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Biomedical subjects

J Vogel

Publications and source records attributed to J Vogel.

At least 91 records · Page 5Linked to original sources

Musculoskeletal involvement in cystic echinococcosis: report of eight cases and review of the literature.

OBJECTIVE: Our purpose was to describe the morphologic appearance of musculoskeletal lesions in patients with cystic echinococcosis shown by CT and MR imaging. CONCLUSION: Patients with musculoskeletal lesions of cystic echinococcosis typically have cystic structures in adjacent soft tissues. These cysts morphologically resemble abscesses, with peripheral uptake of contrast medium and variable signal intensities on T1-weighted MR images. The absence of calcifications or endovesicular daughter cysts does not exclude the diagnosis of cystic echinococcosis.

Adult↗

Displaced metallic biliary stents: technique and rationale for interventional radiologic retrieval.

OBJECTIVE: We investigated the spontaneous course and the possibility of transhepatic removal of displaced biliary stents. MATERIALS AND METHODS: Displaced biliary stents were observed in 11 patients (13-75 years old) between October 1988 and August 1996. Stent types included the Palmaz stent (n = 3), Wallstent (n = 3), and the Strecker stent (n = 5). Reasons for stent displacement included primary misplacement (n = 4), dislocation due to transhepatic endoscopy with biopsy (n = 2), dislocation resulting from a recanalization maneuver in stent occlusion (n = 3), and unknown causes (n = 2). In three cases, the stent was displaced into the proximal bile duct system. Seven patients had primary malignancy. RESULTS: Eight of 11 displaced biliary stents were removed transhepatically. Extraction was performed using either a wire loop (n = 4) or forceps (n = 4). No complications occurred. In the remaining three patients, whose stents were displaced into the intestine, no invasive action was taken. In one of these patients, a Palmaz stent was passed spontaneously after 1 week. In the second of these patients, a 6 cm Wallstent remained innocuously at a position in the right lower abdomen, and the patient died as a result of malignancy. In the third patient, who had a 10-cm Wallstent, an abscess developed in the stent region 4 months after displacement and resulted in formation of an ileocutaneous fistula. CONCLUSION: Transhepatic extraction of displaced biliary stents is technically possible, even in the case of rigid stents such as the Palmaz stent. Because of the risk of intestinal perforation, displaced stents should be removed.

Adolescent↗

[Technical adaptation of impulse oscillometry to special research conditions].

The technical adaptation of the Impulse-Oscillometry (IOS) to different conditions of measurement allows a wide range of applications so that even questions of peripheral user groups using lung function tests can be answered. Thus, the variable connection of the IOS head via fold hose opens the field of bedside measurements and additional applications in pediatrics, intensive care and veterinary medicine. Rhinomanometric examinations are possible with little expenditure and high practicability using nasal tips.

Adult↗

[Impulse oscillometry and body position].

To assess diurnal profiles of impulse-oscillometry (IOS) changes of IOS-parameters between different body positions have been studied using a special set IOS-Bedside for individual home care. IOS has been applied in lateral lying and in sitting position in 20 healthy female and male probands, aged 10-67, during 24 hours in intervals of 3 hours. In each test during normal breathing for approximately 30 sec about 130 spectral and structural analyses have been performed at an impulse distance of 0.2 sec. The global means of resistance at 5 Hz (R5) in lying position are in men about 0.6 and in women about 0.3 hPa/l/s higher than in sitting position, those of reactance in men and women are only about 0.2 hPa/l/s lower. There is a distinct diurnal periodicity of the differences. The maxima of them may occur at different hours of the day in single probands; but at the average mean the maxima are found at the end of night. The differences of oscillation parameters between lying and sitting position are bigger at end-expiration than at end-inspiration. The resistance-flow-gradients, representing the component of turbulent flow, are enlarged in lying position especially at night.

Adolescent↗

[Diurnal profile of impulse oscillometric impedance in healthy subjects].

Diurnal profiles of impulse oscillometry during 24 hours in 3 hour intervals in sitting and lateral lying position have been studied in 20 healthy female and male probands 10-67 years of age. Approximating the profiles by a sine-cosine-function the amplitude of resistance was found up to 3, that of reactance up to 1 hPa/l/s in single cases, preferably for end-expiratory values and for the resistance-flow- and the resistance-volume-gradients, more pronounced in lying than in sitting position. The daytime reaching maxima of resistance and minima of reactance is different in single individuals. Single persons with obviously high vitality or sensibility showed very high amplitudes reproducible within IOS measuring limits of 0.2 hPa/l/s after 6 months.

Adolescent↗

Postnatal distribution of Glut1 glucose transporter and relative capillary density in blood-brain barrier structures and circumventricular organs during development.

In the adult brain, Glut1 is associated with capillaries that form a tight barrier whereas Glut1 is lacking in capillaries with non-barrier properties, i.e. the circumventricular organs. In the present study the postnatal developmental changes of brain capillaries and Glut1 were compared in different tight and non-barrier structures. Rats were investigated at birth, 5th postnatal day (P5), P10, P15, P20, P30 and at the age of one year. Antibody stains of brain capillaries (fibronectin) and of Glut1 were visualized by fluorescent microscopy in identical brain cryosections. All brain capillaries of structures that have a tight barrier in adult animals showed the existence of Glut1 during postnatal development. Most non-barrier structures lacked Glut1 in their capillary endothelium after birth although Glut1 was found in the area postrema and subfornical organ at P0 and disappeared thereafter. The relative capillary density in tight barrier structures of the gray matter was more than doubled from birth to P20 with minor changes later. In contrast white matter structures missed any significant increase during development. It is concluded that Glut1, as an indicator of barrier properties, is existing in all blood-brain barrier structures at birth already. The capillary densities observed in different brain structures at birth are not related to the values found in adult animals.

Age Factors↗

Wilms' tumour in adults. Review of 10 cases.

Nephroblastoma (Wilms' tumour) is very rarely found in adult patients. We report on 10 cases to demonstrate the diagnostic and therapeutic problems. In case of flank pain, large tumour mass, fast tumour growth and young age, the possibility of Wilms' tumour should be taken into consideration even in adult patients. The chances for a successful treatment by primary surgery with adjuvant therapy are favourable for the lower stages I and II. All our patients presenting with tumour stages I and II have survived and have been free of disease for 68 months now. One of the patients with stage III Wilms' tumour died 8 months postoperatively while the other one has been free of disease for 120 months now. In the advanced stage IV no patient survived. In cases of inoperable large tumours in adults, the possibility of primary chemotherapy should be considered under certain circumstances. Rapid tumour regression may confirm the diagnosis and will make feasible a salvage operation in some cases.

Adolescent↗

Elastofibroma and pre-elastofibroma--a biopsy and autopsy study.

Two biopsy cases of elastofibroma--one unilateral and one bilateral--are described. A study of 100 autopsies revealed 13 elderly patients with elastofibroma. Males (n = 10; 16.9%) were more affected than females (n = 3; 7.3%). Pre-elastofibroma-like morphological changes (e.g. few or many degenerated elastic fibres) were observed in 81% of the autopsies. Minor pre-elastofibroma-like changes were seen in males and major changes predominantly in females. In addition to physiological ageing as yet unknown factors, rather than abnormal elastogenesis or degeneration, seem to be involved in this pseudotumour.

Adolescent↗

[Clinical relevance of mammography in men].

PURPOSE: During a period of four years 104 mammograms were performed in 89 men. Mastectomies were carried out on 23 men (group 1). 66 patients (group 2) were followed up clinically and in 15 patients serial mammograms were obtained. MATERIAL AND METHOD: In group 1 there were 5 patients with bilateral gynaecomastia, 9 with unilateral gynaecomastia and two with pseudogynaecomastia and there were 7 patients with malignancies. In group 2 there were 46 patients with bilateral gynaecomastia and 10 patients with unilateral gynaecomastia. Pseudogynaecomastia was found in 25 patients. There were 7 malignancies, of which 5 had been suspected clinically and one had been diagnosed as gynaecomastia by mammography. Two carcinomas in situ were missed clinically and also by mammography. CONCLUSION: When malignancy is not suspected on clinical grounds the first examination should be sonography, mammography being reserved for cases of doubt. Where, however, malignancy is suspected, and for follow-up, mammography retains its primary position.

Adolescent↗

[Thrombectomy using a high-speed rotatable catheter--initial results].

Evaluation of the Amplatz rotational catheter for the recanalisation of acute thrombotic occlusions in various vascular regions. The Amplatz air-driven rotational catheter was used in 5 patients with acute vessel occlusion in various vascular regions: superficial and profundal femoral artery respectively and popliteal artery with tibiofibular trunk (case 1 and 2), a Collier-Shunt (case 3), the left main pulmonary artery (case 4) and the portal vein after TIPS procedure (case 5). A complete or partial recanalisation was achieved in all cases. Time accounted for recanalisation was between 40 and 90 seconds. No adjunctive intervention was necessary. No complications occurred. The Amplatz thrombectomy device allows a fast, safe and effective mechanical thrombectomy of peripheral arteries and haemodialysis shunts. Partial recanalisation of large caliber vessels is also possible.

Adult↗

[Percutaneous dynamic atherectomy with the aid of 12-F and 14-F transluminal atherectomy catheters (TEC): initial results].

OBJECTIVE: The presented study reports on the first experience with the large diameter 12 F and 14 F TEC system for percutaneous dynamic atherectomy of peripheral vascular obstructions. METHODS AND PATIENTS: The 12 F and 14 F TEC-extraction catheter was used to recanalize peripheral vascular obstructions in 4 patients. The extracted material was continuously aspirated during the procedure. Three patients with intermittent claudication suffered from chronic arterial occlusion (two cases) or from stenosis of an implanted stent (one case) in the region of the superficial femoral artery. In another patient with long-term dialysis history an insufficient collier shunt was treated by atherectomy. RESULTS: Complete vascular recanalisation was achieved in all cases. Supplementary intervention was not necessary. There were no complications. CONCLUSION: Atherectomy with the large diameter 12 F and 14 F TEC allows a safe and complete recanalisation of complex peripheral vascular occlusions. Further studies must show whether the enlarged vascular intrusion is justified by more favourable results.

Angiography, Digital Subtraction↗

[Superselective embolization of tumor nodes in solitary kidney in inoperable patients].

PURPOSE: Evaluation of superselective embolisation of renal tumours in inoperable patients with solitary kidneys. METHODS AND PATIENTS: Eight inoperable patients with solitary kidneys bearing tumour nodules underwent 1-3 superselective embolisation procedures with ethibloc (5x) or polyvinyl alcohol (1x). Renal function was monitored with creatinine levels. Tumour size was controlled every three months by means of sonography. RESULTS: Technical success rate was 100%. In 3/3 patients haematuria could be stopped. Post-embolisation renal function was unchanged in 6 patients and deteriorated in two patients; creatinine level rose to a maximum of 2.2 mg%. We observed no other side effects. Seven of eight patients died during a median follow-up period of 9.3 months (4-18 months); in two cases they died due to their underlying malignant disease. One patient had local tumour progress. CONCLUSIONS: Superselective embolisation of renal tumours in patients with solitary kidneys may be a helpful, well-tolerated therapeutic option in inoperable, symptomatic patients.

Adult↗

[The diuresis urogram in patients with a bladder replacement].

PURPOSE: To differentiate between urodynamically relevant obstruction and functionally unimportant dilation of the upper urinary tract in patients with neobladder using a modified furosemide urogram. METHOD: An excretory urogram with furosemide loading was carried out in 19 patients with neobladder and sonographically and urographically confirmed dilation of the upper urinary tract. Once strong contrasting of the renal pelves and calyces has been achieved, 20 mg of furosemide were applied and late radiographs were obtained at 15 min and 30 min, respectively. An obstruction was defined as increasing dilation of the renal pelves and calices during forced diuresis and lack of washout effect of the contrast medium. RESULTS: In 32 cases, the renoureteral unit (RUU) was dilated on ultrasound. Of these, 25 RUU's showed good emptiness of contrast medium upon stimulation of diuresis, six RUU's returned a borderline findings, while one RUU was found to exhibit a decompensated anastomotic stenosis, which was dilated. Two further patients with borderline findings were later treated surgically due to their pain symptoms. No patient required further preoperative diagnostic procedures. CONCLUSIONS: The modified furosemide urogram represents a cost-effective diagnostic orientation strategy in patients with neobladder and dilated renal pelves and calyces and is both well-tolerated by patients and meets with broad acceptance from the urologic staff.

Adult↗

[Presentation of a new self-expanding vascular spiral stent].

The technical details as well as first clinical results of a newly developed Nitinol stent are presented. The spiral-shaped Nitinol stent was implanted in two patients with complicated peripheral arterial obstruction after bypass surgery. Stent implantation was very exact and technically simple using a special implantation catheter. While one patient is free of symptoms three months after stent implantation, an early obstruction was observed in the other patient one day after the interventional procedure. The specific spiral design allows a simple percutaneous extraction of the stent. A cross-over use of the stent seems principally possible, but limited due to the length of the implantation catheter of 70 cm. Prospective clinical studies are, however, warranted.

Adult↗

Experimental intracerebral hemorrhage: description of a double injection model in rats.

For experimental purposes, the most common technique of producing an intracerebral hematoma in rats is the injection of unclotted autologous blood. All modifications of this model share the problem that size and extension of the hematoma are not reproducible, because the injected blood either ruptures into the ventricular system or it extends to the subarachnoid or subdural space. Therefore a double injection model of experimental intracerebral hemorrhage in rats has been developed using 19 male Sprague-Dawley rats. After inducing anesthesia a cannula was stereotactically placed into the caudate nucleus and an intracerebral hematoma was produced with the double injection method in which first a small amount of fresh autologous blood is injected which is allowed to clot (preclotting) in order to block the way back along the needle track; the actual hematoma is produced in a second step of the injection. The clot volume was measured on stained serial sections. A total injection volume of 50 microliters of autologous blood produced intracerebral hematomas of 41.1 +/- 10.0 microliters and of similar shapes. The double injection method allows to generate reproducible hematomas in rats. This new model of intracerebral hemorrhage will allow further investigation of fibrinolytic and cytoprotective therapies.

Animals↗

Endovascular stenting in patients with Iliac compression syndrome. Experience in three cases.

The authors report their experience in the percutaneous treatment of the iliac compression syndrome in three women (20-53 years old) with acute iliofemoral deep venous thrombosis; in one case, there was an additional thrombus in the inferior caval vein. They were treated by percutaneous implantation of Palmaz stents in the left common iliac vein 1 day after surgical thrombectomy and construction of an arterial venous fistula. All patients showed marked improvement, as determined from venograms obtained immediately after stent implantation. The arteriovenous fistulae were closed 3 months later. At 6 months follow-up, the median clinical and color-coded duplex ultrasound indicates that all stents are patent and all patients are free of symptoms.

Adult↗