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Biomedical subjects

W Steinbrich

Publications and source records attributed to W Steinbrich.

At least 127 records · Page 7Linked to original sources

[Ovarian tumors in the computer tomographic image--the correlation of histology and CT diagnosis].

The value of CT in respect of preoperative determination of tumour status and of tumour classification was studied using 127 histologically identified ovarial tumours as basis in a blind study via mutual image classification by the two participating institutes. The medium accuracy of diagnosis was 82%, but the results were found to be greatly dependent on tumour histology. Quotas of more than 90% were obtained in case of functional cysts, cystomas , cystadeno -carcinomas and dermoids, whereas classification was less successful with the other types of tumours such as germ cell tumours, tumours of the sexually differentiated stroma, metastases and tubo- ovarial abscesses.

Cystadenoma↗

[Radiologic diagnosis of intra-abdominal abscesses by stepwise use of imaging procedures].

Plain radiographs of the abdomen in supine and left decubitus position were combined with additional contrast medium examinations, ultrasonography and computed tomography and used for diagnosis in 47 patients with surgically verified abdominal abscesses. Typical abscess signs were analysed to establish the stepwise use of imaging procedures. Diagnosis of an intraperitoneal or retroperitoneal abscess can be made in over 50% of the cases by accurate interpretation of abdominal plain films. If combined with ultrasonography, diagnosis is possible in even almost 90% of the cases. Computed tomography may additionaly show the exact localisation and extension of the lesion and is mainly used in planning further surgical treatment.

Abscess↗

Problems of dissolution after long-term placement of a Celestin oesophageal tube.

The reported cases of Latex material dissolution after longterm placement of Celestin oesophageal tubes, and the ensuing complications are discussed. Also discussed is a case of ours with adenocarcinoma of the distal oesophagus in which dissolution of the Celestin tube was found 8 months after placement. What is needed is a stable substance to replace Latex. So far, no problems have been reported with the Latex-Silicone Haering tube.

Adenocarcinoma↗

[Preoperative classification of ovarian tumors by computed tomography].

127 histologically demonstrated ovarial tumors were studied in a blindfold test in order to find out to what extent a preoperative determination of dignity or diagnosis of the tumor kind is possible by computed tomography. The overall rate of correct determinations of dignity is 82%. In case of functional cysts and cystomas with thin cyst walls, cystadenocarcinomas and dermoid cysts, this rate is about 95%, whereas the classification results are less exact in case of cystic tumors with broadened cyst walls, preponderantly solid tumors and tumor-like lesions.

Abscess↗

[Sézary syndrome (author's transl)].

Morphological demonstration of the typical Sézary cell in peripheral blood confirmed the diagnosis of Sézary syndrome in a 64-year-old patient with generalized erythrodermia and typical histopathological skin changes. Enzymes and immunocytological membrane characteristics of Sézary cells changed in the course of the disease after cytostatic therapy. Polychemotherapy clinically led to transitory complete regression of skin changes. Reviewing the few published investigations it is found that the morphologically sufficiently defined Sézary cells are apparently not uniform cytochemically and immunocytologically in different patients.

Autopsy↗

[CT examination of the organs of the minor pelvis (author's transl)].

Since the organs of the minor pelvis are not characterized by any significant differences in density, it is not possible to differentiate between neighbouring structures. This underlines the special importance of fatty deposits and fatty tissue margins with their clearly lower density, as structures outlining the pelvic organs. However, there are individual and constitutional differences in the manner of development of these fatty outlines, so that the ability to distinguish between the various pelvic structures may be different from patient to patient. Structural analysis is facilitated by marking the hollow organs with contrast medium, and generous use should be made of this possibility. With modern computer tomographs, minor details can be detected which may be as fine as the smaller vessels, provided these vessels are embedded in the fatty layers, However, it is very difficult to differentiate them from the nerves, lymphatics tissue and connective tissue septums; this requires an accurate knowledge of anatomy.

Female↗

[Computer tomography in the diagnosis of local recurrences after resection for carcinoma of the rectum (author's transl)].

Presacral or pelvic floor tumour recurrence after abdomino-perineal resection for rectal or anal carcinomas has not been amenable to early radiological diagnosis. Computer tomography is a procedure which can demonstrate recurrences of two to three cm. Within the pelvis with certainty. The reliability of the method has been demonstrated in 27 patients suspected of having recurrences. The effect of demonstrating or excluding a recurrence on subsequent treatment is discussed. The value of computer tomographic examination of the pelvis for demonstrating the position and extent of a recurrence, the displacement of neighbouring organs, destruction of the pelvis and involvement of iliac lymph nodes is shown.

Adult↗

Hydro-MRI for the visualization of gastric wall motility using RARE magnetic resonance imaging sequences.

BACKGROUND: Although different imaging techniques such as conventional X-ray, ultrasonography, and hydro-computed tomography are available for the imaging of the stomach, none can depict this organ in full size without radiation. Therefore, the study of the entire gastric wall motility of the stomach is difficult and in principle only performable with rapid magnetic resonance imaging (MRI) techniques. T1-weighted imaging sequences have been used for the dynamic study of gastric wall motility. This technique was combined with the oral intake of para- or superparamagnetic contrast agents to achieve sufficient intraluminal contrast. The technique described in the present study is based on a different contrast mechanism. METHODS: The stomach was filled with 500 mL of 10% of aqueous dextrose solution, and a strongly T2-weighted fast rapid acquisition with relaxation enhancement (RARE) type imaging sequence was used for data acquisition. No other contrast agents were applied. An ultrafast RARE imaging sequence with an asymmetric phase-encoding scheme was developed to achieve a high temporal and spatial resolution. The scanning time per image was approximately 1 s. RESULTS: The stomach was imaged in full size. The concentric constrictor rings moved from the proximal part of the body toward the antrum. The mean duration for one contraction cycle was approximately 17.9 +/- 2.5 s, the mean contractile frequency was 3.4 +/- 0.5 s, and the mean spreading velocity was 65.5 +/- 3.6 cm/min. CONCLUSIONS: The purpose of this study was to demonstrate a new technical approach for a noninvasive dynamic study of gastric motor function with hydro-MRI. This robust method may have clinical application, e.g., in the diagnosis of gastroparesis, and may be extended to the rest of the gastrointestinal tract.

Administration, Oral↗

Coronal acetabular fractures: the anterior approach in computed tomography-navigated minimally invasive percutaneous fixation.

PURPOSE: To demonstrate the technical feasibility of the anterior approach to the coronal roof component of carefully selected acetabular fractures in computed tomography (CT)-navigated closed reduction and percutaneous fixation (CRPF). METHODS: Four patients with nondisplaced or slightly displaced coronal fractures of the acetabular roof were treated with percutaneous screw fixation. Screws were implanted over guidepins placed under CT navigation. Mean clinical and radiological follow-up was 16 months. RESULTS: All screws could be placed as intended. There were no peri- or postoperative complications. Radiological follow-up showed primary osseous union. Clinical results were excellent according to a median Merle-d'Aubigné score of 18. CONCLUSION: Nondisplaced or slightly displaced coronally oriented fractures of the acetabular roof can be treated by minimally invasive percutaneous CT-navigated fixation through an anterior approach that does not endanger the sciatic nerve. Early clinical results are encouraging. Close cooperation between trauma surgeons and radiologists and careful selection of cases is mandatory.

Acetabulum↗

Posterior pelvic ring fractures: closed reduction and percutaneous CT-guided sacroiliac screw fixation.

PURPOSE: To assess the midterm results of closed reduction and percutaneous fixation (CRPF) with computed tomography (CT)-guided sacroiliac screw fixation in longitudinal posterior pelvic ring fractures. To document radiographic and CT follow-up patterns. METHODS: Thirteen patients with 15 fractures were treated. Eleven patients received a unilateral, two a bilateral, screw fixation. Twenty-seven screws were implanted. Continuous on-table traction was used in six cases. Mean radiological follow-up was 13 months. RESULTS: Twenty-five (93%) screws were placed correctly. There was no impingement of screws on neurovascular structures. Union occurred in 12 (80%), delayed union in 2 (13%), and nonunion in 1 of 15 (7%) fractures. There was one screw breakage and two axial dislocations. CONCLUSION: Sacroiliac CRPF of longitudinal fractures of the posterior pelvic ring is technically simple, minimally invasive, well localized, and stable. It should be done by an interventional/surgical team. CT is an excellent guiding modality. Closed reduction may be a problem and succeeds best when performed as early as possible.

Adolescent↗

Massive pulmonary embolism: treatment with thrombus fragmentation and local fibrinolysis with recombinant human-tissue plasminogen activator.

PURPOSE: To report the results of thrombus fragmentation in combination with local fibrinolysis using recombinant human-tissue plasminogen activator (rtPA) in patients with massive pulmonary embolism. METHODS: Five patients with massive pulmonary embolism were treated with thrombus fragmentation followed by intrapulmonary injection of rtPA. Clot fragmentation was performed with a guidewire, angiographic catheter, and balloon catheter. Three patients had undergone recent surgery; one of them received a reduced dosage of rtPA. RESULTS: All patients survived and showed clinical improvement with a resultant significant (p < 0.05) decrease in the pulmonary blood pressure (mean systolic pulmonary blood pressure before treatment, 49 mmHg; 4 hr after treatment, 28 mmHg). Angiographic follow-up in three patients revealed a decrease in thrombus material and an increase in pulmonary perfusion. Two patients developed retroperitoneal hematomas requiring transfusion. CONCLUSION: Clot fragmentation and local fibrinolysis with rtPA was an effective therapy for massive pulmonary embolism. Bleeding at the puncture site was a frequent complication.

Angiography, Digital Subtraction↗