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Biomedical subjects

M Georgi

Publications and source records attributed to M Georgi.

At least 199 records · Page 11Linked to original sources

[Current status of preoperative localization in primary hyperparathyroidism (author's transl)].

Since Seldinger demonstrated in 1953 parathyroid adenomas by arteriography, numerous localizing procedures have been advocated. Based on our experience with selective venous sampling for measurement of parathyroid hormone by radioimmunoassay, selective arteriography, pneumomediastinography and scanning with 75Se-selenomethionine, a survey on localization techniques used up to now is given and their value and applications are discussed. Preoperative localization of parathyroid tissue should be limited to patients with previous unsuccessful surgery. In these cases we perform selective venous sampling following selective arteriography for demonstration of the venous drainage pattern and subsequent venous catheterization. Pneumomediastinography is recommended in suspected mediastinal parathyroid adenoma. Scanning with 75Se-selenomethionine is not in use because of its limited success.

Adenoma↗

[Occlusion of the renal artery by intra-arterial injection of thrombin in a case of inoperable renal tumour (author's transl)].

In a 53-year-old man with an inoperable metastasizing renal carcinoma embolic occlusion of the renal circulation was achieved by injection of thrombin (600 NIH units) through a balloon catheter into the renal artery. With short-term administration of analgesics and under anti-biotic cover the post-embolic course ran without complications. The general condition of the patient is good and macrohaematuria had, at the time of the report, not recurred for two months.

Catheterization↗

[Transvenous cholangiography in the differential diagnosis of biliary stasis (author's transl)].

Transvenous cholangiography is an alternative to the direct puncture of the biliary tract. It was successfully performed in 13 of 21 patients of a personal series. The method does not require stand-by facilities for operation and is suitable for differentiating intra- from extrahepatic causes of biliary stasis, as well as for the demonstration of cause and localization of obstructive jaundice. Subcapsular liver haematoma with a rupture into the peritoneal cavity and bilihaemia were the main complications (one case of the former). The procedure is contraindicated in acute cholangitis and after cholangitic episodes.

Acute Disease↗

Ballon occlusion of the renal artery in tumor nephrectomy.

A method of preoperative intraluminal occlusion of the renal artery in cases of kidney tumors using a 5F Swan-Ganz ballon catheter is presented. The procedure was used in 26 tumor nephrectomies without complications and resulted in marked facilitation of the operation in 70 per cent of the cases.

Adenocarcinoma↗

[Echinococcus multilocularis causing extensive biliary obstruction (author's transl)].

Infection of man by Echinococcus multilocularis occurs relatively seldom, most commonly localizing in the liver in the manner of a malignant tumour. A case of alveolar hydatid disease is reported presenting with extensive biliary obstruction, and a large cavitation in the liver due to necrosis. A review of epidemiology, clinical and roentgenological findings is given.

Celiac Artery↗

[Retrograde renal phlebography with balloon occlusion of the renal artery. Technique and scope of a new method (author's transl)].

A new method of retrograde phlebography of the kidney is described; it is carried out by using a balloon catheter in the renal artery for occluding the circulation. The procedure has been carried out in 13 patients without complication. Early experience has provided very good results in the diagnosis of malignant renal tumours; invasion into the venous system can be demonstrated radiologically. In particular, in cases of carcinoma of the renal pelvis, this method represents a significant improvement of the hitherto unsatisfactory angiographic techniques.

Abdominal Injuries↗

[Results of post mortem thyroid gland phlebography (author's transl)].

The anatomic course and variation of the thyroid veins used for retrograde thyroid phlebography were studied in 70 post mortem thyroid phlebograms. Comparison with pathological and anatomical findings showed good agreement in benign diseases of the thyroid with lesions of more than 1 cm. Infiltrating malignant changes could not be delineated with certainty and a post mortem proven parathyroid adenoma was also missed. The practical clinical significance of thyroid phlebography is therefore confined to the localisation of parathyroid tumours in primary hyperparathyroidism by selective parathoromone measurements.

Adenoma↗

[Thyroid phlebography and selective venous sampling for parathormone estimations in primary hyperparathyroidism (author's transl)].

Selective venous sampling for parathormone estimations has become an important method in the diagnosis of primary hyperparathyroidism and, together with thyroid phlebography, is an accurate means for localising hormone active parathyroid tissue. Thirty-three patients were examined by this technique and in 25 of these an exploration was carried out subsequently. Twenty-one had primary hyperparathyroidism. In one case hormone analysis lead to a false positive finding. In 18 of these 21 patients, the hormone-active parathyroid tissue was correctly localised. Phlebography showed evidence of an adenoma in five patients, but is of most use for localising the source of the hormone.

Adenoma↗

[The results of transvenous cholangiography (contrast media)].

Transvenous cholangiography is a method for the direct demonstration of the biliary passages described by Hanafee and Weiner; its main indication is in the investigation of obstructive jaundice. This method, which does not require immediate subsequent operation, was used in 41 patients. In three patients catheterisation of hepatic veins was unsuccessful. Of the remaining 38 patients, puncture of a bile duct was successful in 20. In 29 patients biliary obstruction was present, and this was demonstrated in 19. In the absence of obstruction the procedure was successful in only one case. The main complications were a sub-capsular liver haematoma, with rupture into the abdominal cavity and one case of haemobilia.

Catheterization↗

[Localization diagnosis of epithelial-body tumors through selective determination of parathyroid hormone. Surgical sequelae of a new method].

A new method for the localisation of abnormal parathyroid tissue is reported. This is carried out by selective venous blood sampling from the thyroid veins and the large veins of the neck. Parathyroid hormone levels are measured by radioimmunoassay. The peak hormone level indicates the site of the tumor suspected. Parathyroid venous blood was taken in 15 patients with primary hyperparathyroidism. In 12 patients localisation of the parathyroid tumor was achieved pre-operatively. The procedure is especially valuable in patients with previous unsuccessful parathyroid surgery. There are no complications or contraindications to the method.

Adenoma↗

[Technique and results in adrenal phlebography (author's transl)].

Following a brief description of the anatomy of the adrenal gland the technique of adrenal phlebography is explained. So far this method has been used in 118 patients. This examination is indicated in cases with suspected hormon - active disease of the adrenal glands and to rule out spaceoccupying lesions as well as metastases in the adrenal gland. Characteristic radiologic findings are demonstrated. Causes for complications of this method and their possible prevention are discussed.

Adenocarcinoma↗