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Biomedical subjects

W Hruby

Publications and source records attributed to W Hruby.

71 records · Page 4Linked to original sources
PubMed1984

[Staging of adenocarcinoma of the kidney--CT largely replaces catheter angiography].

In renal adenocarcinoma (hypernephroma) CT as a rule provides the same information as angiography. Our experience is based on a collection of 61 tumour cases, divided in stages according to the TNM system. In retrospect, 39 of our own cases were investigated by CT as well as by angiography; the accuracy of both methods was tested on 33 operative findings. Prospectively 22 cases were examined by CT only and results controlled via 20 operative findings. CT is superior in the T and N stages. Usually demonstration of vein invasion is as good in CT as in catheter angiography. Metastases in the adrenals and the liver are vasible in CT. Seen from the point of view of a "non-touch procedure" (particularly to be demanded with a tumour metastasising as early as this!) the non-invasive method of CT proves especially suitable. We use CT primarily in all cases of suspicion. In singular cases CT is supplemented by further angiographic investigations, e.g. cavography. Exceptions to the topical proceedings mentioned above are a suspected tumour in a solitary kidney, and bilateral tumours. Such cases should be investigated by catheter angiography following i.v. urography and/or sonography.

Adenocarcinoma↗
PubMed1983

[Comparative study on the effect of the dopamine receptor blockers metoclopramide and domperidone on stomach emptying and the visualization of the small intestine in monocontrast].

The effects of a new dopamine receptor blocking agent, domperidone are compared pharmacoradiographically with the well-know action of metoclopramide. The investigated parameters were pyloric muscle function, passage time through the small intestine and, in correction with this, an evaluation of barium filling of the small intestine. Our investigations show that domperidone at dosages of 0.1 mg/kg and 0.2 mg/kg body weight does not accelerate intestinal junction as markedly as 0.3 mg/kg metoclopramide. Nevertheless, domperidone is as well suited as metoclopramide for pharmacoradiography of gastric emptying and for radiological examination of the small intestine. Hence, it can be concluded that the stimulation of the pyloric muscle as the leading pace maker of propulsion is achieved satisfactorily. Contrary to the findings with metoclopramide, domperidone shows no central nervous side effects. It appears that domperidone, at therapeutic dosages, does not pass the blood-brain barrier. Hence, this pharmaceutical preparation should prove of particular value in paediatrics.

Adult↗
PubMed1983

[Increasing importance of biliary cysts (choleceles)].

Biliary cysts are connected with the biliary tract and primarily contain bile. Mostly this connection persists, which differentiates these cysts from all the others in this region. Therefore biliary cysts lead to a number of clinically serious complications such as calculi and abscess formation, cholangitis, cholestatic cirrhosis (possibly leading to portal hypertension or hepatoma), continuous enlargement of the cyst resulting in perforation into the abdominal cavity (and biliary peritonitis). The biliary cysts occur as a congenital-hereditary disease or develop because of an occlusion of hepatic artery branches. The congenital disease ist extremely rare. The secondary choleceles are caused by thrombo-embolic disorders (infarcts, periarteritis nodosa) or iatrogenically (ligations of vessels after traumatic liver rupture, embolization). Over the past years the secondary choleceles have gained in importance. Each case of cholecele should be diagnosed as early as possible. Though sonography and CT display cystic lesions excellently, differential diagnosis, however, remains difficult. The diagnosis is requested from the radiologist because therapeutic consequences are considerable.

Adult↗
PubMed1983

[The renal pelvic tumor in the sonogram].

A prospective study evaluates screening investigations of the kidneys of 2350 patients. Sonographic criteria of the renal pelvic tumour are established. So-called "indirect signs" are only recognized by the compound scanner. By these ultrasonic symptoms a pelvic tumor could be detected with 15 patients which is a frequency of 6,5%. Part of the patients were preselected. The possibility of false-negative findings remains unconsidered. The study proves the great relevancy of ultrasonography in this disease. When operations of renal pelvic carcinomas were retrospectively checked our diagnostic results were underlined.

Humans↗
PubMed1983

[Observation of the radiologic course in long-term artificial respiration].

In a retrospective study, 108 patients were followed up who had to undergo artificial respiration treatment because of respiratory insufficiency. X-ray diagnosis showed a shock lung in all the patients. X-ray morphology correlates with the pathologicoanatomical substrate which develops progressively in phases. 24 patients (22%) could be saved, which is a remarkable success in view of the usually fatal prognosis. It was encouraging to find that follow-up examinations of the surviving patients did not reveal any detectable sequels of the "shock lung"; likewise, no unfavourable effects of the respiratory therapy were noticed.

Adult↗
PubMed1982

[Ultrasound diagnosis in Caroli syndrome--the method of choice].

Ultrasonic exploration of the upper abdomen renders diagnosis of Caroli's syndrome easier, whereas the recognition of this condition has been very difficult so far. Secondary diseases complicated the course and resulted in unsuccessful surgery, since the underlying cause was not detected. It would be desirable to diagnose this congenital disease during adolescence by ultrasonic screening. Once the correct diagnosis has been made, it seems possible to considerably improve the otherwise fatal prognosis by means of an adequate drug therapy.

Adolescent↗
PubMed1982

[Liver hemangioma--an angiographic contribution to the differential diagnosis of sonographic lesions (author's transl)].

Small liver hemangiomas are displayed as echogenic as well as sonolucent patterns on ultrasonic scans. Differentiation from malignomas is difficult and responsible, hepatomas and solitary metastases being possible. By partial liver resection the malignant diseases can be treated successfully. Therefore an accurate diagnosis is to be aimed at. Of all the methods only angiography can ensure a certain amount of clarity. This is possible under the following circumstances: The cavernomas must be of a certain size. They must not withdraw from evidence due to large avascular areas which can result from thrombosis, fibrosis or necrosis. Moreover a superselective filling of the hepatic artery is claimed but not always possible. If the portal vein is opacified it conceals the radiologically typical image of the cavernoma. Under these circumstances only few moments of the late arterial and the hepatovenous phases remain to detect the hemangioma in the seriogram.

Adult↗
PubMed1982

[The post-traumatic biliary cyst (author's transl)].

The case report communicated here illustrates a late complication subsequent to an emergency operation for liver rupture. This complication may result from ligating a branch of the hepatic artery to stop bleeding. If the necessary second operation is omitted for any reason, the hepatic sequester can develop into an abscess or biliary cyst. It is to be expected that these late complications will occur more frequently in future owing to a probable increase in the incidence of the so-called blunt abdominal traumas. The reason for this is, on the one hand, the growing number of traffic accidents and, on the other hand, the increasing use of safety seat belts which tend to promote the occurrence of ruptures of the liver as part of the blunt abdominal traumas. However, we must emphasize that it is the use of safety seat belts only which ensures the traffic victims' chance of survival.

Abdominal Injuries↗
PubMed1981

[Functional assessment of the hepatic arterial blood flow by pharmacoradiography (author's transl)].

By means of celiacography it was possible to demonstrate that parenteral medication with parathormone creates a selective dilatation of the liver vessels in man, provided that they are dilatable. This hemodynamic hormone effect could not be traced in the other mesenteric vessels. The increase of portal hypertension resulting from cirrhosis leads to a loss of the dilating ability of liver vessels. This regressive reaction is well demonstrated on the parathormon-celiaco-gram. Thus a functional assessment of the hepatic blood flow is possible. The extent of the dilatability of the liver artery seems to be of great importance for the prognosis and indication of the porto-systemic shunt-operation. Moreover we could show that an increase in the liver perfusion demonstrates pathologic liver processes in a better way.

Celiac Artery↗
PubMed1980

[Miction cystourethrography effected on-target by X-ray examinations and executed under physiological conditions (author's transl)].

A conventional method in pediatric urology is recalled, regarding the investigation of obstructive mictiurition difficulties in males. The value of the voiding cystourethrogram, performed by means of fluoroscopy in standing position following excretory urography, is evaluated in fifty patients with the conventional method (retrograde cystourethrogram). According to the gratifying results and to the improved radiological technique, this method can now be suggested as a screening examination.

Humans↗
PubMed1979

[Responsibility of the radiologist in gastric studies].

The radiologist's responsibility for the investigation of the stomach. The most successful results in the gastro-intestinal examination is obtained by combination of ray-examination (double contrast method) with gastroendoscopy and biopsy. It is of main importance, that the X-ray examination is performed at the beginning of all diagnostic step. The radiologist is obliged to use the best examination method. Therefore an economic standardized process of diagnosis is recommended which can take place also at the radiologist's consulting room. The high accuracy which can be reached by the recommended proceeding justifies the little additional expenditure of time and material.

Biopsy↗
PubMed1979

[Problems concerning diagnosis and therapy of poorly vascularized malignant kidney tumors (author's transl)].

Clear directives for the indication of diagnostic and therapeutic procedures have as yet not been formulated. We postulate a solution using poorly vascularized and avascular tumors of the kidney verified by x-ray studies and surgical exploration. An attempt was made to achieve an exact diagnosis of poorly vascularized space occupying processes of the kidney (the available figures range from 3--10% among kidney tumors) using optimal economical standardized test methods. We suggest that the time between the first diagnosis and the surgical exploration be kept as short as medically responsible.

Aged↗
PubMedDate not supplied

Filmless digital radiology--feasibility and 20 month experience in clinical routine.

We present the clinical experiences of PACS based on 20 months routine operation of the first filmless radiology department worldwide. PACS planning and implementation strategies for potential vendors are discussed. The actual implementation status of this major teaching hospital with currently 560 acute-care beds comprises three computed radiography systems, five digital fluoroscopic units, eight ultrasound machines, five mobile units, three angio suites and two CT's interconnected with a PACS, a RIS, which is coupled with three voice-recognition systems for report generation during nights, and a HIS. Primary diagnosis is performed on 16 workstations with two to six high-resolution, high-contrast monitors. Twenty-six peripheral viewing stations provide image display on the wards and in outpatient clinics. During the first 20 months 586.047 images have been acquired, resulting in 1.3 Tbyte of data stored on optical disks. Currently the daily data production is 5-6 Gbyte, the network traffic 15-18 Gbyte. Benefits of PACS primarily are reliable access to image information, speeding up report cycle time, which contributes to the reduction of the average patient length of stay (LOS). The LOS in our hospital is the shortest (6.4 days) of all Austrian hospitals. So it may be stated that PACS improves the quality of health care.

Artificial Intelligence↗