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Biomedical subjects

W D Strohm

Publications and source records attributed to W D Strohm.

At least 37 records · Page 2Linked to original sources
PubMed1984

Radiological and ultrasonographic investigations with respect to patient selection and monitoring for chemical gallstone dissolution.

786 consecutive patients with suspected gallstones investigated radiologically and ultrasonographically, 231 (33.0%) were found to have stones. Radiological examinations showed that 59.3% of these were suitable for chemical dissolution with cheno- or ursodeoxycholic acid. The percentage of treatable patients fell from age 20 to age 65 from 71% to 48% (p less than 0.05) and then rose again to 61% (not significant). The benefit of litholysis is greater, the earlier it is begun. The results are in disagreement with those of two studies in operated patients. Here only 19-24% were suitable for stone dissolution. Comparative ultrasonographic and radiological studies in 23 patients have shown that monitoring of patients during litholysis can be carried out ultrasonographically. Stone size measured ultrasonographically corresponds sufficiently accurately with that obtained radiographically.

Adult↗
PubMed1984

Detection of atrial and ventricular septum defects by transoesophageal two-dimensional echocardiography with a mechanical sectorscanner.

Two-dimensional (transthoracic) echocardiography (2DE) and two-dimensional endoscopic (transoesophageal) echocardiography ( 2DEE ) were performed in 19 consecutive patients with atrial septum defect (ASD), and in 17 controls, 3 with ventricular septum defect (VSD) and 14 with various diseases. In detection of ASD the sensitivity was 61% (11/18) and the specificity 88% (2/17) with 2DE whereas 2DEE revealed a sensitivity of 95% (18/19) and a specificity of 100% (0/17). 2DEE enabled to visualize the VSD in all 3 patients (2DE in 1/3). With 2DEE the site and size of the atrial septum defects could be estimated well as confirmed in 14 patients who underwent cardiac surgery. The lateral resolution of the 7.5 MHz transoesophageal probe was about 0.5 cm. Further studies are required to clarify if cardiac catheterization prior to surgery of an ASD may be replaced by 2DEE .

Adult↗
PubMed1984

Anatomical aspects in ultrasonic endoscopy.

The combined use of gastroscopy and sonography will yield both methods an enhancement of its diagnostic range. By this new method, ultrasonography has to face new aspects of the examination. Endosonographical examinations were performed in 26 normal patients. The technique of endoscopic ultrasound tomography ( EUT ) is complicated and different because of the orientation, the predestined nature of the GI tract, and the limited movements within the GI tract. Seven standard positions are proposed: distal duodenum, papilla Vateri, bulbus duodeni, antrum ventriculi, corpus ventriculi, fundus ventriculi, and distal oesophagus. But up to now, there has been no general examination technique for the visualization of the individual organs. Nevertheless, with EUT new sonographic windows were opened. The first experiences show that the contours of organs and vessels may be imaged with a distinction unknown up to now. The sector and magnifying effect of EUT may contribute to the knowledge of anatomical, topographical and pathological conditions and changes.

Adult↗
PubMed1984

Detection of biliary stones by means of endosonography.

For its particular qualities, endoscopic ultrasound tomography ( EUT ) appears to be a suitable method for achieving better results in diagnostics of bile duct alterations than conventional UT. In 10 patients with enlarged common bile duct. EUT was carried out with three different prototypes (mechanical sector scan, ultrasound gastrofiberscope . Olympus/ Aloka ). The encouraging results suggest that the high discriminating investigational technique of EUT may be superior to conventional UT for finding common bile duct stones, probably for the differential diagnosis of biliary drainage problems caused by tumors, too.

Adult↗
PubMed1984

Limits of conventional abdominal sonography and features of endoscopic sonography.

The reasons for the sometimes poor imaging of different organs and structures are mainly to be explained by limiting factors in conventional ultrasound tomography (UT). It is the aim of endoscopic UT ( EUT ) to omit the limiting factors and to overcome the ultrasound barriers like ribs and gas. High frequencies enable a better discrimination of details. Preliminary indications of EUT will be: tumors of the pancreas, of the spleen kidney angle, of biliary ducts, of the stomach, of the liver and the gallbladder, choledocholithiasis, adrenal disorders, and cardiac diseases.

Abdominal Neoplasms↗
PubMed1984

Pancreatic pseudocysts and tumors in endosonography.

In endoscopic ultrasound tomography (UT), the ultrasound probe positioned in the stomach has direct access to the pancreatic region. In first experiences, 62 patients were investigated by EUT . 22 of them had a pancreatic infection. EUT seems to be a new method being a valuable complement to conventional UT with a high diagnostic potential and with broad possibilities of application. The increased resolution of structural details of pathological alterations could be of diagnostic value.

Adult↗
PubMed1984

Diagnostic efficacy of endoscopic ultrasound tomography in pancreatic cancer and cholestasis.

By direct access to the target organs and by improved detail resolution, endoscopic ultrasound tomography (EUT) broadens the range of sonographic diagnostics. In this preliminary study, the accuracy of EUT was tested in 34 patients with suspected pancreatic carcinoma and/or painfree jaundice. In all 10 patients with pancreatic carcinoma and in all 6 patients with chronic pancreatitis, the diagnosis made by EUT was correct. Three patients with benign tumors of the pancreas were also diagnosed correctly. The diagnostic sensitivity of EUT in pancreatic cysts was in 4 of 5 cases 80%, in dilatations of the main pancreatic duct in 10 of 11 cases 91%, and in cholestasis in 14 of 15 cases 93%. All 5 common bile duct concrements and all 3 tumors of the papilla Vateri were diagnosed by EUT. The differential diagnosis between pancreatic tumor and pancreatitis was improved by EUT in 1 of 18 cases. In the region of the papilla Vateri, EUT was superior to conventional UT in the diagnosis of ampullary concrements and papillary tumors in 6 of 8 cases (4/5 and 2/3, respectively). EUT could become an important complementary diagnostic method for disorders of the pancreas and the common bile duct with a particular sensitivity for the region of the papilla Vateri.

Adult↗
PubMed1983

[Endoscopic-sonographic diagnosis of the stomach wall].

Endoscopic ultrasonography makes it possible to measure and examine the wall of the upper gastrointestinal tract. It complements endoscopic visualization of the surface with analysis of the wall layers. Endoscopic ultrasound imaging reveals five different layers. Preliminary results indicate that benign gastric tumours can be distinguished from infiltrating gastric carcinoma. The extent and adjoining reaction of a gastric ulcer can also be visualized. Endoscopic ultrasonography of the stomach is a method of investigation that can be further developed and already shows considerable diagnostic potential.

Adenocarcinoma↗
PubMed1983

Diameters of abdominal veins and arteries during nitrate therapy.

The effects of 1.6 mg NTG on the diameter of abdominal veins and arteries were investigated by means of ultrasound tomography in 26 and 28 healthy persons respectively. Fourteen patients served as controls in the venous studies and 28 in the arterial measurements. The diameter of the caval vein decreased in anterior-posterior direction within 5 minutes after nitroglycerin administration by about 22% from 14.2 +/- 4.0 mm to 11.1 +/- 3.3 mm (p less than 0.005). In contrast, the portal vein enlarged by about 27% from 10.3 +/- 1.8 mm to 13.1 +/- 2.3 mm, the superior mesenteric vein by about 12% from 8.2 +/- 1.6 to 9.2 +/- 1.4 mm, and the splenic vein by about 23% from 6.6 +/- 2.3 mm to 8.1 +/- 1.8 mm (p less than 0.001). The superior mesenteric artery and the proper hepatic artery dilated by about 12% from 7.8 +/- 0.9 mm to 8.7 +/- 0.9 mm and from 6.5 +/- 1.0 mm to 7.3 +/- 0.7 mm respectively (p less than 0.001). There was no significant change in the diameter of the abdominal aorta, however. The results show that NTG induces a relaxation of the abdominal veins and of the abdominal arteries of the muscular type. They suggest that the splanchnic veins participate essentially in the therapeutically important venous pooling effect of NTG. The reduced peripheral venous return is made sonographically visible by a collapse of the inferior vena cava. Furthermore, the influence on the windkessel function after administration of NTG seems to be mediated not by the aorta itself, but rather by its large muscular-type branches like the mesenteric and hepatic arteries.

Abdomen↗
PubMed1982

[Clinical features of inflammatory bowel disease (author's transl)].

Inflammatory bowel disease may be caused by virus, bacteria, fungus, parasites or mechanical conditions. Among the inflammatory bowel diseases caused by bacteria salmonellosis and cholera are most important. Their treatment has been revolutionized within the last decade. Instead of the administration of antibiotics the usage of fluids, glucose and electrolytes represents the method of choice. Using the so called "traveller's disease" as an example the pathophysiological aspects of the treatment may be best explained. Etiology and pathogenesis of Crohn's disease, the incidence of which seems to be increasing lately, are still unknown. Before onset of treatment it is essential to establish an exact diagnosis, further to determine distribution and inflammatory activity, as those control the therapy. Salazosulphapyridine and steroids have proved effective drugs. Azathioprine should only be used combined with steroids. Recent investigations suggest that certain formula diets, such as e. g. Survimed, may be useful in the management of the disease as well.

Azathioprine↗
PubMed1981

[Acute virus hepatitis and venereal infection (author's transl)].

100 patients with acute viral hepatitis were examined. In 10 of these the infection was found to be associated with homosexual activity and in 7 with promiscuity. Sexual intercourse was a likely cause of infection in 61% of all men aged from 20-40 years who had contracted hepatitis B by a non-parenteral route. Of these patients, 8 had acute syphilis and 2 had acute gonorrhea along with their hepatitis. The clinical course of the hepatitis was more severe in the group of syphilitic patients than in the controls. These observations indicate that simultaneous venereal disease influences the incidence and course of acute viral hepatitis.

Acute Disease↗
PubMed1981

[Peritoneoscopy and liver biopsy in the diagnosis of liver disease (author's transl)].

In two prospective studies including 962 patients and one retrospective study including 165 patients the problem was investigated, to what extend ultrasonography might change the diagnostic value of clinical examination, peritoneoscopy, guided liver biopsy and blind liver biopsy. It turned out, that liver biopsy is the method of choice in diffuse-parenchymatous disease (e.g. chronic active hepatitis, chronic persistent hepatitis, fatty liver), whereas laparoscopy is to be preferred if focal lesions (e.g. liver carcinoma) are present. Diffuse liver disease was present in 80% of the cases investigated; in this group of patients the diagnostic value of blind biopsy is equivalent to the diagnostic value of guided biopsy. Thus, blind biopsy does yield satisfactory results in most patients if it is possible to differentiate between diffuse and focal disease by ultrasonography. Such differentiation could be achieved in 77-98% of our cases, thus ultrasonography could intake a decrease in numbers of peritoneoscopies and an increase of blind liver biopsy.

Biopsy, Needle↗
PubMed1980

Ultrasonic tomography by means of an ultrasonic fiberendoscope.

The diagnositc value of ultrasonic tomography of the upper abdominal organs is sometimes limited by bones and gas. Endoscopic ultrasonography (EUST) combines the advantages of the direct visualization of the upper GI tube and the ultrasonic imaging of adjacent organs. The ultrasonic probe consists of a 5 MHz array that generates a good resolution at the acustical focus, the endoscope is a conventional Olympus gastroscope type GFB3. The ultrasonic transducer is firmly attached to the distal end of the endoscope. Combined examinations are performed in 18 patients with biliary, pancreatic and hepatic disorders or postoperative changes. EUST may be of value not only for gastrointestinal but also for retroperitoneal, cardiac, and mediastinal diseases.

Adult↗
PubMed1979

[Correlation between hepatic vein pressure and diameter of portal vein and spleen as determined by ultrasound tomography in patients with liver disease (author's transl)].

The diameter of the portal vein and the transversal diameter of the spleen on the ultrasound scan were significantly greater in 15 patients with chronic active hepatitis than in controls and in 43 patients with cirrhosis of the liver than in patients with chronic active hepatitis. In patients with cirrhosis of the liver there was a significant correlation between the diameter of the portal vein and both spleen size and wedged hepatic vein pressure. In many cases ultrasound tomography is a reliable method for detecting portal hypertension.

Adolescent↗