[Coronary insufficiency and sudden death due to coronary artery anomalies (author's transl)].
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Adolescent↗
Biomedical subjects
M Thelen
Publications and source records attributed to M Thelen.
[Selective transfemoral embolization of the internal iliac artery in carcinoma of the bladder (author's transl)].
Inoperable bladder cancer and massive bleeding is an indication for selective bilateral transfemoral embolization of the internal iliac arteries. The method is preferred to the open ligation of these arteries. Histoacryl is the optimal material for longterm vascular embolization. In five patients with bleeding inoperable bladder cancer (stage T4N2) immediate and permanent haemostasis and a regression of pain was achieved.
Embolization, Therapeutic↗
[Mitral stenosis on conventional radiographs. II. The relationship between pulmonary venous and arterial hypertension, their haemodynamic parameters and calcified mitral valves (author's transl)].
In the second paper, the relationship between pulmonary venous and arterial hypertension and calcification in the mitral valve is analysed statistically and its patho-physiological significance discussed. In one hundred cases of mitral stenosis the left atrium, as seen on the lateral projection, was always enlarged, but its size was independant of atrial pressure or the pressure gradient across the mitral valve. Apart from pulmonary fibrosis and haemosiderosis, the abnormal findings increased with increasing mean atrial pressure. Pulmonary-arterial mean pressure of more than 30 mmHg was found particularly in the presence of mitral valve calcification (94%). Calcification of the valve is the most important and reliable indicator for evaluating the severity of the stenosis.
Adult↗
[Morphological changes following arterial catheter embolisation of the kidney (author's transl)].
Arterial catheter embolisation of the kidney is used as a form of treatment for uncontrollable haematuria due to inoperable tumours of the kidney or bladder; it can also be used as a preoperative measure for operable renal tumours in order to make surgery easier. Time-related morphological examinations are not yet available in the literature. The histological changes in the tumour-containing kidney are described in four patients at two, six, twelve and thirteen days after Histo-acryl embolisation. After embolisation there are wedge-shaped anaemic infarcts and extensive necrosis in tumour and normal kidney with leukocytic demarkation and reabsorption of cellular inflammatory material. Complete necrosis of the tumour was not found. There is therefore not complete destruction of the tumour as a result of arterial catheter embolisation, even when the veins are thrombosed by tumour.
Catheterization↗
[Changes in liver haemodynamics after mesenterico-caval dacron prosthesis anastomosis ("H-shunt") in portal hypertension (author's transl)].
In fourteen patients with portal hypertension and bleeding from oesophageal varices, mesentericocaval anastomoses using a dacron-velour prosthesis ("H-shunt") were carried out. Evaluation of the haemodynamics showed: 1. Comparison of 13 pre- and post-operative angiograms showed an haemodynamicically effective shunt in 12 and a stenosed shunt in one. 2. The aim of relieving the portal circulation while maintaining antegrade portal flow was achieved in six patients. 3. In six patients, the portal vein was not seen in a splenic or mesenteric portogram despite an open shunt. Functionally, this corresponds to a porto-caval anastomosis. 4. Pressure reduction in the portal circulation can be so marked as to obtain retrograde portal flow from the hepatic artery. 5. If the portal blood flow through the liver disappears, the hepatic artery may obtain additional flow from the superior mesenteric artery (reversed flow in the gastroduodenal artery). 6. Increased arterial flow to the liver is made possible by a reduction in intrahepatic resistance. The role of collaterals, either arterio-portal shunts or shunts between the sinusoids, is discussed. 7. The hepato-fugal collateral circulation was reversed in twelve patients.
Adult↗
[Arterial catheter embolisation for bleeding from bladder carcinoma (author's transl)].
An inoperable bleeding carcinoma of the bladder is an indication for embolising the internal iliac artery. Catheter embolisation is to be preferred to surgical ligation of the internal iliac artery, since it is a simpler procedure. The desired effect, a cessation of bleeding, was immediately obtained in all patients. An additional patient with pyocystitis and a carcinoma was also helped.
Angiography↗
[Experiences with transcatheter emoblization in urology (author's transl)].
Transcatheter embolization of the kidneys and bladder is increasingly important. The main indication for embolization is persistent hematuria involving surgically nonaccessible renal and bladder cancer. Additional surgical management of the disease can be avoided. Another indication is the preoperative embbolization of the kidney which facilitates surgical procedure and possibly prevents tumor cell embolization in the venous circulation. The indication for embolization of bleeding bladder carcinoma is different and permanent arterial occlusion is only justified if other measurements fail.
Adult↗
[Changes in pulmonary blood flow during surgery in the lateral position; a computer-scanning study (author's transl)].
The changes in blood flow in the pulmonary circulation arising from the lateral position during surgery were tested by means of 99mTc microspheres and a scanning camera computer system in 30 patients who had urological operations. Blood flow in the undermost lung increased by an average of 17% of the total pulmonary blood flow (SD = 8.0) in a group of 18 persons whose average age was 39.9 years. This redistribution occurred immediately after the patient was placed on his side and was more marked in younger persons than it was in older ones. Accompanying changes in O2 pressure showed no quantitative correlation with the changes in perfusion. The lateral position also affected ventilation by reducing ventilation of the undermost lung. This ventilatory disturbance which was demonstrable in more than 50% of the cases persisted for a short time after the operation whereas the pulmonary circulation returned to normal immediately after the patient resumed a normal position.
Adult↗
[Direct antegrade cholangiography and percutaneous transhepatic drainage of the biliary tract (author's transl)].
Direct antegrade cholangiography via transjugular access or as transcutaneous, transhepatic fine-needle cholangiography reduces the examination risk involved in the direct visualisation of the bile duct via needles of thick calibre. The article reports on the results obtained with 83 patients. Direct puncture of the bile duct by means of a fine needle is superior to transjugular antegrade cholangiography in respect of the required technical equipment and cost, and also as far as the proportion of accurate results is concerned, since visualisation of cholangiectasis will always be successful, whereas the visualisation of undilatated bile ducts can be effected in 50% of the examinations. Transvenous access should be chosen in such cases where liver tissue biopsy is necessary. Dilatation of the transcutaneous, transhepatic bile duct access via the temporary transcutaneous, transhepatic bile duct drainage, is necessary in those situations where the bile flow cannot be ensured by surgery, or where surgery is ruled out on account of the patient's general condition.
Bile Ducts↗
[Sequential hepato-splenic scintigraphy for measurement of hepatic blood flow (author's transl)].
The arterial and portal components of total liver blood flow were determined quantitatively in 31 patients by means of a new, non-invasive method. Sequential hepato-splenic scintigraphy has been employed, using a scintillation camera linked to a computer system. In normals, the proportion of portal flow was 71%, whereas in patients with portal hypertension it averaged 21%. Our experience indicates that the procedure can be of considerable value in the pre-operative diagnosis and postoperative follow-up of portal hypertension.
Adolescent↗
[Hepatobiliary scintigraphy with (99m)Tc-diethyl-IDA (author's transl)].
A short description of the pharmacology and kinetics of (99m)Tc-diethyl-IDA is given; our experience with this new radiopharmaceutical as a functional test of liver and bile ducts is illustrated by a number of typical examples. The ability to use increased activity together with high resolution "low energy" detectors provides excellent detail recognition in the hepato-biliary system. In addition, sequential scintigraphy with its resulting time-activity curves provides information regarding the function of the hepatocytes. The significance of hepatobiliary scintigraphy is its ability to distinguish between parenchymal and obstructive jaundice.
Acetanilides↗
[Mitral stenosis in the conventional radiograph. I. Relationship between heart size and haemodynamic parameters (author's transl)].
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Adult↗
[Supravalvular aortic stenosis: Congenital and acquired changes in the ascending aorta near the valve (author's transl)].
Three patients with supravalvular aortic stenosis are described. One was a typical, sporadic-type supravalvular aortic stenosis, another a predominant aortic valve stenosis as part a complex heart lesion and the third inflammatory shrinking of the anulus fibrosus with an inflammatory aortic valve stenosis. The means of diagnosis are discussed. Angiocardiography and aortography are essential in order to demonstrate the pathology, haemodynamics, relation to the coronary arteries and the sinus of Valsalva, and in order to show other abnormalities. The aetiology and pathogenesis of various types of supravalvular aortic stenosis are discussed.
Adult↗
[Sequential hepato-splenic scintigraphy with 99mTc-pertechnetate in experimental post-hepatic block (author's transl)].
Using baloon catheters in the inferior vena cava, post-hepatic blocks were produced in experimental animals. Subsequent liver perfusion scintigraphy showed marked reduction in portal flow. The significance of these findings in the diagnosis of the Budd-Chiari syndrome and its differentiation by scintigraphy from an intrahepatic block in cirrhosis of the liver is discussed.
Animals↗
[A comparison of intravenous and infusion cholangiography with intraoperative and tomocholangiography (author's transl)].
Seventy-four patients are described who were examined by various cholangiographic methods. 1. In the diagnosis of stenosis of the papilla, intraoperative cholangiography was found to be the most reliable. Intravenous and infusion cholangiography were of equal value and provided less information than the intra-operative examination. 2. For stones, intravenous and infusion cholangiography is significantly better than the intro-operative cholangiogram. Tomography provides no additional information. 3. For stones in the papilla, the intra-operative method is best and is superior to intravenous and infusion cholangiography. Pre-operative tomography resulted in a loss of information.
Ampulla of Vater↗
Renal hamartoma: therapeutic aspects.
Hamartomas are benign renal tumors. In most cases they can be diagnosed by means of angiography. Treatment varies in accordance with clinical manifestation and progression. Symptom-free hamartomas need no treatment. In case of bleeding, embolization may be performed. Nephrectomy ought not to be performed save in emergency or if malignancy is suspected.
Adolescent↗
Scintigraphy of liver and spleen in vinyl chloride workers.
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Adult↗