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  • 1
    ISSN: 1432-1084
    Keywords: Key words: Reject analysis ; Digital radiography ; Quality control
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was comparative analysis of rejected radiographs in conventional and digital radiology under the aspects number of rejected images and reasons for rejection. During 2 months waste films of conventional radiography were collected; in digital radiography each image-delete command at the postprocessing workstation was documented. Rejected images were analysed and assigned to four categories. The overall reject rate was 27.6 % in the conventional and 2.3 % in the digital department. Whereas in the conventional department the main reason for rejection was “exposure” and “others” (i. e. problems related to film handling), the main reason in the digital environment was “positioning”. The high exposure tolerance of digital systems markedly reduces the amount of faulty images. This is not only economically rewarding, but may also reduce unnecessary X-ray exposure of patients due to image retake.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 17 (1993), S. 553-562 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Parmi 7057 cholécystectomies traditionnelles réalisées entre 1972 et 1991, on a enregistré 16 lésions de la voie biliaire principale, ce qui représente un risque de 0.22%. Depuis le mois d'avril 1990, on a réalisé 1022 cholécystectomies sous coelioscopie, sans observer un seul de ces accidents. Nous avons analysé rétrospectivement les dossiers de 64 patients ayant une lésion ou une sténose secondaire à une cholécystectomie traditionnelle. Chez 14 de ces 16 observations personnelles, la lésion a été reconnue pendant l'intervention et a été réparée immédiatement avec un résultat à long terme satisfaisant chez 93% de ces patients; un de ces patients a dû être opéré deux fois. Chez deux patients ayant une lésion non reconnue pendant l'intervention, le traitement a été conservateur. Parmi les 48 patients vus en seconde main, il y avait 10 patients ayant une lésion récente, apparue dans les suites immédiates d'une intervention (21%) et 38 sténoses apparues dans les suites d'une cholécystectomie “non compliquée”. Seulement 10 patients (16%) ont été traités de facon conservatrice alors que 54 patients ont nécessité une réparation chirurgicale. Le suivi moyen a été de 7.4 ±4.9 ans. La plupart des cas (93%) ont été réparés par une anastomose bilio-intestinale, le plus souvent des anastomoses hépatico-jéjunales, avec un taux de resténose de 18%. En incluant les réparations secondaires et tertiaires, un total de 60 interventions (14 reconstructions primitives et 46 reconstructions secondaires) ont été pratiquées, sans aucune mortalité. Les résultats à long terme après réparation biliaire étaient considérés comme des succès chez 75% des patients, alors que 17% des patients ont eu des suites compliquées de resténose ou mort (10% de mortalité en 10 ans). Ainsi, la réparation immédiate des lésions de la voie biliaire offre un bien meilleur pronostic que les réparations secondaires.
    Abstract: Resumen Se presentaron 16 lesiones de la vía biliar en 7.057 colecistectomías (1972–1991), lo cual significa un riesgo de 0.22%. Desde Abril de 1990 se han practicado 1.022 colecistectomías laparoscópicas sin que se haya prsentado tal complicación. En un estudio retrospectivo se estudiaron 64 pacientes con lesión o estenosis debido a colecistectomía convencional. En 14 de 16 la lesión fue reconocida y reparada inmediatamente con un buen resultado a largo plazo en 93%, incluyendo una exitosa reparación de una estrechez subsiguiente. Dos casos propios de lesión no reconocida fueron manejados por medios no operatorios. El grupo de 48 pacientes referidos estuvo conformado por 10 casos de complicaciones postoperatorias tempranas (21%) y 38 estrecheces luego de colecistectomía hecha “sin complicaciones”. Diez pacientes (16%) fueron tratados por medios no operatorios y 54 requirieron cirugía. El promedio de seguimiento después de la cirugía fue de 7.4 ±4.9 años. La mayoría de los casos (93%) fueron reparados mediante anastomosis bilioentérica, principalmente hepaticoyeyunostomía con una tasa de reestenosis de 18%. Incluyendo segundas y terceras reparaciones por estenosis, se realizaron 60 operaciones (14 reconstrucciones primarias y 46 secundarias) sin mortalidad hospitalaria. Se logró un buen resultado a largo plazo en 75% de los pacientes con reparaciones por estenosis y 17 pacientes exhibieron mal resultado, a juzgar por reestenosis o por muerte (10% mortalidad en 10 años). Por lo tanto, aparece obvio que la reparación inmediata de una lesión de la vía biliar ofrece la mejor oportunidad de un pronóstico favorable en comparación con la reparación secundaria de una estrechez.
    Notes: Abstract During 7057 conventional cholecystectomies (1972–1991), 16 bile duct injuries occurred, amounting to a risk of 0.22%. A total of 1022 laparoscopic cholecystectomies were performed without such a complication since April 1990. In a retrospective study, 64 patients (16 of our patients and 48 referrals) with an injury or stricture due to conventional cholecystectomy were investigated. In 14 of our 16 patients the injury was recognized and immediately repaired with a good long-term result of 93%, including one successful repair of a subsequent stricture. Two cases of unrecognized injury were managed by nonoperative means. The group of 48 referred patients comprised 10 early postoperative complications (21%) and 38 strictures after an “uneventful” cholecystectomy. Of the 64 total patients, 10 (16%) underwent nonoperative treatment, and 54 required surgery. The mean follow-up period after surgery was 7.4 ±4.9 years. Most cases (93%) were repaired by bilioenteric anastomosis (i.e., foremost hepaticojejunostomy) with an 18% restricture rate. Including second and third repairs for restricture, a total of 60 operations (14 primary and 46 secondary reconstructions) were performed without hospital mortality. A good long-term result after stricture repair was achieved in 75% of the patients, whereas 17% had a poor outcome owing to restricture or death (10% had related mortality within 10 years). The other 8% had a moderate result due to recurrent cholangitis. Thus immediate repair of a bile duct injury offers the better chance of a favorable prognosis compared to secondary stricture repair.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 12 (1988), S. 788-797 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé La technique d'angioplastie transluminale percutanée (ATP) a été développée par les radiologues et elle est employée le plus souvent par les radiologucs interventionnistes, souvent sans formation angéiologique très solide. Celle-ci est pourtant indispensable pour la sélection des patients susceptibles de bénéficier de l'ATP et pour traiter ces complications. Pour cette raison, l'ATP est faite à la Clinique Chirurgicale de Mannheim avec une étroite collaboration entre chirurgiens et radiologues. On a traité ainsi 196 sténoses artérielles iliaques, 397 sténoses ou occlusions fémoropoplitées, et 65 sténoses de l'artère rénale avec un taux de succès respectifs de 100%, 84%, et 96%. Dans 79 cas, l'ATP a été employée peropératoirement comme complément à la chirurgie reconstructive sur les vaisseaux homo ou controlatéraux. Puisque l'ATP comporte un risque certain de complications (2 à 6%) qui peuvent mettre en danger une extrémité ou un viscère, les indications sont limitées aux seuls patients symptomatiques qui, autrement, auraient subi un geste chirurgical. L'indication de l'ATP chez le patient ayant une sténose asymptomatique ne saurait être recommandée.
    Abstract: Resumen La técnica de angioplastia transluminal percutánea (ATP) fue desarrollada por radiólogos, y son los radiólogos intervencionistas quienes con mayor frecuencia realizan estos procedimientos, generalmente con escasos conocimientos en angiología. Sin embargo, los conocimientos en angiología parecen ser indispensables en cuanto a la selección de pacientes para ATP y en cuanto al manejo de las complicaciones. Por tal razón, en los últimos 10 años la ATP ha sido realizada en la Clínica Quirúrgica de Mannheim en íntima cooperación entre cirujanos y radiólogos; 196 estenosis ilíacas, 397 estenosis y oclusiones femoropoplíteas, y 65 estenosis de las arterias renales en 60 pacientes han sido tratadas con tasas inciciales de éxito de 100%, 84%, y 96%, respectivamente. En 79 casos la ATP fue utilizada intraoperatoriamente como complemento de la cirugía reconstructiva en vasos ipsilaterales o contralaterales. Puesto que la ATP no está libre de complicaciones (2–6%), las cuales pueden poner en peligro a la extremidad u órgano respectivo, las indicaciones para su uso se limitan a pacientes que se encuentran sintomáticos, quienes de lo contrario requerirían cirugía. No se recomienda realizar ATP en casos de estenosis asintomáticas.
    Notes: Abstract The technique of percutaneous transluminal angioplasty (PTA) was developed by radiologists and it is the interventional radiologist who mostly performs these procedures—often with little angiological background. But the latter seems indispensable when it comes to selecting patients for PTA and dealing with its complications. For this reason, PTA has been performed at the Mannheim Surgical Clinic for the past 10 years in close cooperation between surgeons and radiologists; 196 iliac arterial stenoses, 397 femoropopliteal stenoses and occlusions, and 65 renal artery stenoses have been treated with an initial success rate of 100%, 84%, and 96%, respectively. In 79 cases, PTA was used intraoperatively as a complement to reconstructive surgery on ipsilateral or contralateral vessels. Since PTA is not free of complications (2–6%), which may jeopardize limb or organ, indications for its use are restricted to patients who are symptomatic and, therefore, would otherwise require surgery. PTA of asymptomatic stenoses is not recommended.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1084
    Keywords: Key words: Colon – CT – Three-dimensional CT – Virtual endoscopy – Image processing – Radiation exposure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of our study was to evaluate the interdependency of spatial resolution, image reconstruction artifacts, and radiation doses in virtual CT colonoscopy by comparing various CT scanning protocols. A pig's colon with several artificial polypoid lesions was imaged after air insufflation with helical CT scanning using 1-, 3-, and 5-mm collimation, and pitch values varying from 1.0 to 3.0. Virtual endoscopic images and “fly through” sequences were calculated on a Sun Sparc 20 workstation (Navigator Software, GE Medical Systems, Milwaukee, Wis.). Several reconstruction artifacts as well as overall image quality were evaluated by three independent reviewers. In addition, radiation doses for the different CT protocols were measured as multiple-scan average dose using a 10-cm ion chamber and a standard Plexiglass body phantom. Generally, image quality and reconstruction artifacts were less affected by pitch values than by beam collimation. Thus, narrow beam collimation at higher pitch values (e. g. 3 mm/2.0) seems to be a reasonable compromise between quality of virtual endoscopic images and radiation dose load.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Archives of gynecology and obstetrics 232 (1981), S. 750-750 
    ISSN: 1432-0711
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-0711
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric radiology 9 (1980), S. 19-26 
    ISSN: 1432-1998
    Keywords: Nephrocalcinosis ; Radiographs ; Computed tomography ; Sonography ; Histology ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 12 patients with nephrocalcinosis, radiographs were compared with computed tomography, sonography and histology. Computed tomography detects nephrocalcinosis at a very early stage of the disease, gives a better picture of the density and exten of nephrocalcinosis and may detect other findings (e. g. cysts). Radiographs may show many more details than computed tomography; they seem to be more suitable for observing the course of the disease and have a lower radiation dose. Sonography has not been helpful in the diagnosis of nephrocalcinosis. Histology correlates only moderately with the degree of nephrocalcinosis demonstrated in radiographs and computed tomography.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 3 (1989), S. 119-120 
    ISSN: 1432-2218
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 36 (1994), S. 152-154 
    ISSN: 1432-1920
    Keywords: GM-2 gangliodoses-Sandhoff's disease ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two children with GM-2 gangliosidosis type 0 (Sandhoff's disease) followed up by MRI at 1.5 Tesla for 1.8 years are reported. One was presymptomatic at the first MRI examination. As her neurological status deteriorated, MRI showed low signal in bilaterally, on T2-weighted images the white matter with involvement of the optic radiations. In the second, MRI correlated well with the clinical progression of the disease, showing in the different stages involvement of thalamus and basal ganglia. There was no contrast enhancement and the grey matter remained normal.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 366 (1985), S. 624-624 
    ISSN: 1435-2451
    Keywords: Carcinoid ; Carcinoma ; Appendix ; Hemicolectomia dextra ; Carcinoid ; Carcinom ; Appendix ; Hemicolektomia dextra
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Das Krankheitsbild des seltenen Carcinoid (0,2%) und Carcinom der Appendix (etwa 200 Fälle in der Weltliteratur) wird dargestellt und durch eigene Beobachtungen ergänzt. Jede entfernte Appendix soll histologisch untersucht werden, da Carcinoid und Carcinom makroskopisch nicht sicher erkannt werden. Für das therapeutische Vorgehen können nur vorläufige Empfehlungen gegeben werden. Gültige Regeln insbesondere für die Behandlung des Appendixcarcinoms werden von Fallstudien mit Langzeitergebnissen erwartet, zu denen hier aufgerufen wird.
    Notes: Summary The rare carcinoid (0.2%) and carcinoma of the appendix (approximately 200 cases in the literature) are described and our own observations given. Every appendix removed should be examined histologically, as the carcinoid and carcinoma are not detectable macroscopically. Only preliminary recommendations can be made regarding therapy. Valid guidelines, especially for the therapy of appendix carcinoma, are expected from well-documented studies with long-term results. These case studies are recommended.
    Type of Medium: Electronic Resource
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