonstrated with CO2. In one patient 2 cm of the obstructed duct segment was visualised. The intrahepatic duct system could not be examined sufficiently by CO2 administration. CONCLUSION: Because of its low viscosity, CO2 is a useful contrast medium to visualise the extrahepatic biliary system before performing an external-internal biliary drainage in biliary obstruction. Unnecessary intraductal manipulations may be reduced.

Carbon Dioxide↗
PubMed1997

[Stent implantation and balloon dilatation in the treatment of stenosis and obstruction of the lacrimal apparatus].

PURPOSE: To evaluate treatment of epiphora caused by obstructions of the nasolacrimal duct system with balloon dilatation and stent implantation. MATERIAL AND METHODS: 28 dacryocystoplasties were performed in 20 patients with complete (n = 7) or incomplete (n = 13) obstruction of the nasolacrimal duct system. RESULTS: Dacryocystoplasty was technically successful performed in 26 cases (93%). Recanalisation was not achieved in two patients with complete obstructions. 17 patients showed complete or partial resolution of epiphora during follow-up of up to two years (clinical success 85%). Complete reobstruction occurred only in one patient 9 months after balloon dilatation and recanalisation was not possible. CONCLUSION: With a technical success rate of 93% and a clinical success rate of 85% dacryocystoplasty is a non-operative alternative for treatment of epiphora caused by obstructions of the nasolacrimal duct system.

Adult↗
PubMed1997

[MRI diagnosis and follow-up of bilateral necrosis of the humeral head as a complication after chemotherapy].

A 14-year old female patient was treated with chemotherapy including cortisone for malignant T-cell lymphoma. After chemotherapy she complained of pain in both hips and shoulders. Bone scintigraphy and conventional radiography failed to show any abnormality. However, bilateral femoral and humeral head necrosis was seen with MR imaging, which was also useful for follow up.

Adolescent↗
PubMed1997

[Hepatic pseudolesion caused by puncture].

We report the diagnosis and differential diagnosis of a hepatic pseudolesion due to percutaneous liver biopsy in a 30-year-old female patient with known chronic hepatitis C and renal insufficiency. In the course of transplant preparation, an abdominal spiral-CT examination pre and post i.v.-contrast injection as well as an angiography with CT-hepaticography and CT-portography were performed. In these examinations a 1 cm, hepatocellular-carcinoma mimicking liver lesion was found; it was hypodense in the CT-portography and showed a marked enhancement in the CT-hepaticography. This "pseudolesion", which was supposed to be due to the liver biopsy, resolved spontaneously.

Adult↗
PubMed1996

[Percutaneous removal of displaced metal stents in TIPS].

PURPOSE: Basing on our experience with three dislocated or displaced stents (one Wallstent, two Plamaz stents) during or after TIPS-procedure, we describe our technique to reposition or remove the stents. METHOD: The stents were moved back into the inferior vena cava by means of a balloon catheter, an alligator forceps, or an Amplatz gooseneck snare. They were secured against further dislocation by a central guidewire. After insertion of a balloon catheter into each dislocated stent, they were coaxially grasped with an Amplatz gooseneck snare. Stent diameter was reduced by forceful closure of the snare, and then the stent was either relocated or removed. CONCLUSION: To prevent further stent migration it is necessary to remove the stent via a guidewire. By using a balloon catheter and a coaxially inserted Amplatz gooseneck snare, reduction of the outer stent diameter is possible even in Plamaz stents, facilitating their relocation or removal.

Adult↗
PubMed1996

[Temporary vena cave filter: critical comments].

PURPOSE: Retrospective evaluation of the reasons for complications caused by the placement of temporary vena cava filters. METHOD: Retrospective analysis of 9 complications in 6 implanted temporary (2 anthéor TC-, 4 Filcard RF 02-Filter) and 6 retrievable vena cava filters (1 Dil-, 5 FCP 2002-Filter). RESULTS: We observed 7 filter thromboses and two severe infections. 5 filter thromboses occurred in temporary filters, two filter thromboses and two infections occurred in facultative temporary filters. CONCLUSION: The main complications of temporary vena cava filters, like filter thrombosis and infection, were associated with the fixation mechanism of the filter. Our results indicate that facultative temporary vena cava filters without a permanent percutaneous retrieval system seem to be the safer system.

Evaluation Studies as Topic↗
PubMed1995

[Stent implantation for the palliative therapy of upper inflow obstruction in bronchial carcinoma].

AIM OF STUDY: To analyse results obtained in the palliative treatment of obstruction of the upper inflow veins by stent implantation in patients with bronchial carcinoma. PATIENTS AND METHODS: Stents were implanted in 14 patients with upper venous obstruction due to bronchial carcinoma (three women, eleven men: mean age 64 [48-74] years), 4 of the superior vena cava (SVC), 6 of the SVC and brachiocephalic vein, 4 of the SVC and subclavian vein. To prevent thromboembolic phenomena all patients received heparin in therapeutic doses for 1-3 days from the time of stents implantation. RESULTS: Treatment was successful (regression of the clinical signs) in 12 of the 14 patients. Six patients died, without recurrence of the clinical signs, an average of 141 (10-420) days after the procedure. Mean survival time of the six patients who remained without symptoms was 3 months (longest interval 9 months). In one patient thrombotic occlusion of the SVC occurred 6 days after stent implantation. However, local thrombolysis successfully re-opened the vessel. Renewed upper vein obstruction occurred in two patients during follow-up. None of the stent filaments fractured and there was no stent dislocation. CONCLUSION: With a success rate of 86% stent implantation proved to be a sparing procedure in the palliative treatment of upper inflow vein obstruction, especially in patients with extensive malignant disease.

Aged↗
PubMed1995

[The value of fine needle puncture in adrenal gland tumors].

UNLABELLED: The value of fine needle biopsy (FNB) in adrenal masses was investigated in 33 patients presenting with such masses. Representative material was obtained 18 times from 19 patients with a history of tumour. 4 of them were diagnosed to be genuinely benign and 14 to be genuinely malignant. Further representative material was obtained 13 times from 14 patients with incidental findings of adrenal masses. The material gained by puncturing was classified correctly as benign in 9 cases, and twice it was considered benign although the tumours later proved malignant. In one case a clinically not suspected malignant lesion was detected by FNB, while in another case a malignant lesion was suspected by FNB, whereas a benign tumour was proven by means of surgery. The share of malignant diagnoses corresponded with the size of tumour, ascertained by the application of ultrasound or CT. The rate of malignant adrenal masses, which were found incidentally, increased from 7 cm onwards; however, the rate of malignant adrenal masses obtained from patients with a history of tumour increased distinctively already from 4 cm onwards. From 11 patients out of 33, adrenal tissue was obtained and classified as benign lesion (adenoma), although, by means of FNB and the conditions for reasons of method, a well differentiated carcinoma cannot be excluded. CONCLUSION: FNB is indicated for non-functioning tumours examined in patients with a history of tumour, furthermore, for incidental findings of the size between 4-6 cm. A diagnostic approach to adrenal masses is suggested.

Adrenal Cortex Neoplasms↗
PubMed1995

[The measurement of vascular diameter to determine stent and balloon size in percutaneous procedures in the pelvic circulation].

AIM: Should the sizes of balloons and stents used in the pelvic circulation be determined by the size of the ipsilateral or contralateral vessel? STUDY DESIGN: The angiographic findings in 31 patients were analysed; in 10 an occlusion and in 21 a high grade stenosis (greater than 75%) of the common iliac artery had been treated by stenting (26) or simple PTA (5). RESULTS: In 26 of the 31 patients there was marked reduction in the lumen distal to the lesion up to 40%. In 17 patients this was reversed immediately after the procedure and in five others the lumen increased but a difference between the two sides remained. The changes on the two sides following treatment were statistically significant (external iliac artery: p = 0.00013). CONCLUSION: The results indicate that the "normal" contralateral measurements should be used rather than the distal ipsilateral vessel diameter.

Adult↗