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Biomedical subjects

M Thelen

Publications and source records attributed to M Thelen.

At least 397 records · Page 22Linked to original sources
PubMed1980

[A fine-needle puncture set for percutaneous bile duct drainage (author's transl)].

A new instrument for percutaneous bile duct drainage has been employed on 30 patients with obstructive jaundice. The instrument consists of a 28 cm. long needle of 0.7 mm. diameter placed inside a 15 cm. long Teflon sheath of 1.4 mm. external diameter. This permits fine-needle cholangiography and biliary duct drainage as a single procedure. It causes little trauma and speeds up and simplifies the examination. The instrument is also suitable for transhepatic portal vein puncture.

Bile Ducts↗
PubMed1980

[Focal nodular hyperplasia (author's transl)].

Focal nodular hyperplasia was diagnosed angiographically in 14 patients and confirmed histologically. Differentiation of this benign lesion from other space-occupying diseases of the liver can be very difficult, since focal nodular hyperplasia produces a variable angiographic appearance. The typical angiogram showing radial vessels in the arterial phase and sharply demarcated foci in the parenchyma phase is found in only one third of patients. Angiographic differential diagnosis includes adenomas and carcinomas of the liver. Resection of the tumours in case of malignant tumours is not indicated. Foci at the margin of the liver, or if they are pedunculated, should be removed in case of spontaneous perforation. Tumours in the centre of the liver should be observed (computer tomography). Oral contraceptives stimulate the growth of these foci. They may diminish in size after stopping these drugs. 70% of cases of focal nodular hyperplasia remain clinically silent and were discovered accidentally or at autopsy.

Adenoma↗
PubMed1980

[Extracranial arterial occlusive disease in arteriopathies with peripheral vascular disease (author's transl)].

Aortography and angiography of the aortic arch were carried out in 176 patients with peripheral arterial occlusive disease. In 63,6% there were haemodynamically relevant stenoses or occlusions of the supraaortic vessels, the carotid arteries with 39,2% and the vertebral arteries with 35,2%, being the most commonly involved. Peripheral arterial disease included haemodynamically relevant changes in the femoro-popliteal arteries in 83%, in the aorto-iliac region in 67,1% and in the calf vessels in 58,5%. There was a statistically significant correlation between the clinical severity of the cerebrovascular insufficiency and of the Frontaine stages with the angiographically demonstrable extent of the arteriosclerosis. In addition there was an increasing statistical risk of extracranial arterial occlusion if the disease affected more than one arterial level.

Aorta, Abdominal↗
PubMed1979

Management of concomitant occlusive disease of the supraaortic and lower-limb arteries.

Angiography examinations of the extracranial cerebral arteries in patients with peripheral occlusive disease of the lower limbs indicate cerebro-vascular disease more often than might be assumed from clinical-neurological examinations alone. In total, 61.5% of the patients examined showed lesions of the extracranial cerebral arteries which necessitated an operation. The elimination of risks in an operation requiring extensive peripheral vessel reconstruction necessitates initial supraaortic vessel reconstruction. Of the 48 patients with reconstructions in both vascular systems, none has suffered any postoperative neurological dysfunction. Concomitant occlusive disease of the supraaortic and peripheral arteries should not be treated simultaneously.

Aortography↗
PubMed1979

[Transfemoral aspiration of a thrombus from a renal artery with an angiographic catheter (author's transl)].

Thrombosis in a renal artery occurred in a 60-year-old woman after regional hypothermia of the kidney for which balloon occlusion of the artery had been used. Perfusion of the kidney was re-established by aspiration and flushing of the thrombus; this was confirmed angiographically and anatomically. Renal function did not recover, however, since removal of the thrombus by means of an angiographic catheter was carried out too late. We regard early aspiration of emboli from major abdominal vessels as a further application of arterial catheterisation by the Seldinger technique.

Female↗
PubMed1979

[Evaluation of hepato-biliary functional scintigraphy with 99mTc diethyle-IDA. Findings in normal livers (author's transl)].

Hepato-biliary functional scintigraphy was performed on 51 patients with normal livers after in the injection of 99mTc diethyle-IDA. The results were analysed according the morphological criteria (demonstration of the bile duct, intra-hepatic ducts, gall bladder and renal tract) and functional criteria (T max, half-time biliary excretion values, development of activity in the bile duct, in the gall bladder and in the gut). Demonstration of the bile duct and gall bladder was successful in all cases if the examination was carried out after an appropriate interval following food. 84.3% of patients showed a gall bladder excretary pattern of the tracer and 15.7% a gall bladder storage pattern. Correspondingly, bile appeared in the duodenum at 16.5 +/- 6.5 minutes (excretion) or 79.3 +/- 49.5 minutes (storage). The left hepatic duct was shown in 58.8%, the right hepatic duct in only 58.8%. Sixty minutes after the injection no activity could be determined in the bile ducts beyond the liver parenchyma. The gall bladder could be identified after 26.6 +/- 24.4 minutes, occasionally it was much later, up to 110 minutes. The liver function curve showed a Tmax level of 6.8 +/- 2.7 minutes and half value time of 15.8 +/- 6.7 minutes. At 5 minutes after injection the renal pelvis could be identified in 19.6%, but in no case was this still present beyond 15 minutes. Duodeno-gastric reflux was not demonstrated.

Acetanilides↗
PubMed1979

[The treatment of idiopathic varicocoeles by transfemoral spiral occlusion of the left testicular vein (author's transl)].

The standard surgical procedures for the treatment of idiopathic varicocoeles are unsuccessful in, or show a recurrence rate of, up to 25%. An alternative method is transcutaneous embolisation using the Seldinger catheter technique. For this technique of transcutaneous catheter embolization, we have used the Gianturco spiral. The embolization is carried out following diagnostic transfemoral phlebography of the left testicular vein, which also provides the indications or contra-indications for this procedure. The method has been used on nineteen patients with varicocoeles requiring treatment; amonst these were three patients who had had unsuccessful operations. Follow-up period so far is six months. In all cases the varicocoele had disappeared, including one patient who had suffered complications following previous surgery.

Embolization, Therapeutic↗
PubMed1979

[Diagnosis and differential diagnosis of osteosarcoma (author's transl)].

A primary malignant bone disease can generally be suspected on the basis of x-ray findings and may be even highly probable if several signs of malignancy are seen on one and the same film. Such changes include bone lesions larger than 6 cm on the first film with blurred outlines, showing patterns of destruction resembling moth-eaten textiles, the covering periosteum revealing spicula or Codman's triangles. Rapidly growing tumours can break cortex components from the continuous layer and shift them outwards. Roentgenological case controls are useless and must be replaced by a sample excision, since x-ray malignancy signs have no absolute value as decisive criteria in view of the fact that they are seen, inter alia, also in osteomyelitis, myositis ossificans and callus formations.

Bone Neoplasms↗
PubMed1979

[A new therapeutic concept for the selection of liver cirrhotics with recurrent bleeding esophageal varices for selective shunt].

Analysis was made of almost 600 patients who received shunt operations between January 1, 1952 and January 1, 1975 because of liver cirrhosis and repeated bleeding from gastroesophageal varices. The emergency portosystemic shunt was abandoned owing to its 50% lethality; the portocaval shunt was also discontinued, because of an encephalopathy rate of 25%. The splenorenal shunt (Linton) and coronary-caval shunt (Gütgemann) gave comparatively satisfactory results. A more recent introduction was the mesocaval interposition shunt (Drapanas). We also developed new criteria of indication for a shunt operation: elective shunt, liver volume 1000--2500 ml, portal vein perfusion 15%--40%, avoidance of celiac trunk and hepatic artery stenosis. Using only the types of shunt operation and criteria of indication here recommended, lethality among 65 patients operated on between January 1, 1975 and July 1, 1978 was only 6%, delayed lethality only 3%. The rate of encephalopathy was reduced to 5%. The 5-year life expectancy should increase to more than 70%. Thus, support is provided for the proposed therapy concept and criteria for shunt indication.

Aged↗
PubMed1979

[Indications and value of chest radiography in patients with respiratory insufficiency (author's transl)].

Chest X-rays of patients with respiratory insufficiency provide different information depending on the stage of the disease. The indications for chest radiography should, therefore, be determined by whether the examination is intended to establish the diagnosis and causes of the respiratory disease, to arrive at the differential diagnosis or test the efficacy of treatment.

Adolescent↗
PubMed1979

[Classification of x-ray findings and correlated oxygen tensions in "shock lung" (author's transl)].

The classification of the radiological features of the "shock lung" into stages represents a description of the characteristic radiological changes as they develop in the course of the lesion. As these changes do not succeed each other step by step but are superimposed their attribution to a particular stage therefore describes only the dominant substrate. Since the radiological changes and the corresponding oxygen tensions generally show satisfactory correlation a lack of correspondence during treatment may be an early sign of secondary disturbances or complications.

Humans↗
PubMed1979

[X-ray equipment for standardized diagnostic radiology in intensive care units (author's transl)].

The increasing demands made by intensive care medicine on chest and abdominal radiography and on angiography have created the need for new X-ray equipment that combines short exposure with high tension. Battery-operated medium-frequency generators have an adequate output to satisfy these demands. For visualizing peripheral vessels in intensive care patients xeroradiographic arteriography has proved its value.

Angiography↗
PubMed1979

[Operative treatment of deep vein thrombosis (author's transl)].

From 1973 to 1977 a total of 63 patients with thrombosis of the deep veins in leg and pelvis and in the V. cava inferior was treated by operative thrombectomy. Prior to the operation all patients were submitted to phlebography. The mean age of all was 52 years. One patient died from pulmonary embolism during thrombectomy, there was no further hospital mortality. Because of low mortality incidence and rarely postthrombotic complications we prefer the operative treatment of deep vein thrombosis. The preoperative cavography helps to avoid pulmonary embolism during thrombectomy.

Adolescent↗
PubMed1979

[Animal experiments with 99mTc-diethyl-HIDA in acute complete bile duct occlusion (author's transl)].

In order to establish whether a complete obstructive jaundice can abolish the accumulation of diethyl-HIDA (EHIDA) in the liver parenchyma, the common bile duct was ligated in 14 mongrel dogs. Before as well as at regular intervals after ligature of the common bile duct, a sequence scintigraphy was performed with 2 mCi 99mTc-EHIDA. For evaluation, time-activity curves (Tmax, T1/2), and analogue scintigrams as well as laboratory parameters were used for assessment. Up to seven weeks after ligation of the common bile duct, there was a marked accumulation of EHIDA in the liver parenchyma. The relative liver uptake (liver/background ratio) fell from 8.9 to 2.7, whereas conversely the cholestasis indicators aP and bilirubine rose markedly. Tmax did not show any significant alterations, whereas T1/2 was prolonged from about one week after ligation. Because of the duct ligation, there was no excretion of activity into the intestines. Immediately after ligation of the common bile duct, the gallbladder was shown up as a "hot" area in which the majority of the applied activity appeared from about one hour p.i. Begining with the fifth to the seventh day after ligation, the gallbladder was seen as a "cold" area in the liver paraenchyma. Bilirubine and aP were raised by about 50 times the initial value. With longer lasting cholestasis, the scintigram no longer altered whereas bilirubine and aP rose further. Histological examination after ligation for more than five weeks showed slight alterations as a whole. Gamma-GT and in particular GPT were likewise slightly raised compared to bilirubine and aP. The conclusion was drawn from this that the good accumulation of EHIDA in the liver parenchyma which is to be observed without exception even in cholestasis lasting for several weeks could be explained by a relatively slight hepatocellular damage. Only when there is a consecutive parenchymal damage in extrahepatic jaundice, accumulation of EHIDA in the liver can be abolished.

Acute Disease↗