Biomedical subjects

M Thelen

Publications and source records attributed to M Thelen.

At least 433 records · Page 24Linked to original sources

PubMed1977

Cell-kinetical analyses of squamous cell carcinomas of the oral region and the effect of a combined therapy of 5 fluorouracil and irradiation. A contribution to the discussion about tumorcell-synchronization.

Out of 180 incubations of human biopsies 33 were from patients with malignant tumors of the oral region. In 9 cases it was possible to analyse the cell cycle of the tumor cells with the double labeling in vitro method (3H and 14C-thymidine). Histologically the tumors were keratinizing squamous cell carcinomas with high labeling indices. The generation time of the tumor cells ranged from 20 to 130 hours. The length of the DNA synthesis phase varied between 7.3 and 17.9 hours. With the knowledge of the cell-kinetic data the patients received an infusion of 5 Fluorouracil throughout the length or parts of the calculated G 1 phase. At the end of the 5 FU infusion there was a constant two-hour pause and after the duration of the calculated DNA synthesis phase the tumors were irradiated with 150 rd per session. The treatment was repeated until a total dose of 6000 rd was achieved. Under the combined therapy of 5 FU and irradiation the inoperable keratinizing highly differentiated squamous cell carcinomas regressed extraordinarily fast. The patients were free of pain after a very short time. No vital tumor tissue was visible in control biopsies. Some patients remained without any tumor recurrence now more than 2 years after onset of therapy. In the discussion it is stressed that the reason for the successful treatment of highly differentiated squamous cell carcinomas with 5 Fluorouracil and subsequent irradiation is not easily explained, because recent experimental findings and impulsecytophotometrical studies on human biopsy material suggest that both the synergistic action of thecytostatic drug and the irradiation as well as an altered recruitment of the tumor cells are responsible for the clinical success rather than a synchronisation effect.

Adult↗

PubMed1977

[New technic of the transjugular cava blocking in the removal of acute pelvic vein and inferior vena cava thrombosis].

Thrombosis of the inferior vena cava rarely occurs. However, it mostly develops by continous growth from thrombosis of the deep leg and pelvic veins. Thrombus formation in the inferior vena cava carries a potentially lethal risk because of possible involvement of the renal veins with consecutive renal failure or development of fulminant pulmonary embolism. Therapy of choice consists in early diagnosis and immediate thrombectomy. Choice of the operative procedure is of the utmost importance for immediate and late results. Our technique consists of inserting a balloon catheter via a side vessel of the internal jugular vein and placing it into an infrarenal position, where it is blocked, thereby preventing blood flow from the area to be cleared. Three cases in which this technique was employed are presented.

Acute Disease↗

PubMed1977

[Relation between the degree of coronary artery sclerosis and collateral vessel formation (author's transl)].

A numerical index was developed for reproducible and comparative judgement of the degree of coronary sclerosis. This graded index method takes into account the amount of stenosis as well as its distance from the ostium. 152 selective coronary angiograms were evaluated by this method. There was a close correlation between the degree of sclerosis and collaterals; the index of 63 patients with collaterals was 3.5 times that of patients without collaterals. Anastomoses and collaterals showed typical localisations depending on the antomical position of stenoses. For the evaluation of the clinical importance of collaterals, a classification into one, two and three vessel disease is not adequate; the reduction in perfusion cannot be reliably estimated and should be judged by a more detailed index method.

Angiography↗

PubMed1977

[Results of transjugular antegrade cholangiography and retrograde portography (author's transl)].

Via the jugular approach to the liver diagnosis of the liver could be extended by transjugular cholangiography, liver biopsy and retrograde portography. Transjugular cholangiography makes possible an antegrade picture of the bile ducts - particularly when conventional techniques or retrograde measures fail. 85% of blocked bile ducts were recognized. Transjugular liver biopsy complements cholangiography. Tissue can be removed from right and left lobes of the liver. Retrograde portography makes possible assessment of hemodynamics of the liver in portal hypertension before and after shunt operations. Isolated pictures of portal circulation in the right or left lobes permits clear allocation of tumorous or parasitical disease in the respective parts of the liver. This is of special importance for surgery of the liver, a precondition of hemihepatectomy.

Adult↗

PubMed1976

[Scanning in progessive pulmonary failure (shock-lung): preliminary results of a clinical study].

Lung scanning was performed on five patients with shock lung. It gave no evidence of morphological (pre-capillary) arterio-venous shunts or of increased pulmonary arterial pressure. Nor was there evidence of perfusion-ventilation inequality in the scan. The cause of the progressive pulmonary insufficiency was most likely due to maldistribution of gases in the microscopic region and to diffusion abnormalities.

Adult↗

PubMed1976

[Mediastinal and pulmonary complications of the sclerosing treatment of oesophageal varices (author's transl)].

One hundred and twenty patients with oesophageal varices were seen in the surgical clinic between 1970 and 1975; 290 individual treatments with endoscopic sclerosis were carried out. The typical radiological complications in the mediastinum and lungs have been assembled. Clinically significant complications such as oesophageal perforations with large pleural effusions are separated from uni-important complications, such as minor effusions and plate atelectases. The method of conservative treatment of varices is described and the indications for it, as against other forms of treatment, are described.

Esophageal Perforation↗

PubMed1976

[Laevocardiographic evaluation of left ventricular function. III. Aortic valve insufficiency (author's transl)].

1. The normally functioning left ventricle is characterised by a definite relationship between end-diastolic volume and ejection fraction (reduction of lateral systolic projectional area by 50 to 60%. 2. With increasing volume, the left fentricle shows increasing, end-diastolic size. 3. With pure aortic insufficiency, end-diastolic ventricular size is larger than it is with combined aortic valve disease. Hypertrophy is the predominant reaction of the left ventricle to increased resistance, but also to co-existent insufficiency. In addition the ejection fraction rises with increasing resistance. 4. End-diastolic areas up to 85 cm.2 and end-diastolic pressures up to 20 mmHg. can be regarded, rare cases excepted, as indices of normal contraction and are associated with a normal ejection fraction.

Adult↗

PubMed1976

[Radiological lung changes in progressive pulmonary insufficiency (author's transl)].

Chest radiographs can reflect increasing pulmonary insufficiency of shock lung. In the early and intermediate stages, there is almost pure interstitial oedema which, in the later stages becomes alveolar-interstitial. In addition one may find evidence of broncho-pneumonia. Respiratory insufficiency is due to abnormalities of perfusion and distribution and is aggravated by disturbance of oxygen diffusion. The latter is due to an increase in the alveolo-capillary diffusion distance in the presence of interstitial oedema. It was not possible to demonstrate quantitatively significant precapillary shunts greater than 25 mu.

Adult↗

PubMed1976

[Catheter embolisation of metastasising renal carcinomas using butyle-2-cyano-acrylate (author's trabsl)].

Embolisation with butyle-2-cyano-acrylate was carried out in four inoperable renal carcinomas. By mixing this tissue adhesive with 50% glucose it remains suitable for embolisation for eight to ten minutes. Contact with blood produces the desired effect of immediate and permanent vascular occlusion. Since the material adheres to the vessel wall, it is not carried to any other vascular areas. No complications due to this material have been observed.

Adenocarcinoma↗

PubMed1976

[A review of the findings on chest examinations and at autopsy in surgical patients under intensive care (author's transl)].

The present paper deals with the findings on examination of the chest and at autopsy in 100 selected surgical patients under intensive care; of these 17% were post-traumatic, 55% had post-operative lung complications and in 28% there had been no trauma or previous operations. The accuracy of the radiological diagnosis was checked against the autopsy findings. Pneumonia and pulmonary oedema were the most common lung complications in all three groups, with an incidence of 59 to 82%, and were diagnosed with an accuracy of 92 to 95%. Other conditions which were looked for were pulmonary congestion, emboli and lung infarcts, pleural effusions, atelectasis, pulmonary haemorrhage or contusion and pneumothorax. The most common mis-diagnosis was in the demonstration of emboli and infarcts, where accuracy was only 64%. The difficulties in differential diagnosis of the radiological appearances due to these pulmonary complications are discussed.

Autopsy↗

PubMed1976

[Trans-jugular retrograde portography. Preliminary communication].

Retrograde portography is carried out through a trans-jugular route. Contrary to previously available techniques of trans-juglar portography, the method does not inflict any trauma on the parenchyma or vessels. Demonstration of the portal system is achied by reserved flow through the liver sinusoids. Together with arterial hepatography and indirect splenic and mesenteric portography, the method provides additional information in various forms of pre-, intra- and post-hepatic block without submitting the patient to any additional risk.

Aged↗

PubMed1976

[Coronarography, technique and results (author's transl)].

Coronary angiography is a radiologic special technique with its place in the diagnosis of coronary disease. It demands much equipment and time. Evaluation, particularly in coronary sclerosis, is valuable, since it makes subtile differential diagnosis possible. This in turn is the basis for modern individual therapy.

Adult↗

PubMed1976

[Radiological lung changes after thoracoabdominal surgery in the lateral decubitus position (author's transl)].

Radiological changes that may occur in the depenent lung when surgery is performed in the lateral position are generally of a transient nature; they disappear when the position of the patient is changed after the operation, but may, in some cases, be demonstrable post-operatively as atelectatic areas. From the second post-operative day onwards, and reaching a peak on the 5th post-operative day, there is an increased incidence of ventilatory disturbances and infiltrations. The course and distribution of these pulmonary disturbances point to post-operative immobilization in the recumbent position as the main causal factor.

Adult↗

PubMed1976

[Significance of inhalation and perfusion scintigraphy for the diagnosis of pulmonary embolism (author's transl)].

Inhalation and perfusion scintigrams, general radiological examination of the thorax and an EKG were done on 43 patients with clinically suspected pulmonary embolism. In 11 cases, the clinical diagnosis could be confirmed on the basis of the scintigraphic examination. In the remaining 32 patients, an embolich event could be excluded by pulmonary scintigram, radiological examination and later the clinical course. A synopsis of clinical observations, X-ray and scintigraphy, therefore, permitted a basically reliable diagnosis of pulmonary embolism; selective pulmonary angiography should be used only in exceptional cases.

Adult↗

PubMed1975

[Primary malignant nephrosclerosis (author's transl)].

Primary malignant nephrosclerosis shows a haemolytic-uraemic symptomatology and can be differentiated from secondary malignant nephrosclerosis on clinical and histological grounds. The disease was observed in 4 patients: a 25-year-old man and 3 women aged 19, 28 and 49 years. The disease is characterized by a fulminating course, malignant hypertension with progressive retinopathy, and development of progressive renal failure with subsequent irreversible anuria. In addition haemolytic anaemia or posthaemolytic states as well as consumption coagulopathy occur. In 2 cases schizozytes and in particular helmet-shaped forms could be demonstrated. On histology an obliterating necrotizing vascular change is seen which is limited to the kidneys as was demonstrated in one case by angiography. Therapeutic attempts included antibiotics, steroids, heparin, streptokinase, antihypertensive drugs, and haemodialysis. The 3 female patients died, the man survived after bilateral nephrectomy.

Acute Disease↗

PubMed1975

[Radiographs of the thorax in acute myocardial infarction].

Radiographs of the thorax were evaluated in 240 patients during the acute phase following a myocardial infarct. Following the acute infarct, 53% of the patients showed some cardiac enlargement, in a quarter this was marked. Congestive lung changes were found in 53% of patient following the infarct, interstitial pulmonary oedema in 22% and intra alveolar oedema in 9%. Patients with marked cardiac enlargement and those with congestive lung changes showed a bad prognosis, particularly if the congestion did not regress rapidly. Even advanced pulmonary congestion and interstitial oedema may be missed by clinical examination. Radiography of the thorax following acute myocardial infarction is of value in treatment and prognosis.

Acute Disease↗

PubMed1975

[Laevo-cardiography for the functional evaluation of the ventricle. I. The normal left ventricle].

The possibility of evaluating left ventricular function from lateral laevo-cardiogram has been investigated. A planimetric comparison of the end-diastolic and end-systolic areas of a normal left ventricle shows a 50 to 60% reduction of the systolic area, compared with the diastolic value. Assuming concentric contraction of the left ventricle, the systolic/diastolic reduction in area is proportional to the ejection fraction. This provides a measure for the quantitative evaluation of myocardial function.

Adult↗

PubMed1975

[Catheter embolisation of a bleeding renal hamartoma, with a contribution to its angiographic diagnosis].

Hamartomas of the kidney, often associated with tuberous sclerosis, have a typical angiographic appearance. Despite the similarity of the angiographic signs with malignant renal tumours, it is possible to differentiate these, as was shown in two patients which we have documented. If there is massive bleeding, fibrin embolisation carried out at the end of a diagnostic angiogram may lead to occlusion of the vessels and stop the bleeding. This was demonstrated in one of our patients.

Adolescent↗