Search PubMed⌕ Search

Biomedical subjects

K Stellamor

Publications and source records attributed to K Stellamor.

At least 37 records · Page 2Linked to original sources

[Comparison of the side effects of urographic contrast media (iothalamate, diatrizoate, iodamide, iopamidol) within the scope of a CT study].

In 1465 patients the side effects of urographic contrast media for enhancement in CT were compared. The results show that the reaction frequency with iotalamate is 5.1%, with diatrizoate 7.0% and with iodamide 8.9%, but only 0.5% with iopamidol. The number of incidents to be expected with iopamidol is one decimal place lower. Obviously this has to do with its low osmolality. On the other hand we interpret the comparatively slightly higher incidence rate when using iodamide as a result of its higher lipophilic nature.

Adolescent↗

[Clinical significance of symmetric basal ganglia calcification].

Since CT it has been possible to detect subtle SCBG. Usually they are without any symptoms. Massive calcification is visible in conventional radiogram; it can form the patho-anatomical substrate for neuro-psychiatric defects. Fahr's triad consists of SCBG, typical neuropsychiatric symptoms, and decreased activity of the parathyroid glands leading to a pathologic calcium-metabolism. In our opinion SCBG is of clinical relevance in each stage. Calcium-metabolism, intoxications and sclerosis of cerebral vessels have to be looked for. The combination of hypoparathyroidism and sclerosis of the cerebral vessels turned out to be fatal with one of our patients. In a case of SCBG the neuro-psychiatric symptoms were progressive. Interventions in the calcium-metabolism e. g. in strumectomy should depend on the status of the cerebral vessels.

Aged↗

[Testicular tumor staging: the ranking of CT and ultrasonic diagnosis].

In a retrospective study 79 patients suffering from a tumour of the testis were analysed between March 1977 and March 1983. Of these, 31 patients were examined via CT. The radiologist's task was the staging of these cases. The results show the superiority of CT diagnosis, which led to only one false-negative report. For the evaluation of stage II ultrasonography is useful, too, even though small lymphomas might be overlooked. If CT is not available, sonography, which is less costly, might be a good substitute. With regard to cooperative therapy, staging together with the histology of the primary tumour and determination of tumour markers are of essential importance.

Adolescent↗

[Staging of adenocarcinoma of the kidney--CT largely replaces catheter angiography].

In renal adenocarcinoma (hypernephroma) CT as a rule provides the same information as angiography. Our experience is based on a collection of 61 tumour cases, divided in stages according to the TNM system. In retrospect, 39 of our own cases were investigated by CT as well as by angiography; the accuracy of both methods was tested on 33 operative findings. Prospectively 22 cases were examined by CT only and results controlled via 20 operative findings. CT is superior in the T and N stages. Usually demonstration of vein invasion is as good in CT as in catheter angiography. Metastases in the adrenals and the liver are vasible in CT. Seen from the point of view of a "non-touch procedure" (particularly to be demanded with a tumour metastasising as early as this!) the non-invasive method of CT proves especially suitable. We use CT primarily in all cases of suspicion. In singular cases CT is supplemented by further angiographic investigations, e.g. cavography. Exceptions to the topical proceedings mentioned above are a suspected tumour in a solitary kidney, and bilateral tumours. Such cases should be investigated by catheter angiography following i.v. urography and/or sonography.

Adenocarcinoma↗

[Comparative study on the effect of the dopamine receptor blockers metoclopramide and domperidone on stomach emptying and the visualization of the small intestine in monocontrast].

The effects of a new dopamine receptor blocking agent, domperidone are compared pharmacoradiographically with the well-know action of metoclopramide. The investigated parameters were pyloric muscle function, passage time through the small intestine and, in correction with this, an evaluation of barium filling of the small intestine. Our investigations show that domperidone at dosages of 0.1 mg/kg and 0.2 mg/kg body weight does not accelerate intestinal junction as markedly as 0.3 mg/kg metoclopramide. Nevertheless, domperidone is as well suited as metoclopramide for pharmacoradiography of gastric emptying and for radiological examination of the small intestine. Hence, it can be concluded that the stimulation of the pyloric muscle as the leading pace maker of propulsion is achieved satisfactorily. Contrary to the findings with metoclopramide, domperidone shows no central nervous side effects. It appears that domperidone, at therapeutic dosages, does not pass the blood-brain barrier. Hence, this pharmaceutical preparation should prove of particular value in paediatrics.

Adult↗

[Increasing importance of biliary cysts (choleceles)].

Biliary cysts are connected with the biliary tract and primarily contain bile. Mostly this connection persists, which differentiates these cysts from all the others in this region. Therefore biliary cysts lead to a number of clinically serious complications such as calculi and abscess formation, cholangitis, cholestatic cirrhosis (possibly leading to portal hypertension or hepatoma), continuous enlargement of the cyst resulting in perforation into the abdominal cavity (and biliary peritonitis). The biliary cysts occur as a congenital-hereditary disease or develop because of an occlusion of hepatic artery branches. The congenital disease ist extremely rare. The secondary choleceles are caused by thrombo-embolic disorders (infarcts, periarteritis nodosa) or iatrogenically (ligations of vessels after traumatic liver rupture, embolization). Over the past years the secondary choleceles have gained in importance. Each case of cholecele should be diagnosed as early as possible. Though sonography and CT display cystic lesions excellently, differential diagnosis, however, remains difficult. The diagnosis is requested from the radiologist because therapeutic consequences are considerable.

Adult↗

[The renal pelvic tumor in the sonogram].

A prospective study evaluates screening investigations of the kidneys of 2350 patients. Sonographic criteria of the renal pelvic tumour are established. So-called "indirect signs" are only recognized by the compound scanner. By these ultrasonic symptoms a pelvic tumor could be detected with 15 patients which is a frequency of 6,5%. Part of the patients were preselected. The possibility of false-negative findings remains unconsidered. The study proves the great relevancy of ultrasonography in this disease. When operations of renal pelvic carcinomas were retrospectively checked our diagnostic results were underlined.

Humans↗

[Observation of the radiologic course in long-term artificial respiration].

In a retrospective study, 108 patients were followed up who had to undergo artificial respiration treatment because of respiratory insufficiency. X-ray diagnosis showed a shock lung in all the patients. X-ray morphology correlates with the pathologicoanatomical substrate which develops progressively in phases. 24 patients (22%) could be saved, which is a remarkable success in view of the usually fatal prognosis. It was encouraging to find that follow-up examinations of the surviving patients did not reveal any detectable sequels of the "shock lung"; likewise, no unfavourable effects of the respiratory therapy were noticed.

Adult↗

[Roentgen diagnosis of Fahr's disease].

The symmetrical calcification of the basal cerebral ganglia (SCBG) in conventional skull radiographs has been known as a pathological entity of Morbus Fahr. Fahr's triad consists of typical neuro-psychiatric symptoms, hypoparathyroidism and SCBG. Since the introduction of CT, SCBG is found in computed tomography of the skull with a frequency of approx. 1% of the patients but often without Fahr's triad. the question of clinical relevance is therefore, raised. A connection between calcium metabolism, sclerosis of cerebral vessels and intoxication seems to exist and has to be considered clinically.

Aged↗

[Ultrasound diagnosis in Caroli syndrome--the method of choice].

Ultrasonic exploration of the upper abdomen renders diagnosis of Caroli's syndrome easier, whereas the recognition of this condition has been very difficult so far. Secondary diseases complicated the course and resulted in unsuccessful surgery, since the underlying cause was not detected. It would be desirable to diagnose this congenital disease during adolescence by ultrasonic screening. Once the correct diagnosis has been made, it seems possible to considerably improve the otherwise fatal prognosis by means of an adequate drug therapy.

Adolescent↗

[Liver hemangioma--an angiographic contribution to the differential diagnosis of sonographic lesions (author's transl)].

Small liver hemangiomas are displayed as echogenic as well as sonolucent patterns on ultrasonic scans. Differentiation from malignomas is difficult and responsible, hepatomas and solitary metastases being possible. By partial liver resection the malignant diseases can be treated successfully. Therefore an accurate diagnosis is to be aimed at. Of all the methods only angiography can ensure a certain amount of clarity. This is possible under the following circumstances: The cavernomas must be of a certain size. They must not withdraw from evidence due to large avascular areas which can result from thrombosis, fibrosis or necrosis. Moreover a superselective filling of the hepatic artery is claimed but not always possible. If the portal vein is opacified it conceals the radiologically typical image of the cavernoma. Under these circumstances only few moments of the late arterial and the hepatovenous phases remain to detect the hemangioma in the seriogram.

Adult↗

Influence of x-ray treatment on antigen-induced experimental arthritis.

Six groups of 3 rabbits each were immunised with ovalbumin and received one intra-articular injection of antigen. The animals of 3 groups received local x-ray irradiation of 600 rads for 8 minutes to the right knee joint 12 days after the intra-articular challenge. Animals of the other 3 groups were not irradiated. The antigen-induced arthritis was investigated by determining the exudation is synovial fluid and by histological study of the synovium examined 48 hours, 7 days, and 4 weeks after the irradiation date. All animals in the nonirradiated groups showed a distinct chronic synovitis. Irradiated animals showed almost no synovitis 48 hours and 7 days following irradiation. In 2 rabbits synovitis had reappeared 4 weeks after irradiation with findings similar to those in the control groups. Only one animal still showed an inhibition of synovitis. X-ray irradiation of non-challenged knees did not induce any pathological changes. This time-limited effect of one local irradiation on antigen-induced arthritis seems to be mainly an anti-inflammatory action. Local immunological inhibition might possibly operate too. X-ray induced inhibition of synovitis is compared with the effect of locally injected radiocolloids.

Animals↗

[The post-traumatic biliary cyst (author's transl)].

The case report communicated here illustrates a late complication subsequent to an emergency operation for liver rupture. This complication may result from ligating a branch of the hepatic artery to stop bleeding. If the necessary second operation is omitted for any reason, the hepatic sequester can develop into an abscess or biliary cyst. It is to be expected that these late complications will occur more frequently in future owing to a probable increase in the incidence of the so-called blunt abdominal traumas. The reason for this is, on the one hand, the growing number of traffic accidents and, on the other hand, the increasing use of safety seat belts which tend to promote the occurrence of ruptures of the liver as part of the blunt abdominal traumas. However, we must emphasize that it is the use of safety seat belts only which ensures the traffic victims' chance of survival.

Abdominal Injuries↗

[Angiographic investigation with parathyroid hormone administration as functional gauge of liver blood flow (author's transl)].

Parenteral administration of parathyroid hormone causes dilatation of the main hepatic artery adn the intrahepatic branches, as demonstrable on coeliacography. This applies to healthy persons as well as to patients suffering from cirrhosis of the liver. When hormone is given intraarterially, i.e. into the coeliac trunk, the effect on the hepatic arteries is stronger than after intravenous administration. No effect can be be shown on the splenic, upper mesenteric or gastroduodenal arteries. The reaction of the hepatic arteries to parathyroid hormone seems to be a good parameter of the degree of dilatory capacity of these vessels in cirrhosis. Relevant conclusions can probably be drawn as to the prognosis of porto-systemic shunt operations and their indication. This haemodynamic hormone effect, the cause of which is still unknown enabled better visualisation of primary liver tumours on coeliacography.

Adult↗

[Estimation of hepatic blood flow with 133-Xenon (author's transl)].

Regional hepatic blood flow was measured by two methods using 133-Xenon washout technique: 1. "portal method" (injection of 133-Xenon into the spleen), and 2. "arterial method" (direct application of 133-Xenon into the A. hepatica propria by an indwelling catheter after celiacography). The portal method was performed in 38 patients (30 patients with cirrhosis of the liver, 4 patients with chronic hepatitis, 4 controls with normal liver function). The results show that using this method regional liver blood flow can be measured accurately. Patients with cirrhosis of the liver had a highly significantly decreased hepatic blood flow in comparison to the control group. The advantage of this method is that extra- and intrahepatic shunts can be visualized simultaneously. However, using this method in patients with hemodynamically very effective extrahepatic collaterals the tracer does not reach the liver. In these patients regional hepatic blood flow can be estimated by the arterial method (12 patients with cirrhosis of the liver, 2 with normal liver function). However, no information about the morphology of the portal circulation can be obtained using this method. Direct comparison of the quantitative estimation of regional hepatic blood flow was performed in 6 patients. The data obtained by the 2 methods correlated highly significantly (r = 0.91).

Adult↗