Biomedical subjects

M Trappe

Publications and source records attributed to M Trappe.

8 recordsLinked to original sources

PubMed1994

[Pain reduction after pelvi/-laparoscopic interventions by insufflation of CO2 gas at body temperature (Flow-Therme)].

Intraabdominal pain, shoulder pain and tachycardia are observed after pelviscopic interventions. Recent publications blame this on hypothermia caused by the CO2 gas used. The authors discuss in detail the physics of the problems connected with the heating of CO2 gas. The heating of carbon dioxide gas to 37 degrees C in the heating tube of the WISAP-Flow-Therme will not only reduce intra-operative hypothermia (down to 28 degrees C intra-abdominally and 34 degrees C in the rectum) but also the occurrence of tachycardia (reduced by 40% to 11%). Heating will also result in reduced CO2 consumption, which is also of ecological significance. As a result of the overall improvement of the female patients' perception of pain there is a significant reduction in postoperative palliative medication required by 31%. The physical laws and data permit fitting the WISAP Universal Flow Therme to all commercially available CO2 gas insufflators. The rinse water, as an additional factor causing hypothermia, should be preheated to 40 degrees C (WISAP water bath).

Body Temperature Regulation↗

PubMed1994

[What is the place of conventional radiology in the exploration of esophageal dyskinesia and hiatal hernia?].

Esophageal dyskinesias are due to various aetiologies and sometimes present with marked clinical symptoms. The barium swallow remains the preferred first-line examination. Upper GI endoscopy and manometry are useful to confirm the functional nature and eliminate any concomitant or secondary mucosal lesions of these motor disorders. The clinical signs of hiatus hernia are essentially due to complications related to gastro-esophageal reflux. They can be asymptomatic or may present in the form of atypical, sometimes extra-gastrointestinal, symptoms. Although conventional radiology allows the diagnosis of hiatus hernia by specifying the type, the morphology and the anatomical relations, it may fail to detect the consequences of gastro-esophageal reflux, especially ulcerated lesions. Upper gastrointestinal endoscopy appears to be the first-line examination of choice for the diagnosis of hiatus hernia. Barium swallow is useful in cases of failure of endoscopy and in the context of preoperative assessment, as these two investigations are often complementary.

Esophageal Achalasia↗

PubMed1994

[Megaesophagus].

Although it was first described a long time ago, the pathophysiology of megaesophagus, a primary esophageal motor disorder due to an abnormality of the esophageal sphincter reflex ("achalasia"), remains poorly understood. Our paper shows that it may also be missed clinically for a long time, sometimes for psychological reasons.

Adult↗

PubMed1993

[Meniscal lesions].

The polymorphism and richness of arthrographic imaging and MRI of meniscal lesions require a perfect understanding of the anatomy of the menisci and the mechanisms of production of the lesions. Arthrography remains the reference diagnostic investigation with a good sensitivity and excellent spatial resolution. However, it is an invasive and operator-dependent technique. MRI of the knee, a non-invasive and independent method, allows the diagnosis of the majority of meniscal lesions. By using specific surface coils and appropriate sequences, MRI constitutes complete imaging technique allowing examination of all anatomical structures of the knee in all planes. Once MRI becomes more widely available, it should replace arthrography in the majority of clinical situations. The indications for arthrography will then be confined to contraindications of MRI.

Aging↗

PubMed1992

[Radiological exploration of the shoulder rotator cuff].

Plain X-rays and Lecler's manoeuvre constitute the essential basic assessment in the diagnostic approach to lesions of the rotator cuff. The preoperative assessment of the lesions and the search for associated lesions are based on more or less invasive investigations. For many years, arthrography was the reference examination to establish a precise assessment, but was sometimes insufficient for the diagnosis of small partial non-communicating lesions and certain longstanding massive ruptures. Ultrasonography is an attractive non-invasive technique, but the quality of the results depends on the operator's experience. Although computed tomography and CT arthrography provide a perfect analysis of the anterior aspect of the cuff and evaluate the trophicity of the muscles, they are difficult to interpret, irradiating and sometimes incomplete. MRI, a non-invasive and non-irradiating technique, is the modality of choice due to its excellent contrast resolution and the possibility of multidirectional studies and a spatial resolution which is continually improved by new acquisition sequences and the use of better adapted surface coils.

Arthrography↗

PubMed1992

[Retrograde perineural extension of a metastatic recurrence of a frontal skin tumor].

Perineural metastatic spread of malignant tumours has been described for a long time, but has only recently been demonstrated by medical imaging. MRI, guided by the clinical findings, with fine sections on T1-weighted sequences without and with gadolinium, allows the diagnosis of this type of spread. The tumours most frequently responsible are squamous cell carcinomas and cylindromas. The trigeminal and facial nerves are the most frequently affected. Recognition of such lesions is essential in the initial staging of a malignant tumour of the face, as it alters the therapeutic strategy.

Cranial Nerve Diseases↗

PubMed1991

[Parotid metastases: value of imaging. Review of the literature, apropos of 4 cases].

Parotid gland is a very unusual site of metastasis. Four proven cases are described. The tumor was occult in three cases out of four. In one case, an extra neck primitive tumor was suspected. Two kinds of metastases are described: firstly, metastases within the salivary gland with look like pleomorphic adenoma and are secondary to hematogenous spread; secondly, lymph node metastasis (two cases). Their diagnosis appear easier as they are not usually completely surrounded by parenchyma. They can reveal either occult head and neck tumor or visceral tumor.

Adult↗

PubMed1991

[Study of the salivary glands in 1990].

Radiologic examination of the salivary glands can provide clinically useful information that may help to establish the diagnosis and indicate appropriate therapy. US and conventional sialography remain the standard methods of examination for inflammatory diseases and superficial parotid masses. However, CT and MR have allowed a new means of examination of parotid lesions, or of lesions around the parotid gland. MR appears to be the procedure of choice to investigate adenoid cystic carcinoma, recurrence and tumors expanding into the pterygopharyngal space or the sub-tonsillar space. Stenon duct endoscopy is a new imaging and therapeutic procedure to be introduced into the therapeutic strategy in these patients.

Humans↗