Biomedical subjects

N Gritzmann

Publications and source records attributed to N Gritzmann.

At least 55 records · Page 3Linked to original sources

PubMed1992

[Imaging procedures in diagnosis of laryngeal cancer with special reference to high resolution ultrasound].

Sonography was compared with operative and histological results in 42 patients with advanced laryngeal cancer. Sonography was accurate in the imaging of supraglottic tumours. Infiltration of the base of the tongue (n = 4) and of the pre-epiglottic space (n = 12), as well as of the thyroid cartilage (n = 8) and subglottic extensions (n = 3) were visualized too. Infiltration of the piriform sinus was correctly assessed sonographically in 8 patients. Endoscopy was superior to sonography in endolaryngeal delineation of the tumour, with in exception of paraglottic tumours. In cervical lymph node staging sonography was more accurate than palpation (86% versus 69%). The diagnostic capabilities of sonography were compared with computed tomography and magnetic resonance imaging (MRI). Due to its widespread availability and high accuracy in the delineation of supraglottic and extralaryngeal extensions and in cervical lymph node staging, sonography can be performed as primary imaging modality in advanced laryngeal cancer. If it is not possible to obtain complete delineation of the tumour by sonography, MRI must be undertaken.

Carcinoma, Squamous Cell↗

PubMed1991

Combined modality treatment of advanced cancers of the oral cavity and oropharynx.

From May 1985 to June 1988, 70 evaluable patients with advanced squamous cell cancers of the oral cavity and the oropharynx were treated with preoperative combined radio-chemotherapy. Treatment consisted of 50 Gy/25 fractions/5 weeks, combined with concomitant administration of mitomycin C on day 1 (15 mg/m2, i.v. bolus) and 5-fluorouracil during the first 5 days of irradiation (750 mg/m2/24 hours, continuous infusion). Surgery was performed 3 to 5 weeks following irradiation. Treatment tolerance was good and local mucosal reaction was increased, but no major systemic side effects were recorded. At surgery, 3-5 weeks following irradiation, 48.6% of the operation specimens did not contain any histologically detectable residual tumor. Overall survival is 61%, being 69% in T2 and T3, while none of the patients with bone invasion has survived. Median survival is 28, 26, and 9 months in T2, T3 and T4 stages, respectively. Loco-regional relapses have been recorded in 33% of the patients, occurring in 27% of T2, 25% of T3, and 88% of T4 stages. Patients have been spared mutilating radical neck dissection because of combined presurgical treatment without impaired survival or loco-regional relapse rate.

Adult↗

PubMed1991

Ultrasonographic measurement of the soft-tissue of the upper jaw.

For preimplantation diagnoses, various mechanical methods for measuring the width of the soft tissue and thus measuring indirectly the osseous bed of the implant can be used. The ability to determine soft tissue thickness above the jaw by ultrasound was evaluated in 8 autopsy specimens. The data obtained were compared with findings from the needle measurement method which is usually employed in clinical practice. The ultrasound measurement method produced realistic data in all sectional planes chosen.

Anthropometry↗

PubMed1990

Sonography versus palpation in the detection of regional lymph-node metastases in patients with malignant melanoma.

High-resolution real-time sonography was done in 217 patients with malignant melanoma to compare its value in detecting regional lymph-node metastases with that of palpation. Lymph-node metastases were found in 29 patients by ultrasound whereas, by palpation, metastases were detected in 15 patients only. The presence of metastases was proven by histopathology after surgical lymphadenectomy in these ultrasound positive cases. Thus sonography was superior to palpation, and in addition permitted distinction between metastatic changes and inflammatory lymph-node enlargement. Ultrasound is recommended for preoperative staging as well as in postoperative monitoring of patients with malignant melanoma.

Adult↗

PubMed1990

Diagnostic imaging of tumor invasion of the mandible.

Several imaging techniques, such as conventional radiography, sonography, computed tomography, isotope scanning and magnetic resonance tomography are used for evaluation of malignant tumors in the region of the floor of the mouth and the tongue. At present, conventional radiography, as well as computed tomography and isotope scanning are the techniques preferred for examination of the mandible. In this study, the results of conventional radiographic examination, computed tomography, ultrasound and Tc scanning in detecting tumor invasion of the mandibular bone, are documented and correlated to surgical and histological findings. The results suggest that ultrasound--our primary diagnostic imaging technique for evaluation of tumors of the floor of the mouth and the tongue--not only provides excellent imaging of tumor extension in soft tissue but also allows accurate diagnosis of osteodestructions of the mandible. In most regions ultrasound had the same accuracy in detecting tumor invasion of the mandible. In the alveolar process, however, sonography was superior to other imaging techniques. The lingual surface of the mandibular ramus can not be screened by the extraoral sonography.

Carcinoma, Squamous Cell↗

PubMed1990

[Sonography in malignant tonsillar tumors].

In this retrospective study the value of sonography in the preoperative staging of malignant tumours of the tonsils was evaluated in 36 patients. According to our results sonography is indicated in small tumours. In greater tumours, especially if bone destruction could be expected, MR or CT should be performed additionally to sonography. Good results were achieved in assessing the infiltration of the tongue with or without crossing the midline (accuracy 92 to 97%) and the detection of cervical lymph node metastasis (accuracy 94%).

Adult↗

PubMed1990

Invasion of the carotid artery and jugular vein by lymph node metastases: detection with sonography.

Knowledge of invasion of the walls of the cervical vessels by tumor is of great clinical importance before surgery. We performed sonography on 83 patients with palpable cervical lymph node metastases in the region of the carotid bifurcation to determine the relationship of the metastases to the carotid artery and jugular vein. In all patients, the sonographic results were proved by surgery. The wall of the carotid artery was hypo-echogenic in 11 of 12 patients with surgically proved tumor invasion of the artery. Four results were false-positive. Palpation or swallowing during real-time scanning showed mobility of the tumor relative to the wall of the artery in 47 patients (57%). In these patients, tumor invasion could be excluded. Bilateral compression or invasion of the internal jugular vein was identified correctly with sonography in all five patients in whom this was confirmed surgically. These results suggest that real-time sonography is a valuable method for determining the relationship between cervical lymph node metastases and the carotid artery and jugular vein.

Carcinoma, Squamous Cell↗

PubMed1990

Evaluation of arteriovenous fistulas and pseudoaneurysms in renal allografts following percutaneous needle biopsy. Color-coded Doppler sonography versus duplex Doppler sonography.

One hundred one patients with renal allografts were studied by two independent observers using duplex Doppler sonography (DDS) and color-coded Doppler sonography (CCDS). In all patients, single or multiple percutaneous needle biopsies of the transplant had been performed 1 to 30 days before. In 6 patients CCDS following the biopsy demonstrated an area of combined red and blue color-coded blood flow within the renal parenchyma (n = 5) or within the sinus (n = 1); the Doppler waveform was abnormal in these areas with signals above and below the zero line indicating turbulent blood flow. Consecutive intraarterial digital subtraction angiography (DSA) revealed the presence of an arteriovenous fistula (n = 4) or of a pseudoaneurysm (n = 2). In one patient, gross hematuria with obstruction of the bladder occurred as a complication of a pseudoaneurysm within the renal sinus; the bleeding could not be stopped by embolization of the lesion and the kidney had to be removed. DDS demonstrated the lesion in only one of the six patients. Thus, CCDS is the method of choice for noninvasive detection of vascular lesions due to percutaneous biopsy.

Adolescent↗

PubMed1989

Sonography of unusual extratesticular lesions.

Sonograms of seven patients with extratesticular lesions are presented because of their relatively rare occurrence or unusual sonographic pattern. The sonographic appearance of a malignant extratesticular liposarcoma is described. Infected sebaceous glands and slow-growing malignant tumors of the spermatic cord are demonstrated as possible problems in differential diagnosis. Extratesticular septated cysts or fluid collections surrounding the spermatic cord are documented as complications in hemophilia and acute pancreatitis. These entities are presented because of their differential diagnostic challenge compared with more common disorders such as infected hydroceles and hernias.

Adult↗

PubMed1989

Histological grading of therapy induced regression in squamous cell carcinomas of the oral cavity. A morphological and immunohistochemical study.

Squamous cell carcinomas in the oral cavity and the oropharynx were diagnosed in 84 patients. After verification by biopsy, 79 of these patients were treated preoperatively with mitomycin C and 5-fluro-uracil, radiated and operated 3-5 weeks later. The effectiveness of adjuvant preoperative radio-chemotherapy was evaluated histologically. Serial sections of the entire tumor specimen were investigated and the percentage of vital cancerous tissue in the total tumor area was assessed. Regression was classified into four grades. Grades I and II were regarded as good response to adjuvant preoperative radio-chemotherapy, while grades III and IV stood for bad or no response. Morphologically questionable residual tumor infiltrates could be clarified by immunohistochemical methods with antibodies against vimentin, desmin and Lu-5. The histological assessment of the regression grade of operated tumor specimens allows a clinically relevant, morphologically exact and reproducible evaluation of the effect of preoperative radiochemotherapy.

Adult↗

PubMed1989

[Sonographic detection of osteodestruction of the mandible].

32 patients with osseous destruction of the mandible were examined sonographically. The results were compared with those of plain radiographs. In 30 patients, discontinuation of the cortex was clearly evident. Sonography could detect osteolytic lesions in the corpus region, in the angle and on the buccal side of the rami of the mandible. 2 cases of osteodestruction on the lingual side could not be seen.

Aged↗

PubMed1989

[Duplex sonography after femoro-distal vascular reconstruction using umbilical veins].

In 34 patients femoro-distal reconstructions with umbilical vein grafts were assessed by means of pulsed Duplex sonography. Dilatations of the grafts and aneurysms were diagnosed easily by means of DS, likewise thrombotic plaques and perivascular pathologies. Haemodynamically significant stenoses can be quantified due to the increased velocity measured by pulsed Doppler. It can be concluded that DS is the method of choice for the postoperative follow-up of umbilical vein grafts of the femoro-distal vascular system.

Aged↗

PubMed1989

[Primary lymph node metastases in malignant melanoma studied via high-resolution real-time sonography--its value and indications].

To detect regional lymph node metastases 217 patients with melanoma were examined both sonographically and clinically. Metastases were found in 15 patients by means of palpation, and in 26 patients via ultrasound. Sonography was evidently superior and enabled differentiation between metastatic changes and inflammatory enlargements of lymph nodes. Because of its excellent accuracy ultrasound examination should be performed both in preoperative tumour staging and in posttherapeutic monitoring.

Adult↗

PubMed1989

[The diagnosis of salivary gland lipoma].

8 patients with 9 lipomas of the salivary gland were reviewed retrospectively. The clinical diagnosis, the sonomorphology and the appearance in CT were analysed. By means of palpation none of the lipomas was specifically diagnosed. Usually sonography is the first imaging method in superficial salivary gland tumors. Therefore the knowledge of the sonomorphology is important for indicating CT. Sonographically a lipoma of the salivary gland should be suspected, if an oval shaped, slightly hypoechoic tumor with a typical feathered appearance and good compressibility is visualized. All lipomas of the salivary glands could be delineated sonographically. Due to their negative homogeneous attenuation values lipomas can be diagnosed specifically in CT. This enables the head and neck surgeon to avoid an operation in patients with no or minor complaints.

Adult↗

PubMed1989

Advanced laryngeal cancer: sonographic assessment.

Endoscopy permits visualization of the endolaryngeal spread of laryngeal tumors, yet the depth of tumor infiltration often remains unclear. The authors used high-resolution sonography in 37 patients with advanced laryngeal cancer to assess the tumors and the cervical lymph nodes. Sonographic findings were compared to operative and histologic reports. Sonography demonstrated histologically confirmed infiltration into the thyroid (n = 8) and cricoid cartilages (n = 1), preepiglottic space (n = 12), base of the tongue (n = 4), hypopharynx (n = 8), subglottic space (n = 3), and thyroid gland (n = 2). Except for the retrolaryngeal portion of the tumor, sonography was valuable in assessing extralaryngeal spread of advanced cancers. It enabled detection of subclinical lymph node metastases in four patients. Furthermore, invasion of the wall of the carotid artery was found in two patients. For evaluating the endolaryngeal and hypopharyngeal portions of the tumor, endoscopy remains mandatory.

Female↗

PubMed1989

Sonography of the salivary glands.

In a blinded retrospective study of the efficacy of sonography of the salivary glands, we obtained sonograms on 849 patients. The patients were referred over the last 5 years from the ear, nose, and throat department of our university hospital. Eight-eight percent of the patients had symptoms related to the salivary glands. One hundred fifty-six of the patients (18%) were subsequently proved to be normal. The remaining 693 patients had diseases confirmed by histologic examination (332 patients), sialography (274 patients), or clinical follow-up (87 patients). Of these, 289 had salivary gland tumors (231 benign, 58 malignant), 185 had calculi, 154 had inflammation, 48 had autoimmune disease, 14 had cysts, and three had trauma. Two hundred eighty-seven (95%) of the 302 space-occupying lesions could be completely delineated by sonography, and the benign or malignant nature of the lesions was correctly assessed in 272 (90%). Of the 185 patients with calculi, the calculi were visualized and localized (intraductal vs intraglandular) on the sonograms in 174 (94%) patients. Abscesses were shown on the sonograms in 13 patients, and acute inflammation was shown on the sonograms in 84 patients. These results indicate that sonography is a useful procedure for diagnosis of diseases of the salivary glands.

Autoimmune Diseases↗

PubMed1989

[The value of sonography in salivary gland tumors].

In a prospective study, 178 patients with tumours of the salivary glands were examined both clinically and by ultrasound. All patients have since been operated upon, and the diagnosis was confirmed histologically. The diagnostic accuracy of clinical examination is compared with that of ultrasound. Every tumour of the salivary glands could be diagnosed by ultrasound. In the benign group, an exact diagnosis of the tumour type was possible in 83% of cases. In the malignant group an exact diagnosis was only possible in 57% of cases. Furthermore, it is possible with ultrasound to recognise multiple and bilateral tumours, to determine whether a tumour is intra- or extraglandular, and to show the nature of the tumour (cyst, abscess, central necrosis) to a much greater extent than with clinical examination alone. In addition, a fairly good assessment of the cervical and intraglandular lymph nodes is obtained. We believe that ultrasound is of great importance in the diagnosis of tumours of the salivary glands.

Adenolymphoma↗

PubMed1989

[DSA and duplex sonography of aortic prostheses].

In 95 patients with aortal grafts, DSA was compared with duplex ultrasonography. In 4 patients the graft was better visualized by means of angiography. Kinking, coiling, dilatations, pseudoaneurysms, stenoses, and occlusions could be sufficiently diagnosed with both methods. Marginal thrombosis and periprosthetic pathologies could only be found with ultrasonography. The ultrasonographic and angiographic examination techniques are described and the limitations of both methods discussed.

Adult↗