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Schob S, Voigt P, Höhn A, Meyer H, Wickenhauser C, Behrmann C, Kachel P, Dralle H, Hoffmann K, Surov A. Diffusionsbildgebung mittels RESOLVE-DWI bei 3T kann zwischen differenzierten und undifferenzierten Schilddrüsenkarzinomen unterscheiden. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- S Schob
- Uniklinik Leipzig, Klinik und Poliklinik für diagnostische und interventionelle Radiologie, Abt. für Neuroradiologie, Leipzig
| | - P Voigt
- Uniklinik Leipzig, Abteilung für Neuroradiologie, Leipzig
| | - A Höhn
- Uniklinik Leipzig, Pathologie, Leipzig
| | - H Meyer
- Uniklinik Halle, Radiologie, Halle/Saale
| | | | - C Behrmann
- Uniklinik Halle, Radiologie, Halle/Saale
| | - P Kachel
- Hämatologie und Onkologie, Universitätsspital Zürich, Zürich
| | - H Dralle
- Uniklinik Essen, Endokrine Chirurgie, Essen
| | - K Hoffmann
- Uniklinik Leipzig, Abteilung für Neuroradiologie, Leipzig
| | - A Surov
- Uniklinik Leipzig, Diagnostische und interventionelle Radiologie, Leipzig
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Weber T, Wickenhauser C, Monecke A, Gläser C, Stadler M, Desole M, Ligeti K, Behrmann C, Müller-Tidow C, Müller LP. Treatment of rare co-occurrence of Epstein-Barr virus-driven post-transplant lymphoproliferative disorder and hemophagocytic lymphohistiocytosis after allogeneic stem cell transplantation. Transpl Infect Dis 2014; 16:988-92. [PMID: 25179757 DOI: 10.1111/tid.12287] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 03/28/2014] [Accepted: 06/28/2014] [Indexed: 12/14/2022]
Abstract
In both conditions, post-transplant lymphoproliferative disorder (PTLD) and hemophagocytic lymphohistiocytosis (HLH), infection with Epstein-Barr virus (EBV) is a key mechanism: almost all PTLD in allogeneic stem cell transplantation (alloSCT) is caused by EBV-related neoplastic lymphoproliferation, and secondary HLH is most frequently triggered by EBV infection. Therefore, concomitant EBV-driven PTLD and HLH early after alloSCT require an approach to eliminate EBV and balance immune activation simultaneously. We report on a patient who developed simultaneous PTLD and signs of HLH on day 64 after alloSCT. Treatment was comprised of stopping cyclosporine, short-course dexamethasone, and 3 courses of rituximab. The patient showed full recovery and complete remission of lymphadenopathy. This result indicates that immediate reduction in EBV-carrying B cells by rituximab, suppression of general inflammation, and parallel support of reconstitution of long-term T-cell function, might be an appropriate therapeutic approach in this rare situation.
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Affiliation(s)
- T Weber
- Department of Hematology and Oncology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
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Gottschling S, Bach AG, Schmoll HJ, Behrmann C, Spielmann RP, Wienke A, Abbas J, Surov A. Lungenarterienembolien bei onkologischen Patienten: Häufigkeit und Schweregrad von symptomatischen Ereignissen sowie Zufallsbefunden. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Surov A, Rusner C, Weigand K, John E, Spielmann RP, Behrmann C. Radio-opacity and incidental identified mechanical complications of totally implantable venous access devices placed in the chest. Acta Radiol 2012; 53:1035-9. [PMID: 23028172 DOI: 10.1258/ar.2012.110644] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Totally implantable venous access devices (TIVAD) may be associated with different complications. Certain mechanical port disorders can easily be diagnosed on chest radiographs if the implanted systems are radiopaque and well visible. There are no reports regarding the visibility of TIVAD on chest X-rays. PURPOSE To assess the radio opacity of TIVAD implanted in the chest as well as type and frequency of mechanical complications of ports on chest X-ray images. MATERIAL AND METHODS Chest X-rays of 985 patients from the time period 2007-2009 were analyzed retrospectively. In these patients 1190 TIVAD were inserted. All parts of the TIVAD, i.e. port chamber, connection, and port catheter, were checked for their visibility on chest radiographs. An opacity score was used here as follows: ++ well visible; + visible; - partly or completely invisible. Mechanical complications of TIVAD incidentally detected on chest X-ray were also analyzed retrospectively. RESULTS Nineteen TIVAD models with diverse configuration and visibility of port chambers, connections, and catheters were identified in our study. Eighty-eight percent of the analyzed port systems were well visible or visible on chest radiographs. Twelve percent of the port chambers and catheters were partly visible or completely invisible. In 9% of the TIVAD, different mechanical complications were diagnosed on chest X-ray images. CONCLUSION TIVADs should be evaluated carefully on every chest X-ray. Ideally, they should be radio-opaque and well visible on thoracic X-ray images. Unfortunately, this is not always the case. Therefore, manufacturers of TIVAD should take into consideration to use exclusively radio-opaque materials that allow sufficient visibility of each port component on chest radiographs.
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Affiliation(s)
- Alexey Surov
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Carsten Rusner
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Karl Weigand
- Department of Urology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Endres John
- Department Of Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Rolf Peter Spielmann
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - C Behrmann
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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Schneider R, Ukkat J, Nguyen-Thanh P, Lorenz K, Plontke S, Behrmann C, Sekulla C, Dralle H. [Endocrine surgery for neck paraganglioma: operation, radiation therapy or wait and scan?]. Chirurg 2012; 83:1060-7. [PMID: 22802215 DOI: 10.1007/s00104-012-2326-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Head and neck paraganglioma (HNP) represent rare endocrine tumors. Therapy is decided on genetic findings, tumor characteristics (e.g. tumor size, localization and dignity), age of patient and symptoms. In terms of local control radiation therapy is as equally effective as surgery but surgical morbidity rates secondary to cranial nerve injuries remain high. PATIENTS Based on 6 patients with 11 solitary (4 patients) and multiple (2 patients) HNP (8 carotid body tumors, 1 vagal, 1 jugular and 1 jugulotympanic paraganglioma) the specific characteristics of the need for surgery as well as correct choice of treatment in cases of sporadic succinate dehydrogenase (SDH) negative and hereditary SDH positive HNP will be exemplarily demonstrated. RESULTS A total of 6 carotid body tumors (four sporadic, two hereditary) were resected in 4 patients, five as primary surgery and one as a revision procedure. In one case a preoperative embolization was performed 24 h before surgery. Malignancy could not be proven in any patient. The 30-day mortality was zero. In the patient with bilateral hereditary carotid body tumors, unilateral local recurrent disease occurred. After resection of the recurrent tumor permanent unilateral paralysis of the laryngeal nerve, glossopharyngeal nerve and hypoglossal nerve occurred. All patients were followed-up postoperatively for a mean of 64 months (range 23-78 months) with a local tumor control rate of 100%. The overall survival rate after 5 years was 100%. CONCLUSIONS Given a very strict indication with awareness of surgical risks selective surgery has a key position with low postoperative morbidity in the treatment of HNPs. We prefer surgery for small unilateral paraganglioma, malignant or functioning tumors.
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Affiliation(s)
- R Schneider
- Universitätsklinik und Poliklinik für Allgemein-, Viszeral- und Gefässchirurgie, Martin-Luther-Universität, Ernst-Grube-Str. 40, 06120, Halle/Saale, Deutschland.
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Deschauer M, Gaul C, Behrmann C, Prokisch H, Zierz S, Haack TB. C19orf12 mutations in neurodegeneration with brain iron accumulation mimicking juvenile amyotrophic lateral sclerosis. J Neurol 2012; 259:2434-9. [PMID: 22584950 DOI: 10.1007/s00415-012-6521-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 03/25/2012] [Accepted: 04/14/2012] [Indexed: 11/25/2022]
Affiliation(s)
- M Deschauer
- Department of Neurology, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06097, Halle (Saale), Germany.
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Surov A, Spielmann RP, Schmoll HJ, Fiedler E, Behrmann C. Mechanische Komplikationen vollimplantierbarer venöser Portsysteme. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bach AB, Schramm D, Behrmann C, Spielmann RP, Surov A. Häufigkeit und Bildgebung renaler Non-Hodgkin Lymphome. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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9
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Rusner C, Behrmann C, Spielmann RP, Surov A. Materialbedingt variable Beurteilbarkeit von Portsystemen in der radiologischen Diagnostik. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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10
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Jasaabuu CH, Abbas J, Fiedler E, Spielmann RP, Behrmann C, Surov A. Intramammäre Zufallsbefunde in der Computertomographie. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bach AG, Schramm D, Behrmann C, Spielmann RP, Surov A. Pseudoherzwandaneurysma als Komplikation einer Schrittmacherimplantation. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0031-1300870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Surov A, Behrmann C, Fiedler E. Mechanische Komplikationen vollimplantierbarer venöser Portsysteme. Dtsch Med Wochenschr 2011; 136:2158-64. [DOI: 10.1055/s-0031-1292028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Wilhelm J, Issa H, Behrmann C, Werdan K, Heinroth K. Atypical course of a persistent left superior vena cava through the left atrium. European Journal of Echocardiography 2011; 12:635. [DOI: 10.1093/ejechocard/jer075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
Aquired diverticula of the small bowel (not Meckel?s diverticulum) have a prevalence of 1 to 5 % and are relatively common. They are usually asymptomatic. However, in rare cases they can cause unspecific abdominal symptoms and even critical complications that require surgical intervention. Patients with diverticula of the small bowel were selected from all patients treated at an university hospital of maximal care in a retrospective study covering nine years. In 72 patients with diverticula, 47 % were asymptomatic, 47 % had unspecific abdominal symptoms and 6 % presented acute complications. In 83 % diverticula were localised in the duodenum and proximal jejunum. More distal parts of the small intestine were affected with decreasing frequency. A disseminated affection of the entire small bowel was found in 4 % of all patients. Diagnosis was made by endoscopic techniques in most cases (87 %) and to a smaller extent by CT- and MR-imaging and by other methods. The pattern of complications found is similar to earlier studies. Endoscopic techniques have replaced enteroclysis as the most widespread diagnostic technique in diagnosis of small bowel diverticula.
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Affiliation(s)
- A G Bach
- Klinik für Diagnostische Radiologie, Martin-Luther-Universität Halle-Wittenberg, Halle.
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Fuhrberg B, Hardeland R, Poeggeler B, Behrmann C. Dramatic Rises of Melatonin and 5-Methoxytryptamine in Gonyaulax Exposed to Decreased Temperature. BIOL RHYTHM RES 2010. [DOI: 10.1076/brhm.28.1.144.12978] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Surov A, Holzhausen HJ, Arnold D, Schmidt J, Spielmann RP, Behrmann C. Intramuskuläre Metastasen: Prevalenz, Lokalisation, klinische und radiologische Zeichen. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Surov A, Arnold D, Spielmann RP, Brandt S, Behrmann C. Lymphom der Skelettmuskulatur. Häufigkeit, Klinische Zeichen und Radiologische Manifestation. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Surov A, Behrmann C, Kornhuber M. Carotid embolism. Case Reports 2009; 2009:bcr2006105593. [DOI: 10.1136/bcr.2006.105593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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20
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Stoevesandt D, Friedrich I, Buerke M, Prondzinsky R, Kornhuber M, Schlitt A, Behrmann C. Herzkatheterassoziierte Hirnembolien bei Endokarditis – erste Ergebnisse. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Stoevesandt D, Buerke M, Behrmann C, Heinroth K, Spielmann RP, Werdan K, Schlitt A. Detection of a persistent left superior vena cava by echocardiography, computed tomography, and magnetic resonance imaging. Clin Res Cardiol 2007; 96:191-2. [PMID: 17294348 DOI: 10.1007/s00392-007-0492-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2006] [Accepted: 12/21/2006] [Indexed: 11/27/2022]
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Surov A, Spielmann RP, Ommenzetter M, Behrmann C. Pseudotumor nach Kriegsverletzung. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-941149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ruschke K, Knipping F, Behrmann C, Kösling S. Schädelbasisosteomyelitis. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Albert JG, Martiny F, Krummenerl A, Stock K, Lesske J, Göbel CM, Lotterer E, Nietsch HH, Behrmann C, Fleig WE. Diagnosis of small bowel Crohn's disease: a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis. Gut 2005; 54:1721-7. [PMID: 16020490 PMCID: PMC1774782 DOI: 10.1136/gut.2005.069427] [Citation(s) in RCA: 188] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 06/24/2005] [Accepted: 06/27/2005] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS The diagnostic yield of capsule endoscopy (CE) compared with magnetic resonance imaging (MRI) in small bowel Crohn's disease is not well established. We prospectively investigated CE, MRI, and double contrast fluoroscopy in patients with suspected small bowel Crohn's disease. METHODS Fifty two consecutive patients (39 females, 13 males) were investigated by MRI, fluoroscopy and--if bowel obstruction could be excluded--by CE. In 25, Crohn's disease was newly suspected while the diagnosis of Crohn's disease (non-small bowel) had been previously established in 27. RESULTS Small bowel Crohn's disease was diagnosed in 41 of 52 patients (79%). CE was not accomplished in 14 patients due to bowel strictures. Of the remaining 27 patients, CE, MRI, and fluoroscopy detected small bowel Crohn's disease in 25 (93%), 21 (78%), and 7 (of 21; 33%) cases, respectively. CE was the only diagnostic tool in four patients. CE was slightly more sensitive than MRI (12 v 10 of 13 in suspected Crohn's disease and 13 v 11 of 14 in established Crohn's disease). MRI detected inflammatory conglomerates and enteric fistulae in three and two cases, respectively. CONCLUSION CE and MRI are complementary methods for diagnosing small bowel Crohn's disease. CE is capable of detecting limited mucosal lesions that may be missed by MRI, but awareness of bowel obstruction is mandatory. In contrast, MRI is helpful in identifying transmural Crohn's disease and extraluminal lesions, and may exclude strictures.
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Affiliation(s)
- J G Albert
- First Department of Medicine, Martin-Luther-University Hospital and Clinics, D-06097 Halle (Saale), Germany
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Neudecker S, Bau V, Behrmann C, Wolf HH, Krasnianski M. Unilaterale Amaurose als einziges fokales Zeichen einer Carotis-communis-Dissektion. Klin Monbl Augenheilkd 2005; 221:509-12. [PMID: 15236114 DOI: 10.1055/s-2004-813138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Central retinal artery occlusion with persistent amaurosis as the only focal symptom caused by dissection of the internal carotid artery has occasionally been reported. Central retinal artery occlusion due to a common carotid artery dissection has been diagnosed only very rarely. CASE REPORT We describe a patient presenting with cervical pain, headache and unilateral amaurosis due to a thrombosis of the central retinal artery caused by a common carotid artery dissection, as demonstrated on MR imaging. No other neurological deficits could be detected. The patient underwent an anticoagulative treatment without improvement of his vision, but also without the appearance of further neurological symptoms. CONCLUSION In monocular visual loss combined with cervical pain or headache, carotid artery dissection should be considered. Early treatment might be of crucial importance for the prevention of a devastating hemispheric stroke.
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Affiliation(s)
- S Neudecker
- Klinik und Poliklinik für Neurologie, Martin-Luther-Universität Halle-Wittenberg, Wittenberg
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26
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Krivokuca M, Behrmann C, Sievert M, Werdan K, Prondzinsky R. Thromboembolic cerebral ischaemic attack complicating cardiac catheterization. ACTA ACUST UNITED AC 2005; 94:474-8. [PMID: 15997350 DOI: 10.1007/s00392-005-0251-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2004] [Accepted: 02/08/2005] [Indexed: 12/24/2022]
Abstract
Cerebral ischaemia caused by thromboembolism is a possible complication of diagnostic and interventional cardiac catheterization. In this case report we describe the diagnostic steps and successful treatment strategy in the management of a patient who suffered from cerebral ischaemia during cardiac catheterization. Initial CT scanning to exclude cerebral haemorrhage was followed by angiography through the cardiac catheterization sheath in the right femoral artery. Occlusion just before the intracranial bifurcation of the right internal carotid artery was found and local thrombolysis given with a reduced dose of 34 mg rt-PA. The subsequent angiogram showed restored perfusion in the affected vessel after completion of thrombolytic therapy and resolution of neurological symptoms.
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Affiliation(s)
- M Krivokuca
- Department of Medicine III, University Hospital, Martin-Luther-University Halle-Wittenberg, 06097 Halle, Germany.
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27
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Taute BM, Taute R, Heins S, Behrmann C, Podhaisky H. Hyperhomocysteinemia: marker of systemic atherosclerosis in peripheral arterial disease. INT ANGIOL 2004; 23:35-40. [PMID: 15156128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
AIM Patients suffering from peripheral arterial disease (PAD) are increasingly described as having hyperhomocysteinemia more than in patients with coronary artery or cerebrovascular disease. Cases of symptomatic PAD usually present with associated coronary artery or cerebrovascular disease and renal artery disease. It can thus be postulated that multilocular atherosclerosis is linked to hyperhomocysteinemia and that the extent of atherosclerosis has a possible correlation with homocysteine concentrations. The aim of this study was to ascertain whether fasting total homocysteine concentrations in patients with PAD are associated with the extent and the localization of systemic atherosclerosis in cerebrovascular, coronary and/or renal vascular zones. METHODS A total of 183 patients with PAD, Fontaine stages II-IV, were divided into 2 groups: Group A contained patients with isolated PAD (n=98) and Group B patients with systemic atherosclerosis in PAD (n=85). Characterization of vascular disease in various vascular zones was indication-adapted using non-invasive and/or invasive METHODS Patients with renal insufficiency were excluded from the study. RESULTS Homocysteine concentrations were significantly lower in patients with isolated PAD than in patients with additional systemic atherosclerosis (10.1+/-4.4 vs 16.7+/-7.04 micromol/l, p<0.0001). There were no differences in localization or extent of concomitant systemic atherosclerosis. Logistic regression analysis indicated that elevated plasma homocysteine and decreasing ABPI served independently as significant risk indicators for systemic atherosclerosis in patients with PAD (p<0.0001). CONCLUSION Hyperhomocysteinemia is a precursoral marker of systemic atherosclerosis and thus a prognostic indicator of cardiovascular morbidity and mortality in PAD.
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Affiliation(s)
- B-M Taute
- Department of Internal Medicine III/Angiology, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, Germany.
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Stock K, Peters S, Behrmann C, Spielmann RP. [Bilateral carotid dissection. A not to underestimate cause of neurological loss after road accident]. Unfallchirurg 2002; 105:919-22. [PMID: 12376897 DOI: 10.1007/s00113-002-0431-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The dissection of the internal carotid artery is a rare complication of acceleration traumas of the upper spine. 30% of these dissections are caused by road accidents and again less than 30% of these occur bilateral as shown here. The symptoms are fronto-temporal and periorbital starting headaches spreading out to the occiput and Horner's syndrome. Complete hemiplegia as in our case is an impressive exception but the doctor in attendance should think of the carotid dissection. The exclusion of this complication is obligatory because treatment and outcome depend on it.The dynamic effects of bilateral carotid dissections may, as shown here, lead to relapsing cerebral infarctions with persisting neurologic deficits up to manifest hemiparesis. But restitution can be accomplished if early diagnosed by DSA and/or MRI. Therapy of choice is early prevention of persisting neurologic deficits using effective dosed heparin and depending on the residual lumen of the vessel oral anticoagulants or platelet antagonists for one year.
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MESH Headings
- Accidents, Traffic
- Adult
- Angiography, Digital Subtraction
- Anticoagulants/therapeutic use
- Brain/diagnostic imaging
- Carotid Artery, Internal, Dissection/complications
- Carotid Artery, Internal, Dissection/diagnosis
- Carotid Artery, Internal, Dissection/drug therapy
- Carotid Artery, Internal, Dissection/etiology
- Female
- Fibrinolytic Agents/therapeutic use
- Hemiplegia/etiology
- Heparin/therapeutic use
- Humans
- Magnetic Resonance Imaging
- Time Factors
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Affiliation(s)
- K Stock
- Klinik für diagnostische Radiologie der Martin-Luther-Universität Halle-Wittenberg, Germany
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Voigt W, Behrmann C, Schlueter A, Kegel T, Grothey A, Schmoll HJ. A new chemoembolization protocol in refractory liver metastasis of colorectal cancer--a feasibility study. Oncol Res Treat 2002; 25:158-64. [PMID: 12006767 DOI: 10.1159/000055226] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION In patients with advanced colorectal cancer (CRC) refractory to systemic chemotherapy including 5-fluorouracil (5-FU) / folinic acid (FA), oxaliplatin and irinotecan we assessed the feasibility, toxicity and response to hepatic transcatheter arterial chemoembolization (TACE). At the time of treatment, patients had exclusively or dominantly liver metastasis of CRC. PATIENTS AND METHODS The following protocol was applied via a selective transfemoral hepatic arterial approach: mitomycin C 5 mg/m(2), interferon-alpha2b 4.5 Mio IU, dexamethasone 20 mg mixed with Amilomer DSM 45/25 (Spherex((R))) days 1 and 2 i.a. (bolus), oxaliplatin 50 mg/m(2) (2 h) day 1 i.a., FA 500 mg/m(2) (2 h) day 1 i.v., and 5-FU 1.500 mg/m(2) (24 h) day 1 i.a. Cycles have been repeated at days 15-22. The dose was adjusted according to the pretreatment performance status and elevation of alkaline phosphatase, bilirubin and serum albumin. Treatment was continued until progression or emergence of intolerable toxicity. RESULTS 11 patients received a total number of 43 TACE, with a range of 2-6 per patient. There was no TACE-related mortality. 4 patients died 5, 8, 10 and 11 months after initiation of treatment due to progression of disease. 7 patients are alive at 4+ (n = 2), 5+ (n = 1), 6+ (n = 1), 7+ (n = 1) and 11+ (n = 2) months after start of treatment. Toxicity (CTC) was mild with grade I-II asthenia (n = 10), grade I-II neurotoxicity (n = 5), grade II nausea and/or vomiting (n = 2) and grade II diarrhea (n = 1). Treatment had to be postponed due to grade I thrombocytopenia in 2 patients. No bleeding episodes or obvious infectious complications occurred during treatment intervals. 1 patient experienced an allergic reaction to oxaliplatin which led to exclusion from further therapy. Arterial catheter dislocation occurred in 3 patients. In 10 patients evaluable for response we observed 3 partial responses, 2 minor responses, and 4 times stable disease. Only 1 patient had further progression of disease under treatment. CONCLUSION TACE, using a combination of mitomycin C, dexamethasone and interferon-alpha2b mixed with Spherex((R)), followed by oxaliplatin, FA and 5-FU, appears to be an effective and feasible treatment option in the case of liver metastasis of CRC refractory to standard systemic chemotherapy. This treatment is associated with tolerable toxicity, which becomes apparent mainly as asthenia, neurotoxicity or thrombocytopenia. These preliminary data warrant further evaluation for patients with refractory disease and would probably also be of interest for first-line treatment in this patient population.
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Affiliation(s)
- W Voigt
- Abteilung Hämatologie/Onkologie, Martin-Luther-Universität, Halle-Wittenberg, Halle/Saale, Germany
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Schlüter A, Hirsch W, Jassoy A, Kornhuber M, Behrmann C, Keysser G, Spielmann RP. [MR angiography in diagnosis of vasculitis and benign angiopathies of the central nervous system]. ROFO-FORTSCHR RONTG 2001; 173:522-7. [PMID: 11471293 DOI: 10.1055/s-2001-14995] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE To evaluate TOF 3D magnetic resonance angiography (MRA) of the intracranial arteries in patients with vasculitis or vasculitis-like benign angiopathy of the central nervous system (CNS). METHOD The results of MRA in 20 patients with clinically and radiographically proven vasculitis (17/20) or vasculitis-like benign angiopathy (3/20) of the CNS were retrospectively analysed. Patients with hyperintense lesions of more than 3 mm on T2-weighted MRI images were included in this trial. An inflammatory, embolic, neurodegenerative or metastatic origin of these lesions was excluded by extensive clinical studies. For the MR-examination a TOF 3D FISP sequence was used on a 1.5 T imager. RESULTS MRA showed characteristic changes for vasculitis or angiopathy in 15 of 20 patients (75%). CONCLUSIONS In patients suspected of having a vasculitis or vasculitis-like angiopathy, MRA is recommended as a non-invasive modality. If the results of MRI and extensive clinical studies are carefully correlated, MRA may substitute conventional angiography in cases with typical vascular changes.
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Affiliation(s)
- A Schlüter
- Klinik für Diagnostische Radiologie, Martin-Luther-Universität Halle-Wittenberg.
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Abstract
PURPOSE In the context of quality control, the results of balloon angioplasty of iliac and leg vessels in patients with vascular occlusive disease were investigated pertaining to the technical and clinical success. METHODS 197 conventional balloon angioplasties were evaluated regarding their success over a period of 1-4 years, retrospectively. The localisations of the primary obstructions and the existence of further obstructions, especially in the lower limb, the risk factors, and the technical and clinical results were compared. The clinical stage and the results of duplex ultrasound during follow-up examinations were recorded over a period of 1-4 years. RESULTS The technical success of PTA was 95% for stenotic lesions and 80% for occlusions. In the long-term (up to 4 years) PTA of the iliac arteries achieved the best results with a success rate of 88%. The long-term results for the combination of the risk factors nicotine/hyperlipidemia (69%) was better than for the combination of diabetes/hypertonia (54%). The combined PTA of the main obstruction and of lower limb vascular had better results than the PTA without the dilatation of following stenoses 73% to 79% after one year. In our department we achieved a rise in success rate from 84% in 1995 to 96% in 1997. The number of complications during PTA was reduced from 8% in 1995 to 0% in 1997 and 1998. CONCLUSIONS PTA has a high technical success rate and good clinical long-term results at low complication rates. Combined PTA of the main obstruction and an additional lower limb arterial stenosis or occlusion should be discussed because of the better clinical results after one year. By the quality control we achieved a rising technical success rate and a drop in complication rate.
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Affiliation(s)
- M Hintner
- Klinik für Diagnostische Radiologie, Martin-Luther-Universität Halle-Wittenberg
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Hirsch W, Beck R, Behrmann C, Schobess A, Spielmann RP. Reliability of cranial CT versus intracerebral pressure measurement for the evaluation of generalised cerebral oedema in children. Pediatr Radiol 2000; 30:439-43. [PMID: 10929360 DOI: 10.1007/s002470000255] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the extent to which intracranial pressure (ICP) in children after severe brain trauma can be determined by cranial CT. MATERIALS AND METHODS Two experienced paediatric radiologists, without any knowledge of the clinical symptoms, evaluated 124 CT scans from 65 children (average age 5.4 years) who underwent intracranial measurement of their cerebral pressure. RESULTS CT had high sensitivity (99.1%) for 'high cerebral pressure' but a much lower specificity (78.1%). The examiners tended to estimate ICP as 'high' even when actual ICP was low. Since therapy for lowering cerebral pressure involves potential risks, actual cerebral pressure measurement, particularly in children, should be considered before intervention (e.g. hyperventilation or trepanation). We report the change in different intracerebral fluid compartments with varying cerebral pressure and modifications of the density of the brain tissue in an inter- and intraobserver comparison. CONCLUSION The radiologist cannot differentiate, for methodological reasons, between a change in the intracranial fluid compartments not associated with a change in ICP and one in which it is critically elevated. Before any interventional treatments such as decompression-trepanation or hyperventilation are instituted, measurement of ICP should be considered, especially in children.
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Affiliation(s)
- W Hirsch
- Department of Diagnostic Radiology, University Hospital Halle-Wittenberg, Germany
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Abstract
BACKGROUND/AIMS Doppler sonography has been used to assess hepatic arterial perfusion in a number of published reports. However, adequate validation studies are available for neither the transcutaneous nor the intravascular Doppler approach. The aim of this comparative study was to assess hepatic arterial perfusion with both methods. METHODS In 15 patients the right hepatic artery was examined with intravascular and transcutaneous Doppler sonography after calibration of Doppler devices in vitro with a thread model. The measurements were performed simultaneously in five and separately within 24 h in 10 patients. RESULTS In vitro, the correlations between the velocities of the thread and the velocities as determined by intravascular (r=1.0, p<0.001) and transcutaneous Doppler sonography (r=1.0, p<0.001) were excellent. In vivo, the best correlation was found for systolic peak velocities (intravascular: 58.5+/-18.1 cm/s, mean+/-standard deviation, transcutaneous: 58.2+/-25.2 cm/s, r=0.63, p=0.01). Although lower mean (intravascular: 26.5+/-7.7 cm/s, transcutaneous: 32.5+/-14.4 cm/s) and end-diastolic velocities (intravascular: 11.5+/-4.0 cm/s, transcutaneous: 18.4+/-8.6 cm/s) were found with intravascular compared to transcutaneous Doppler sonography, significant correlations were demonstrable between results obtained by both methods (r=0.63, p=0.01 for mean and r=0.57, p=0.025 for diastolic velocities). Similarly, the calculated resistive (intravascular: 0.79+/-0.07, transcutaneous: 0.68+/-0.06, r=0.65, p=0.009) and pulsatility indices (intravascular: 1.78+/-0.47, transcutaneous: 1.26+/-0.25, r=0.55, p=0.034) were somewhat higher using the intravascular device, but correlated well with the numbers obtained by the transcutaneous approach. CONCLUSIONS The data suggest that with use of different Doppler devices, systolic velocities are the most suitable parameter for Doppler assessment of hepatic arterial perfusion.
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Affiliation(s)
- G H Hübner
- First Department of Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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Dempke W, Behrmann C, Schöber C, Büchele T, Grothey A, Schmoll HJ. [Diagnostic and therapeutic management of the superior vena cava syndrome]. Med Klin (Munich) 1999; 94:681-4. [PMID: 10641510 DOI: 10.1007/bf03044758] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Superior vena cava syndrome (SVCS) is the clinical expression of obstruction of blood flow through the superior caval vein. In more than 80% of patients this complication is due to a malignant tumor, and in 60% of cases the first symptom of this tumor. DIAGNOSIS AND TREATMENT If the clinical course of SVCS represents an absolute emergency, irradiation may have to be started immediately, even before the histologic diagnosis is established. Alternatively, expandable metallic stents have been used with considerable success for treatment of vena caval obstruction since patients respond immediately after stent implantation. For diagnosis, a chest X-ray and a CT scan should be performed. Chemotherapy is the treatment of choice for high-grade lymphomas, germ cell tumors and small-cell lung cancer since this modality is more effective than radiotherapy (response rate: 80%). For less chemotherapy responsive tumors radiotherapy is the primary treatment. Successful experience with thrombolytic agents is limited to treatment of catheter-induced SVCS, in contrast, only 20% of patients respond to thrombolytic therapy in the absence of a central catheter. Surgical resection of SVCS associated tumors has not improved survival rates and should be avoided.
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Affiliation(s)
- W Dempke
- Klinik und Poliklinik für Innere Medizin IV, Martin-Luther-Universität Halle-Wittenberg
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Schlüter A, Stock K, von Poblozki A, Behrmann C, Jassoy A, Spielmann RP. [Radiological evaluation of complications of implantable venous access port systems]. ROFO-FORTSCHR RONTG 1999; 171:324-8. [PMID: 10598170 DOI: 10.1055/s-1999-11092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVE Clinical signs and symptoms sometimes throw suspicion on functional complications and venous thrombosis due to implantable venous access ports. Objective was to determine frequency of these problems using radiologic imaging. METHODS 61 patients were examined by means of fluoroscopy. If indication was given we injected radiopaque (contrast) medium. In the case of suspected vascular thrombosis the radiological finding was verified by sonography, phlebography or by venous magnetic resonance imaging angiography. RESULTS Altogether 46 complications were documented in 37 out of 61 examined patients (61%). Occlusions of port-catheter were proved in 24 cases. It was the radiologically most frequently recorded complication (52%;) and found coincident with other problems in 9 patients (37%;). Pain frequently indicates break of catheters. Implantation of catheters into jugular and axillary veins predisposes to break of catheters just as port-catheters lateral implanted into subclavian veins ("pinch-off-sign"). CONCLUSIONS Functional tests of venous access systems using fluoroscopy and phlebography give information that helps to decide if clinically problematic port-systems should be used furthermore. Directions of catheter which are predestined to complications should be avoided.
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Affiliation(s)
- A Schlüter
- Klinik für Diagnostische Radiologie, Martin-Luther-Universität Halle-Wittenberg.
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Kleber G, Steudel N, Behrmann C, Zipprich A, Hübner G, Lotterer E, Fleig WE. Hepatic arterial flow volume and reserve in patients with cirrhosis: use of intra-arterial Doppler and adenosine infusion. Gastroenterology 1999; 116:906-14. [PMID: 10092313 DOI: 10.1016/s0016-5085(99)70074-0] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS In cirrhosis, liver blood flow becomes increasingly dependent on the hepatic artery. The aim of this study was to investigate hepatic arterial blood flow volume and resistance and hepatic arterial flow reserve in relation to liver function and systemic hemodynamic alterations in patients with cirrhosis. METHODS In 38 patients with cirrhosis, liver function, cardiac output, and systemic vascular resistance were studied, and hepatic arterial blood flow velocity, flow volume, and pulsatility index at baseline and during intra-arterial administration of adenosine (2-40 microg. min-1. kg body wt-1) were assessed by angiography combined with intravascular Doppler flowmetry. RESULTS Hepatic arterial flow velocity was 21 +/- 11, 31 +/- 17, and 41 +/- 27 cm/s; flow volume was 266 +/- 246, 342 +/- 289, and 417 +/- 220 mL/min; and pulsatility index was 2.2 +/- 0.7, 1.7 +/- 0.6, and 1.5 +/- 0.5 in Child-Pugh classes A, B, and C, respectively (differences not statistically significant). Adenosine-induced changes in these parameters were more marked in Child-Pugh class A (68 +/- 15 cm/s, 1246 +/- 486 mL/min, and -1.14 +/- 0.5) than in class C (45 +/- 23, P < 0.05; 704 +/- 492, P = 0.02; and -0.58 +/- 0.38, P < 0.05). Using analysis of variance, cardiac index, systemic vascular resistance, and ascites, but not Child-Pugh class, were related to baseline values and adenosine-induced changes. CONCLUSIONS Adenosine is a potent dilator of the hepatic artery in humans. The data suggest that hepatic arterial blood flow and adenosine-dependent flow reserve in patients with cirrhosis are under systemic hemodynamic or neurohormonal control.
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Affiliation(s)
- G Kleber
- First Department of Medicine, Martin Luther University Halle-Wittenberg, Halle, Germany. Gerhard.
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38
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Abstract
UNLABELLED A traumatic lesion of the ulnar artery (Hypothenar Hammer Syndrome, HHS) is a very rare cause of acral ischemia of the upper extremity. AIM Evaluation of the efficacy of ultrasound techniques in the diagnosis of the HSS. METHOD Based on the knowledge of the patient's history and clinical examination we investigated forearm, hand and digital arteries by continuous wave Doppler. By means of colour-coded duplex sonography (CCDS) we demonstrated the course of the radial and ulnar arteries to the palmar arch. For comparison we used the results of preintervention angiography. RESULTS The diameter of the distal ulnary artery measured in healthy women was 1.8 +/- 0.32 and in men 2.2 +/- 0.46 mm. Among 268 patients with ischemia of the hands we diagnosed HHS in four cases. We identified an aneurysm of the ulnary artery in one case and a thrombotic occlusion in three cases. The thrombotic occlusion of the ulnar artery led to a dilatation of the vascular lumen. The occlusion length could be determined. Vessels diameter and echogenecity gave information about the age of the thrombosis. CONCLUSION The continuous wave Doppler is a major diagnostic contribution because of its ability to register hemodynamic changes. Additionally, CCDS with its combination of sonomorphology and hemodynamics enables a distinction between HHS and other causes of digital ischemia. The CCDS more precisely refines the indications for preinterventional angiography in acute ischemia syndromes of the hand.
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Affiliation(s)
- B M Taute
- Klinik und Poliklinik für Innere Medizin III, Martin-Luther-Universität Halle Wittenberg
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Abstract
Based on two patients suffering from chronic visceral ischemia, the anatomic and pathophysiologic principles prior to surgery are discussed. Antegrade revascularization is supposed to be better hemodynamically. Complete revascularization of multiple arteries seems to be theoretically superior to one-vessel procedures. Within the bypass procedures the aortic-celiac-mesenteric patch bypass could be an excellent surgical possibility combining antegrade with simultaneous revascularization of celiac and superior mesenteric artery.
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Affiliation(s)
- W A Cappeller
- Klinik für Allgemeinchirurgie, Martin-Luther-Universität Halle
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40
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Taute BM, Podhaisky H, Wiegand E, Eifert S, Behrmann C. [Unilateral giant extremity growth, naevus flammeus and chronic venous insufficiency in a 48-year-old patient]. Internist (Berl) 1998; 39:308-11. [PMID: 9561452 DOI: 10.1007/s001080050173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- B M Taute
- Klinik und Poliklinik für Innere Medizin III, Arbeitsbereich Angiologie, Martin-Luther-Universität Halle-Wittenberg
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Deschauer M, Lindner A, Behrmann C, Zierz S. [Multiple, disseminated hypodensities in cranial CT. Multiple disseminated ischemia in pneumococcus-induced cerebral vasculitis]. Radiologe 1997; 37:481-2. [PMID: 9340678 DOI: 10.1007/s001170050242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M Deschauer
- Neurologische Klinik und Poliklinik, Martin-Luther-Universität, Halle-Wittenberg
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Behrmann C, Runge M, Ringe JD. Effects of calcium channel blocking and atrial stimulation on QT time during hyper- and normocalcemia in man. Clin Investig 1992; 70:885-8. [PMID: 1450612 DOI: 10.1007/bf00180433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We investigated how calcium channel blocking agents modify the known decrease of QT time with increasing heart rate and calcium level. Furthermore, we examined how the influence of calcium channel blocking agents is modulated by atrial stimulation. To answer these questions, we measured the QT time both at a spontaneous heart rate and during atrial stimulation with 90 and 110 beats/min before and after intravenous administration of 5 mg verapamil in 23 patients with primary hyperparathyroidism, pre- and postoperatively. Atrial stimulation increased the frequency-related standard values of QT time. The spontaneous heart rate (HR) was influenced by neither the calcium level nor verapamil. The statistically significant correlations QT vs. HR and QT vs. Ca were reduced by verapamil, which indicated its influence. However, this effect did not achieve statistical significance.
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Affiliation(s)
- C Behrmann
- Medizinische Kernklinik und Poliklinik, Universitätsklinik Hamburg Eppendorf
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Behrmann C, Runge M, Ringe JD. Changes in heart rate by verapamil during carotid sinus stimulation in patients with hyperparathyroidism, pre- and postoperatively. Basic Res Cardiol 1992; 87:461-4. [PMID: 1463430 DOI: 10.1007/bf00795058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
It has been investigated whether calcium- and verapamil-dependent sensitivities of carotis baroreceptors also exist in man. To answer this question, we pre- and postoperatively measured changes in heart rate during carotid sinus stimulation before and after intravenous administration of 5 mg verapamil in 23 patients with primary hyperparathyroidism. Findings during hypercalcemia were as expected: a more pronounced reduction of heart rate at comparatively low calcium levels. During normocalcemia, we found an opposite effect: a more pronounced reduction at relatively high calcium levels, which was statistically significant. This fact could be explained according to our interpretation. In previous reports, local effects on baroreceptors were examined, whereas we measured the combined effect of several calcium actions. As expected, verapamil attenuated the decrease in heart rate which, however, was not statistically significant.
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Affiliation(s)
- C Behrmann
- Medizinische Kernklinik und Poliklinik, Universitätskrankenhauses Hamburg-Eppendorf
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