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Feuerlein S, Stolz J, Muche R, Hetzel M, Klass O, Brambs HJ, Pauls S. Cisterna chyli in patients with malignancy--influence of cardiovascular disease on the prevalence of the cisterna. Eur J Radiol 2010; 79:262-5. [PMID: 20223610 DOI: 10.1016/j.ejrad.2010.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Accepted: 02/10/2010] [Indexed: 10/19/2022]
Abstract
UNLABELLED The purpose of this study was to investigate the potential correlation between the presence and size of the cisterna chyli (CC) on computed tomography (CT) and the presence of cardiovascular disease. MATERIALS AND METHODS Out of a 3000-patient cohort 2599 patients who received a CT examination of the chest and/or abdomen with measurable inferior vena cava and azygos vein were included in this retrospective study. To assess the presence of cardiovascular disease the following parameters were recorded from the PACS or clinical information system: diameter of vena cava and azygos vein, presence of ascitis, serum creatinine, history of congestive heart failure, coronary artery disease or arterial hypertension and medication (diuretics, beta-blocker). In addition the volume of the CC and the presence or absence of malignant disease were recorded. Mean values (vessel diameters, creatinine) or percentages were calculated and compared for the groups with (n=416) and without (n=2183) a cisterna. Multivariate logistic regression analysis was performed for all parameters to identify the potential association with the presence and size of a cisterna. In addition the simultaneous influence of the parameter malignancy, cardiovascular disease and age on presence and size of the CC was analyzed in a logistic regression model. RESULTS The presence or absence of a CC was not associated with any of the measured parameter. Regarding the size of the CC, there was a positive correlation with the diameter of the azygos vein, the presence of ascitis and diuretic medication. The influences of malignancy, elevated central venous pressure and age on the development of a CC proved to be highly significant but could not be separated or quantified. CONCLUSION The volume of the cisterna chyli is influenced by pathologic states with an increased central venous pressure, while the presence or absence of the cisterna seems to be independent of those factors.
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Schumann C, Hetzel J, Babiak AJ, Merk T, Wibmer T, Möller P, Lepper PM, Hetzel M. Cryoprobe biopsy increases the diagnostic yield in endobronchial tumor lesions. J Thorac Cardiovasc Surg 2010; 140:417-21. [PMID: 20226474 DOI: 10.1016/j.jtcvs.2009.12.028] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Revised: 11/21/2009] [Accepted: 12/13/2009] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Forceps biopsy is the standard method to obtain specimens in endoscopically visible lesions. It is common to combine forceps biopsy with cytology methods to increase the diagnostic yield. Although the flexible cryoprobe has been established for bronchoscopic interventions in malignant stenosis, the obtained biopsies, called "cryobiopsies," have not been investigated in a large cohort of patients. The aim of this feasibility study was to prospectively evaluate the diagnostic yield and safety of cryobiopsy and forceps biopsy. METHODS During a 6-year period, 296 patients with visible endoluminal tumor lesions were included in the study at the bronchoscopy unit of a university hospital. In the first consecutively conducted 55 cases, both techniques, forceps biopsy and cryobiopsy, were applied simultaneously. Pathologic and quantitative image analyses were performed to evaluate the size and quality of the obtained specimens. We evaluated the safety and diagnostic yield to describe the feasibility of cryobiopsy. RESULTS Comparative analysis of the first conducted and randomly assigned 55 cases revealed a significantly higher diagnostic yield for cryobiopsy compared with forceps biopsy (89.1% vs 65.5%, P < .05). In this cohort, quantitative image analysis showed significantly larger biopsies regarding size and artifact-free tissue sections for cryobiopsy compared with forceps biopsy (P < .0001). The overall diagnostic yield of cryobiopsy was 89.5%. Mild bleeding occurred in 11 cases (3.7%), moderate bleeding occurred in 3 cases (1.0%), and severe bleeding occurred in 1 case (0.3%). CONCLUSION Cryobiopsy is safe and increases the diagnostic yield in endobronchial tumor lesions. The method also is feasible under routine conditions.
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Hetzel M, Hetzel J, Merk T, Willems P, Prettner R, Philipp A, Bartscher E, Muradov A, Babiak A. Endoskopische Behandlung von Karzinoidtumoren mit der flexiblen Kryosonde. Pneumologie 2010. [DOI: 10.1055/s-0030-1251176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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104
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Hetzel M, Hetzel J, Prettner R, Philipp A, Willems P, Merk T, Bartscher E, Berweiler I, Stamatopoulou A, Babiak A. Kryorekanalisation für die Behandlung von Tumorverschlüssen der Lappenbronchien. Pneumologie 2010. [DOI: 10.1055/s-0030-1251173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hetzel M, Hetzel J, Merk T, Philipp A, Willems P, Prettner R, Hnidek K, Bartscher E, Babiak A. Möglichkeiten und Grenzen der Navigationsbronchoskopie. Pneumologie 2010. [DOI: 10.1055/s-0030-1251174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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106
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Rupp A, Neudert M, Hetzel M. Wichtigkeit und Notwendigkeit zur Einführung von Maßnahmen zur Tabakentwöhnung an pneumologischen Akut-Kliniken. Pneumologie 2010. [DOI: 10.1055/s-0030-1251293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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107
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Rupp A, Blattner S, Adzemovic E, Merk T, Hetzel M. Umsetzung einer strukturierten Erhebung der Rauch-Anamnese bei pneumologischen Patienten. Pneumologie 2010. [DOI: 10.1055/s-0030-1251291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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108
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Hetzel J, Eberhardt R, Herth FJF, Petermann C, Reichle G, Freitag L, Dobbertin I, Francke K, Stanzel F, Beyer T, Möller P, Fritz P, Schnabel PA, Kastendieck H, Lang W, Morresi-Hauf A, Szyrach M, Muche R, Babiak A, Hetzel M. Endobronchiale Kryosondenbiopsie oder endobronchiale Zangenbiopsie bei endoskopischem Malignitätsverdacht. Pneumologie 2010. [DOI: 10.1055/s-0030-1251108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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109
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Hetzel M, Hetzel J, Prettner R, Merk T, Philipp A, Willems P, Hnidek K, Berweiler I, Bartscher E, Babiak A. Die transbronchiale Biopsie mit der Kryosonde. Pneumologie 2010. [DOI: 10.1055/s-0030-1251172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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110
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Rupp A, Neudert M, Hetzel M. Hindernisse auf dem Weg zur Tabakentwöhnung. Pneumologie 2010. [DOI: 10.1055/s-0030-1251292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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111
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Hofmann B, Hetzel M, Eller S, Wienhausen-Wilke V. Entwicklung der Wartezeiten nach Erweiterung des Versorgungsangebotes von Schlaflaborplätzen durch das MVZ PNZ GmbH am Krankenhaus vom Roten Kreuz im Großraum Stuttgart im Vergleich eines seit Jahren etablierten Schlaflabors der Klinik Schillerhöhe. Pneumologie 2010. [DOI: 10.1055/s-0030-1251397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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112
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Hetzel M, Hetzel J, Prettner R, Merk T, Rupp A, Willems P, Philipp A, Hnidek K, Bartscher E, Babiak A. Diagnostische Bronchoskopien bei Spontanatmung unter tiefer Sedierung mit Propofol. Pneumologie 2010. [DOI: 10.1055/s-0030-1251106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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113
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Rupp A, Neudert M, Hetzel M. [Smoking cessation programmes at hospitals with departments for lung diseases]. Dtsch Med Wochenschr 2010; 135:501-6. [PMID: 20195956 DOI: 10.1055/s-0030-1247865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Tobacco smoking is the main preventable risk factor resulting in multiple diseases and premature death. In particular, the airways and the lungs are affected by the effects of smoking. Hospitals have considerable potential to advance smoking cessation. However, so far there have only been a few data on availability and effectiveness of smoking cessation programs in hospitals. This study aimed to assess such programs in general hospitals with a special department for lung disease in South West Germany. METHODS 40 hospitals with at least one pulmonary specialist were identified. This doctor was subsequently interviewed by a telephone call. 39 hospitals participated, one could not be reached by telephone. RESULTS Although most of the interviewed specialists confirmed the importance of smoking cessation in the field of pneumology only 3 hospitals had own activities for promoting smoking cessation. Another 7 hospitals cooperated with other institutions. Accompanying pharmacotherapy was not practised regularly. The main reasons for a lack of smoking cessation activities in the hospitals were due to the lack of personnel, time and money. CONCLUSION Our study highlights the tremendous difficulties facing general hospitals when trying to implement a smoking cessation program. Changes in the economic frameworks, and further examination of appropriate measures for brief interventions in the hospital setting are necessary.
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Franke KJ, Theegarten D, Hann von Weyhern C, Nilius G, Brueckner C, Hetzel J, Hetzel M, Ruhle KH, Enderle MD, Szyrach MN. Prospective Controlled Animal Study on Biopsy Sampling with New Flexible Cryoprobes versus Forceps: Evaluation of Biopsy Size, Histological Quality and Bleeding Risk. Respiration 2010; 80:127-32. [DOI: 10.1159/000287251] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Accepted: 12/15/2009] [Indexed: 11/19/2022] Open
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Franke KJ, Szyrach M, Nilius G, Hetzel J, Hetzel M, Ruehle KH, Enderle MD. Experimental study on biopsy sampling using new flexible cryoprobes: influence of activation time, probe size, tissue consistency, and contact pressure of the probe on the size of the biopsy specimen. Lung 2009; 187:253-9. [PMID: 19548030 DOI: 10.1007/s00408-009-9156-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Accepted: 06/02/2009] [Indexed: 12/19/2022]
Abstract
Cryoextraction is a procedure for recanalization of obstructed airways caused by exophytic growing tumors. Biopsy samples obtained with this method can be used for histological diagnosis. The objective of this study was to evaluate the parameters influencing the size of cryobiopsies in an in vitro animal model. New flexible cryoprobes with different diameters were used to extract biopsies from lung tissue. These biopsies were compared with forceps biopsy (gold standard) in terms of the biopsy size. Tissue dependency of the biopsy size was analyzed by comparing biopsies taken from the lung, the liver, and gastric mucosa. The effect of contact pressure exerted by the tip of the cryoprobe on the tissue was analyzed on liver tissue separately. Biopsy size was estimated by measuring the weight and the diameter. Weight and diameter of cryobiopsies correlated positively with longer activation times and larger diameters of the cryoprobe. The weight of the biopsies was tissue dependent: lung < liver < stomach. Only little tissue dependency was found for the biopsy diameter. The biopsy size increased when the probe was pressed on the tissue during cooling. Cryobiopsies can be taken from different tissue types with flexible cryoprobes. The size of the samples depends on tissue type, probe diameter, application time, and pressure exerted by the probe on the tissue. Even the cryoprobe with the smallest diameter can provide larger biopsies than a forceps biopsy in lung. It can be expected that the same parameters influence the sample size of biopsies in vivo.
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Hetzel M, Hetzel J, Babiak A, Willems P, Hofmann B, Philipp A, Hnidek K, Miller M, Balli T. Verwendung von Führungskathetern bei der Untersuchung des Alveolarraumes mittels konfokaler Laserscanmikroskopie. Pneumologie 2009. [DOI: 10.1055/s-0029-1213915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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117
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Balli T, Miller M, Shahid A, Babiak A, Philipp A, Willems P, Hetzel M. Bronchoskopische Kryoextraktion eines trachealen Karzinoids: Ein Fallbericht. Pneumologie 2009. [DOI: 10.1055/s-0029-1213863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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118
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Balli T, Babiak A, Shahid A, Philipp A, Willems P, Hoffmann B, Hetzel M. Die Dilatationsthorakotomie als Zugang für die flexible Pleuroskopie. Pneumologie 2009. [DOI: 10.1055/s-0029-1213867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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119
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Hetzel M, Hetzel J, Bartscher E, Berweiler I, Philipp A, Willems P, Babiak A, Stamatopoulou A, Hnidek K, Blattner S, Balli T. Ein Rekanalisationsverfahren für die flexible Bronchoskopie: Die Kryoextraktion mit flexiblen Kältesonden. Pneumologie 2009. [DOI: 10.1055/s-0029-1213912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Balli T, Miller M, Shahid A, Babiak A, Philipp A, Willems P, Hetzel M. Mehrfach-resistente Lungentuberkulose bei einem Patienten aus Kasachstan: Ein Fallbericht. Pneumologie 2009. [DOI: 10.1055/s-0029-1213877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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121
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Hetzel M, Hetzel J, Babiak A, Bartscher E, Berweiler I, Stamatopoulou A, Willems P, Philipp A, Balli T. Transbronchiale Biopsie mit der flexiblen Kryosonde. Pneumologie 2009. [DOI: 10.1055/s-0029-1214101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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122
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Hetzel M, Hetzel J, Babiak A, Philipp A, Willems P, Hofmann B, Bartscher E, Berweiler I, Willkomm F, Stamatopoulou A, Hnidek K. Therapie von bronchialen Blutungen in flexibler Bronchoskopietechnik. Pneumologie 2009. [DOI: 10.1055/s-0029-1213872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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123
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Balli T, Miller M, Shahid A, Babiak A, Philipp A, Willems P, Hetzel M. Progrediente Lungenfibrose unter Cisplatin und Vinorelbine bei fortgeschrittenem NSCLC: Ein Fallbericht. Pneumologie 2009. [DOI: 10.1055/s-0029-1214039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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124
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Hetzel M, Hetzel J, Topalidis T, Philipp A, Babiak A, Willems P, Bartscher E, Berweiler I, Nguyen T, Miller M, Stamatopoulou A. Kryosondenbiopsien für die Cytopathologie. Pneumologie 2009. [DOI: 10.1055/s-0029-1213871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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125
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Balli T, Babiak A, Shahid A, Philipp A, Willems P, Hoffmann B, Hetzel M. Die Kryobiopsie der Pleura während der flexiblen Pleuroskopie – eine Fallserie. Pneumologie 2009. [DOI: 10.1055/s-0029-1213866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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