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M Galanski

Publications and source records attributed to M Galanski.

At least 91 records · Page 5Linked to original sources
PubMed1993

[Dose-dependent side effects of acetylsalicylic acid therapy. Results of a prospective randomized clinical study in patients with peripheral arterial occlusive disease].

BACKGROUND AND METHODS: In 359 patients with peripheral arterial occlusive disease who had undergone percutaneous transluminal angioplasty (PTA), a randomized double-blind, controlled clinical study was done to investigate the tolerability of acetyl salicylic acid (ASA) given for reocclusion prophylaxis. A comparison was made between a conventional daily dose of 900 mg ASA and a dose of 50 mg ASA. RESULTS: Within an observation period of one year following PTA, 35 patients (20%) in the 900 mg group, and 32 patients (17%) in the 50 mg group left the trial because of side effects (p = NS). Under the higher dose, however, severe gastrointestinal side effects (ulcer, haemorrhagic gastritis requiring transfusion) were significantly more common (nine patients delta 5.1% vs two patients delta 1.1%, respectively; p = 0.03). Overall, 107 patients (30%) reported subjective side effects such as upper abdominal pain, a sensation of fullness or nausea during the course of the trial. 62 of these patients were from the 900 mg group (35%) as compared with 45 patients (24%) in the 50 mg group (p = 0.02). Self-scoring of epigastric pain on the basis of a visual analogue scale revealed a score of 1.3 (95% confidence interval 0.9 to 1.6) in the 900 mg group and 0.8 (95% confidence interval 0.6 to 1.0) in the 50 mg group. The subjective pain intensity showed a uniform time course for all three types of symptom, with a maximum after three months. CONCLUSION: Our results confirm the superior tolerability of the lower dose, in particular in elderly patients. For long-term treatment, the smallest possible effective dose should be chosen.

Aged↗
PubMed1993

Improved parameters for unsharp mask filtering of digital chest radiographs.

Observer performance with four unsharp mask filtering algorithms for storage phosphor chest radiographs was compared with that with conventional screen-film radiographs in the detection of three types of simulated lung disease: nodules, fine lines, and micronodule clusters. Previously studied parameter sets (small [1.4-mm] and medium [5-mm] filter masks) and two new parameter sets (large [2.5-cm] and ultralarge [7-cm] masks) were compared by means of receiver operating characteristic analysis. With medium and small masks, nodule detection was inferior to that achieved with other modes. Use of ultralarge masks decreased the detection of lines compared with detection with conventional screen-film radiographs. Although detection of micronodule clusters was worse with digital images than with conventional screen-film radiographs, results with large and ultralarge masks were better than with small masks. Overall, filtering with large masks was best suited for simultaneously matching linear, nodular, and micronodular structures. These results suggest that lesion-specific processing of digital chest images is not necessary.

Humans↗
PubMed1993

Renal arterial stenoses: spiral CT angiography.

PURPOSE: To evaluate the role of spiral computed tomography (CT) in diagnosis of renal arterial stenoses. MATERIALS AND METHODS: In 22 patients with suspected renovascular hypertension, spiral CT angiography of the renal arteries was compared with arterial digital subtraction angiography (DSA). For each patient, the peak transit time t (from intravenous injection to maximum enhancement of the abdominal aorta) was determined with a bolus injection of 15 mL of contrast medium. Spiral scanning started at the level of the superior mesenteric artery with a delay of t + 5 seconds after the start of injection of 100-150 mL of contrast medium. RESULTS: Spiral CT angiography demonstrated multiple renal arteries in five patients. A renal artery stenosis or occlusion was found in 15 of 22 patients (22 of 54 arteries). All findings were confirmed with arterial DSA. Vessel contrast on spiral CT scans was good to excellent in 19 of 22 patients. For diagnosis, axial-section and multiplanar reformatted images were superior to three-dimensional surface reconstructions and maximum-intensity projections. CONCLUSION: Spiral CT angiography is a promising screening method for renal artery stenosis.

Adult↗
PubMed1993

[Diagnostic possibilities of sonography: ankle joint, foot and Achilles tendon].

In patients with soft tissue swelling and pain of the foot and ankle, ultrasonography is a simple and reliable diagnostic procedure to demonstrate joint effusions or a tendovaginitis which may have caused the symptoms of the patient. The diagnostic puncture of a joint is only necessary to determine the kind of effusion. The diagnostic workup of patients with acute and chronic instability of the proximal ankle joint benefits from the sonographic measurement of the talus tilt and of the anterior drawer. As the diagnostic performance is equal to the radiologic stress test, X-ray exposure can be avoided. As the anatomic structure of the achilles tendon causes the typical fibrillary sonographic pattern, structural changes due to tendinitis or tendon rupture can easily be diagnosed.

Achilles Tendon↗
PubMed1993

Transcatheter coil occlusion of an intrahepatic arterioportal fistula in a transplanted liver.

The incidence of arterioportal fistulas (APFs) following percutaneous transhepatic procedures is quoted to be between 5 and 20%; the majority of them remain clinically asymptomatic and do not require any treatment. However, an APF large enough to cause a reversal of blood flow in the portal vein is rather uncommon especially in a transplanted liver where it may have potentially hazardous consequences. We report on a 21-year-old female patient who received a liver transplantation on account of a Budd-Chiari syndrome. Following a liver biopsy, a large APF developed in the right lobe of the graft. Despite the known risks associated with catheterization of graft vessels, a successful coil occlusion of the fistula could be carried out thus rendering surgery unnecessary.

Adult↗
PubMed1993

[Vascular imaging with spiral-CT. The path to CT-angiography].

Spiral CT is a technique that allows for high-quality two-dimensional angiographic projections and 3D imaging of vascular structures. The authors present the technical and methodological principles of the technique, including scan parameters and parameters of contrast application for various clinical imaging tasks. They present their experience with over 150 clinical cases using spiral CT angiography. Suitable applications of this technique include congenital anomalies, aneurysms, dissections, stenoses, thrombi and vascular tumor involvement. Given a problem-adapted examination technique, pathologic changes in vessels of as little as 2 mm can be visualized. In some cases with complex vascular anatomy, spiral CT angiography can be superior to arterial angiography.

Forecasting↗
PubMed1993

The Filcard temporary, removable vena cava filter: use in local thrombolytic therapy.

Femoral and iliac vein thrombosis with impending pulmonary embolism is a potentially life-threatening condition. The decision whether or not to implant a permanent caval filter always requires critical consideration of a number of factors. Improper positioning of the filter with resultant filtering inefficiency, thrombosis of the filter and of the cava, propagation of the thrombus through the filter, perforation by the filter of the vena cava with penetration of the aorta, the duodenum, the psoas muscle or the vertebral body, fragmentation of the filter and migration of the filter are well-documented complications of the currently available permanent filters. The danger of fatal pulmonary embolism has to be weighed against that of one or a combination of any of the above-mentioned possible complications associated with permanent caval filters which may affect the quality of later life. We present our initial observations with a temporary, removable inferior vena cava (IVC) filter in a young female patient with a floating thrombus in the left femoral and iliac vein who underwent successful local thrombolytic therapy.

Adolescent↗
PubMed1993

Current status of the imaging modalities in the pre- and postoperative diagnostic workup of liver transplant patients.

Before transplantation, imaging procedures are mainly used to exclude factors which may serve as contraindications, render surgery difficult, or necessitate a modification of the operative technique. In addition, assessment of liver volume is necessary before segmental liver transplantation. Sonography or other cross-sectional imaging modalities are sufficient for these purposes. After transplantation, imaging is principally required in cases with suspected complications. Sonography, including Duplex and Doppler sonography, is an excellent first investigative modality for this purpose in addition to assessment of the clinical and biochemical parameters. Sonography can diagnose not only vascular complications but also biliary and infective complications; the former may also be a concealed cause of the latter. In unclear infections sonography often has to be supplemented by other modalities like CT. In equivocal cases a puncture is indicated. Invasive procedures are necessary in only selected cases, in particular when an intervention is under consideration. At present MR plays a limited role in the diagnostic workup as it rarely offers additional information except in very few cases. The early diagnosis of rejection cannot be reliably made by any of the imaging modalities and is essentially dependent on the biopsy.

Diagnostic Imaging↗
PubMed1993

The kissing balloons technique. Simultaneous dilatation of stenoses of branch arteries at the bifurcation of the renal artery.

Whereas dilatation of a single stenosis of the main renal artery is a routine intervention, a narrowing of the renal artery at its bifurcation extending into the branch arteries poses a more complex problem. The procedural risks of renal artery dilatation are compounded by the danger of occlusion of one of the branch arteries during maneuvers to dilate the other. Long-term results of surgical vascular reconstruction at a renal artery bifurcation are not satisfactory. Untreated, these stenoses lead to intractable hypertension and impairment or loss of renal function. We present a patient with hypertension and impaired function of the right kidney on account of a renal arterial bifurcation stenosis. Using a bilateral transfemoral arterial approach 2 balloon catheters were simultaneously placed into the origins of the renal artery branches and both arteries were successfully dilated by the kissing balloons technique. This method provides an elegant alternative to difficult surgery to save an endangered kidney.

Angioplasty, Balloon↗
PubMed1992

Colour Doppler ultrasound assessment of arteriovenous haemodialysis fistulas.

Satisfactory function of the arteriovenous fistula (AVF) is essential for adequate haemodialysis in patients with chronic renal failure. Existing methods to assess AVF function are imprecise (eg, clinical examination) or invasive (eg, angiography). We assessed the value of colour flow-doppler ultrasound (CFDU) in the investigation of clinically suspected AVF dysfunction. 51 patients with suspected impairment of AVF function were studied by CFDU, and 28 also underwent angiography. The findings were compared with the reference standard of the findings at reoperation. CFDU showed AVF stenoses in 18 patients, which were all confirmed at reoperation; the results of angiography in 13 of these 18 patients showed complete agreement with the findings of CFDU and surgery. CFDU showed partial or complete AVF thrombosis in 33 patients, confirmed in all patients at reoperation; 15 patients also underwent angiography, and thrombi were not found in 6 (in 4 because of technical failure). 7 patients had aneurysms on CFDU that were confirmed by surgery in all patients and by angiography in 2 of the 3 patients studied. CFDU enables reliable non-invasive assessment of AVF morphology and function and may become the procedure of choice for AVF assessment in patients with suspected AVF abnormalities.

Adult↗
PubMed1992

[The visibility of a central venous catheter using digital luminescence radiography in intensive care radiology].

The aim of the following study was to assess the impact of dose alterations on the detection of catheters. We compared the performance of well-exposed conventional and digital portable chest radiographs in the detection of thin catheters and tested the influences of dose alterations. Portable chest radiographs of 20 patients were obtained with conventional film/screen (FR) and with storage phosphors at 50% (SRL), 100% (SRN), and 250% (SRH) of the conventionally required exposure dose. The region of the mediastinum was subdivided into an average of 18 fields, 50% of which were superimposed with thin catheter segments. ROC analysis of 11,600 observations by 8 readers found only SRH equivalent to FR in catheter visualisation. Performance decreased significantly with SRN and SRL. Detection of low contrast catheters was found to be significantly decreased in storage phosphor radiographs obtained with standard exposure dose. A dose reduction is not feasible with current equipment if performance equivalent to conventional radiography is to be achieved.

Catheterization, Central Venous↗
PubMed1992

Impact of hard-copy size on observer performance in digital chest radiography.

To determine the impact of reduced hard-copy size on diagnostic performance of digital radiography, screen-film chest radiographs were compared with isodose digital storage phosphor radiographs in the detection of simulated nodules, fine pulmonary lines, and micronodular opacities superimposed on the chests of 10 healthy volunteers. Digital radiographs were laser-printed in a full-size conventional format and in image lengths of two-thirds, one-half, and five-elevenths of the conventional format. Eighteen thousand observations by eight radiologists were analyzed by use of receiver operating characteristics. The detectability of lines and micronodular opacities decreased with declining image format size. In the detection of micronodular opacities, only the nearly full-size digital images were equivalent to conventional images. In the detection of linear opacities, reduction of image length by one-half or more reduced performance (analysis of variance, P less than .05). Only for the detection of nodules was no major difference found.

Humans↗
PubMed1992

[Chemoembolization of hepatocellular carcinoma in cases of isolated liver involvement].

Chemoembolization is an effective treatment for hepatocellular carcinoma, giving results equally as good as surgical therapy for T2 tumours. Survival can be prolonged and side-effects can be reduced by combining Lipiodol and Gelfoam for chemoembolization, employing a modified technique, with repeated procedures, and using appropriate follow-up treatment. The toxicity of the procedure is acceptable, but it requires supportive therapy necessitating an intense interdisciplinary co-operation.

Aged↗
PubMed1992

[The x-ray clinical picture and evaluation criteria of implantable cardioverter-defibrillator systems].

Since the first implantation of an automatic cardioverter defibrillator (ICD) in February 1980, the therapy of ventricular tachyarrhythmia has been changed drastically. The original therapy with antiarrhythmic agents has been increasingly replaced by the implantation of the ICD. The radiologist should be aware of the different types of ICDs and their normal appearance, because thorax radiography is often used during regular routine follow-up of the ICD system. The different types of ICDs, their normal radiological appearances, the indications and the implantation technique are discussed in the present study. The radiologist has to interpret the radiographs with respect to the electrodes, the device and changes in heart configuration. Major migration of electrodes is visible, but the detection of little changes in configuration is only possible with the help of serial radiographs. If extraperitoneal placement of the device is suspected, an ultrasound examination should be obtained. An important complication for the radiologist is a possible deactivation of some devices by electromagnetic interference.

Contraindications↗
PubMed1992

[Radiologic diagnosis before and after liver transplantation].

The main function of imaging procedures before liver transplantation is the exclusion of factors that may either constitute contraindications to surgery or necessitate a modification of the operation technique. Ultrasound and MRI are the modalities best suited for this purpose. After transplantation, imaging procedures are required mainly for diagnosis of and differentiation, in particular, between vascular and biliary complications, rejection, and infection, since these postoperative complications very often cannot be reliably differentiated on the basis of clinical and laboratory parameters alone. As vascular disturbances can vary widely in their presentation and can mimic other complications, duplex Doppler sonography plays a dominant role in clarification of the perfusion status of the graft. If infection is suspected, ultrasound generally has to be supplemented by other imaging procedures such as CT or MRI; if these techniques reveal suggestive lesions, a fine-needle aspiration is mandatory in most cases. Invasive procedures such as angiography or PTC are now applied only in selected cases, especially if an intervention is contemplated. Rejection cannot be reliably diagnosed by any of the imaging techniques and still requires biopsy.

Diagnostic Imaging↗
PubMed1991

[Digital radiography: optimization of chest radiographs using a modified exposure control].

Phototiming over the lung fields frequently compromises the signal-to-noise ratio available in the mediastinal and diaphragmatic regions of the chest. A moderate dose increase would be justified if a significant improvement in diagnostic performance could be achieved. We compared the impact of mediastinal phototiming (150 kVp, 150 cm FFD, 1.0 mm focus, 12:1 grid [higher kVp chosen to minimize dose increase]) to standard lungfield phototiming (125 kVp, 150 cm FFD, 1.0 mm focus, 12:1 grid) on the detectability of simulated pulmonary nodules (wax, 0.5-2.5 cm in diameter) superimposed on human volunteers in storage phosphor radiographs (1744 x 2144 pixels, 10 bit). ROC analysis of 1920 observations by 8 readers showed a significantly higher (p less than 0.03) detectability of simulated pulmonary nodules with mediastinal phototiming (ROC area = 0.89) than standard lungfield phototiming (ROC area = 0.84).

Humans↗