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  • 1
    Electronic Resource
    Electronic Resource
    Management of Hyperparathyroidism in an Endemic Goiter Area (1998)
    Springer
    World journal of surgery 22 (1998), S. 301-308 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. In an endemic goiter area patients with hyperparathyroidism (HPTH) frequently also have thyroid abnormalities. In a retrospective study of 95 patients with HPTH we assessed the diagnostic accuracy of imaging techniques (ultrasonography or radionuclide scanning) for preoperative localization of parathyroid adenomas. Altogether 86% of our patients had goiter, requiring thyroid resections in 37%. For 19 patients the parathyroid exploration was the second or third cervical operation, most of them due to goiter. We found that the overall rate of transient and permanent recurrent nerve paralysis is considerably increased in patients with previous neck surgery (26% vs. 7%). The combination of ultrasonography and radionuclide scanning can lead surgeons to the site of parathyroid lesions responsible for HPTH in 85% of cases, although frequent nodular goiters can produce pitfalls for correct imaging in iodine-deficient countries. In endemic goiter areas preoperative localization studies can be recommended in patients with primary HPTH—for evaluation of thyroid pathology possibly leading to resection or its accuracy in localizing parathyroid adenomas. These studies also seem justified in patients with previously unsuccessful neck explorations for HPTH.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002689900386
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Pankreaskarzinom (1999)
    Springer
    Der Onkologe 5 (1999), S. 208-214 
    Details
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Beim Pankreaskarzinom und beim periampullären Karzinom ist die einzige, wenn auch geringe Heilungschance derzeit nur durch die Radikaloperation gegeben. Es konnte aber gezeigt werden, daß dieser Eingriff gegenüber früheren Erfahrungen mit durchaus vertretbar niedrigen Letalitätsraten (〈5%) durchgeführt werden kann und daß damit unter gewissen Voraussetzungen für die Patienten eine deutliche Verbesserung der Überlebensaussichten (mediane 5-Jahresüberlebensrate über 20%) zu erreichen ist [21]. Auch wenn geeignete Verfahren zur diagnostischen Früherkennung der Erkrankung nach wie vor fehlen, besteht somit kein Grund zu chirurgisch-therapeutischem Nihilismus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007610050344
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Virtual computed tomography colonoscopy: artifacts, image quality and radiation dose load in a cadaver study (2000)
    Springer
    European radiology 10 (2000), S. 183-187 
    Details
    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
    URL: http://dx.doi.org/10.1007/s003300050030
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Histamine release in the course of elective conventional cholecystectomy in aged patients: Problems in defining release in relation to specific intraoperative events (1992)
    Springer
    Inflammation research 36 (1992), S. C155 
    Details
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effectiveness of an H1 −+H2-prophylaxis against perioperative acute pseudoallergic reactions in which histamine is involved, and against postoperative complications the incidence of which may be increased by these reactions, was the central problem of a randomized trial in 162 aged patients during elective conventional cholecystectomy. As main endpoint it was planned to use the systemic histamine release reaction, as it already had been defined for the conscious and anaesthetized human subject. However, it had to be reassessed and redefined for the intraoperative period after improvement of the plasma histamine assay and new findings about stress-induced histamine release and the kinetics of histamine release during certain phases of operation. Intraoperative release is, at present, defined solely as an increase of plasma histamine values after a particular action (phase of operation). It includes criteria concerning plasma histamine changes either in comparison to the base value before surgery or to the preceding value before the last surgical action. Histamine elevations must exceed the last value by more than 3 standard deviations of the analytical error (i.e. 200% if value 〈0.25 ng/ml and 40% above). Basic requirements for the histamine assay (quality control), correct sample taking and appropriate preparation have to be fulfilled over the whole trial period. When these criteria were applied to the 162 patients an overall incidence of histamine release during cholecystectomy of 55.6% was found with 9.7–20% during an individual phase of operation. The data of this study, performed under routine conditions, with a sufficient number of patients with elevated risk and event controlled plasma histamine values, lead to a better understanding of intraoperative histamine release, its incidence and extent.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01997322
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    Paper (German National Licenses)
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