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Biomedical subjects

R Sokiranski

Publications and source records attributed to R Sokiranski.

60 records · Page 4Linked to original sources

[Intra-arterial treatment of therapy-resistant residual tumors of the pelvis].

PURPOSE: Evaluation of intraarterial cancer treatment in recurrent pelvic tumors, which were resistent to other treatment modalities. PATIENTS AND METHODS: Ninety-seven patients suffering from pelvic recurrences originating from bladder (n = 40), rectum (n = 19), cervix (n = 21) oder other organs (n = 17) were treated by intraarterial chemotherapy (111 times) or transcatheter embolisation (52 times). RESULTS: Less than 20% of our patients had remission of the tumor burden but tumor symptoms (especially pain and bleeding) could be controlled in 35 to 87% of the patients. The main complication was a muscle necrosis after intraarterial chemotherapy because of recurrent bladder cancer. CONCLUSION: Intraarterial cancertherapy is a useful procedure for symptomatic treatment of tumor symptoms especially in case of bleeding. Local tumor control can only be achived in a minority of the patients.

Adult↗

[High intensification film-screen systems in thoracic diagnosis. A clinical comparative study].

OBJECTIVE: The quality of chest images was evaluated for a conventional screen-film system, a new asymmetric screen-film system, and a new uv screen-film system. MATERIALS AND METHODS: 138 chest radiographs (69 p.a., 69 lateral) obtained with three different high intensification screen-film combinations were compared. Film density and film contrast were measured. Three readers graded the image quality according to 16 criteria. RESULTS: The asymmetric film-screen combination Insight HC showed the lowest film contrast, the best exposure range, and a elevated film density in the mediastinal area. The asymmetric screen-film system was ranked by all three observers as being substantially better in image quality. CONCLUSION: Compared to conventional screen-film systems, the new screen-film systems can improve the image quality of chest radiographs. Therefore, the new high intensification screen-film combinations can be used as a low cost alternative to the Amber technique and digital radiography.

Humans↗

[The value of the supine chest x-ray with digital luminescence radiography in relation to the experience of the observer. A ROC analysis in CT-validated cases].

The aim of the present study was to evaluate supine chest radiographs obtained by DLR for the diagnosis of pleural and parenchymatous changes and to compare the accuracy of observers in relation to their experience. 50 examinations, which had been checked by CT, were chosen. The images were examined by 7 doctors (2 non-radiologists, 5 radiologists). Our experience indicates that DLR has high specificity but low sensitivity for the diagnosis of a pneumothorax but relatively high sensitivity and low specificity for other changes (pleural effusions, atelectases and other intrapulmonary opacities). The area under the ROC curve averaged over the 7 rater was similar for these 4 entities. There were marked differences between the observers; the radiologists were considerably better than the non-radiologists. Altogether, the diagnostic value of single DLR examinations was relatively low. In indeterminate cases, additional diagnostic methods should, therefore, be used.

Adolescent↗

Percutaneous transluminal rotational atherectomy in the treatment of peripheral vascular disease using a transluminal endatherectomy catheter (TEC): initial results and angiographic follow-Up.

PURPOSE: To evaluate the clinical results of percutaneous transluminal rotational atherectomy in the treatment of peripheral vascular disease. METHODS: Rotational atherectomy was performed in 39 patients aged 39-87 years (mean 66.6 years). A total of 71 lesions (43 stenoses and 28 occlusions) were treated in 40 limbs. Additional balloon angioplasty was required in 54% of lesions. Fifteen patients (37.5%) presented in Fontaine stage II, 10 patients (25%) in Fontaine stage III and 15 patients (37.5%) in Fontaine stage IV. Rotational atherectomy at 750 rpm was carried out over a 0.014-inch guidewire with continuous aspiration into a vacuum bottle. Follow-up angiography and color flow Doppler examinations were performed in 22 patients (23 limbs) after a mean period of 6 months (range 2-14 months). RESULTS: There was one primary technical failure. In 36 of 40 lesions there was a good angiographic result with residual stenoses in less than 30%. In 70 lesions treated by rotational atherectomy, however, 54% showed residual stenoses of 30%-50% and these cases required additional balloon angioplasty. The mean ankle-brachial index improved significantly (p << 0.001) from 0.49 before the procedure to 1.01 after the procedure. A single distal embolus, related to primary recanalization, occurred and there were two large inguinal hematomas. Cumulative clinical patency after 6 months was 83.8% and cumulative angiographic patency after 6 months was 79.1%. CONCLUSION: Percutaneous rotational atherectomy is a promising approach for the treatment of chronic peripheral vascular disease. Further prospective, randomized studies are necessary to compare percutaneous transluminal angioplasty with this new technical approach.

Adult↗

Short-term results with use of the Amplatz thrombectomy device in the treatment of acute lower limb occlusions.

PURPOSE: To evaluate the clinical efficacy of the Amplatz device for the treatment of acute occlusions of the lower limb arteries. MATERIALS AND METHODS: Forty patients with acute occlusion of the lower limb arteries (3 hours to 8 days; mean, 2 days) were treated using the Amplatz clot macerator. Acute thrombotic lower limb occlusion was due to an embolic event in 32 patients and to atherosclerotic disease in eight patients. RESULTS: Complete success, with complete clearing of thrombotic material without an adjunctive procedure, was achieved in 75% (30 of 40) of the patients. Mean thrombectomy time in these patients was 75 seconds. Partial success, with incomplete clearing of the thrombus, requiring additional procedures such as local thrombolysis, angioplasty, or atherectomy, was achieved in 20% (eight of 40) of the patients. The Doppler index increased significantly (P < .001) from .45 before intervention to .96 after intervention. There were two failures (5%). No major complications occurred. CONCLUSION: Mechanical thrombectomy with use of the Amplatz device is a promising approach for quick recanalization of acute peripheral thromboembolic occlusions. Further studies are needed to prove the long-term patency after mechanical thrombectomy with use of this device.

Acute Disease↗