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  • 1
    Language: German
    In: Radiologie up2date, 06/2018, Vol.18(02), pp.91-94
    ISSN: 1616-0681
    E-ISSN: 1617-8300
    Source: Thieme Publishing Group (via CrossRef)
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  • 2
    Language: English
    In: The Lancet, 19 July 2014, Vol.384(9939), pp.280-280
    Description: Contrast-enhanced CT scan showed extensive bilateral pulmonary emboli (figure), with right ventricular dilatation and interventricular septal bowing, confirming the diagnosis of pulmonary embolism.1 Right ventricular dysfunction was shown on transthoracic echocardiography, with paradoxical movement of the ventricular septum. Acute thrombolysis was not considered because of her recent trauma and surgery, and stable vital signs.2 Anticoagulation was continued with the oral Xa inhibitor rivaroxaban.3 Compression ultrasonography of the right leg showed a deep vein thrombus with occlusion of the fibular, posterior tibial, and popliteal veins.
    Keywords: Medicine
    ISSN: 0140-6736
    E-ISSN: 1474-547X
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  • 3
    Language: English
    In: Langenbeck's archives of surgery, January 2012, Vol.397(1), pp.69-74
    Description: The efficacy of Heller myotomy in patients 〉40 years-a significant predictor suggesting a favorable response to pneumatic dilation-has been questioned. The aim of our study was to evaluate the results obtained in patients aged 40 years undergoing minimally invasive surgery (MIS) for achalasia. In January 2008, we established the MIS technique for achalasia in our clinic. In the following period from January 2008 to March 2011, 74 patients underwent primary laparoscopic myotomy for achalasia. The procedure was accomplished with an anterior 180° semifundoplication according to Dor in all patients. The Eckardt score and the Gastrointestinal Quality of Life Index (GQLI) served as outcome measures. The median age of patients was 45.5 years (range, 18-85 years) with a median duration of preoperative achalasia symptoms of 57 months (range, 2-468 months). There were no conversions to open surgery and-except for one patient with a sterile pleural effusion-no postoperative complications. At a median follow-up of 12 months, the preoperative Eckardt score of 7.0 (range, 3-12) was found to be significantly decreased to a median of 2 (range, 0-6; P 40 years, the postoperative Eckardt score obtained in the older patient population was not significantly lower (P = 0.074). There was no statistically significant difference between the two groups with respect to the postoperative GQLI (P = 0.860). Neither gender nor preoperative Botox injection or pneumatic dilation inserted a significant influence on the postoperative clinical outcome (P 〉 0.05). Laparoscopic Heller myotomy for achalasia is associated with a high success rate as the primary therapeutic option and after failure of endoscopic therapy. It can be performed safely and with favorable outcomes also in patients 〉40 years. However, the long-term durability of the procedure remains to be established.
    Keywords: Esophageal Achalasia -- Surgery ; Esophagus -- Surgery ; Laparoscopy -- Methods
    ISSN: 14352443
    E-ISSN: 1435-2451
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  • 4
    Language: English
    In: Journal of Vascular Surgery, September 2015, Vol.62(3), pp.594-599
    Description: In thoracoabdominal aortic aneurysms (TAAAs), a paradigm shift is observed from open surgery toward total endovascular aortic repair using fenestrated and branched endografts. Whereas outcome after open replacement in terms of mortality and paraplegia has been evaluated extensively, no studies exist addressing long-term patency of visceral and renal vessels. To enable comparison of target vessel patency between open and endovascular treatment, we analyzed our series of open TAAA replacements. Our vascular surgery database was screened for patients who received open TAAA replacement between 1998 and 2012, and patient records were analyzed retrospectively. All available imaging scans (computed tomography and magnetic resonance angiography: preoperative, postoperative, and follow-up) were evaluated for graft and vessel patency. We identified 62 patients (mean age, 66 ± 10 years; 40 men) who had been operated on for aneurysms of Crawford types I (8), II (13), III (13), and IV (24) and Safi type V (4). A total of 181 vessels were revascularized by either patch inclusion (n = 147) or selective revascularization (bypass or transposition, n = 34); 48 survived the procedure, resulting in a number of vessels available for follow-up of 154 (patch, 126; selective revascularization, 28). The respective patency rates for overall, patch, and selective revascularization were 95.2%, 94.2%, and 100% at 5 years and 83.7%, 81.3%, and 100% at 10 years, respectively. In addition, a trend for better performance of selective revascularization (bypass or transposition) was evident as all vessel occlusions were observed in cases of patch inclusion, whereas all selectively revascularized vessels were patent. The respective patency rates for the celiac trunk, superior mesenteric artery, and left and right renal artery were 100%, 97.5%, 92.3%, and 90.3% at 5 years. In our series of open thoracoabdominal aortic replacement, excellent patency rates for revascularized renal and visceral vessels were observed during long-term follow-up. We were able to provide a reference value of long-term target vessel patency that can and should be taken into account to judge the efficacy of endovascular repair in TAAA.
    Keywords: Medicine
    ISSN: 0741-5214
    E-ISSN: 1097-6809
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  • 5
    Language: English
    In: The Lancet, July 19, 2014, Vol.384(9939), p.280
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0140-6736(14)60882-5 Byline: Konrad F Schlicht, Klaus Mann, Florian Jungmann, Joachim Kaes, Felix Post, Thomas Munzel, Klaus Lieb Author Affiliation: (a) Department of Psychiatry and Psychotherapy, University Medical Centre Mainz, Mainz, Germany (b) Department of Radiology, University Medical Centre Mainz, Mainz, Germany (c) Department of Cardiology and Angiology, University Medical Centre Mainz, Mainz, Germany
    ISSN: 0140-6736
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  • 6
    Language: English
    In: BMC Surgery, 01 May 2018, Vol.18(1), pp.1-5
    Description: Abstract Background The anatomic variations of the visceral arteries are not uncommon. The liver arterial blood supply shows 50% variability between humans, with the most common anatomy being one hepatic artery arising from the celiac trunk and one pancreatico-duodenal arcade between the celiac trunk and the superior mesenteric artery. Occlusion of one artery are mostly asymptomatic but may become clinically relevant when surgery of the liver, bile duct or the pancreas is required. If these pathologies are not reversible, an oncologic pancreatic head resection cannot be performed. Case presentation We report the case of a 64-year-old Caucasian female patient with a locally advanced, resectable adenocarcinoma of the pancreas with complete atherosclerotic occlusion of the celiac trunk and the superior mesenteric artery. This vascular anomaly was missed on the preoperative imaging and became known postoperatively. A collateral circulation from a hypertrophic inferior mesenteric artery to the celiac trunk and the superior mesenteric artery compensated the blood supply to the visceral organs. The postoperative course was complicated by an elevation of the transaminases AST/ALT, which normalized under conservative treatment with alprostadil (prostavasin™) and anticoagulation, since angiographic recanalization failed. The patient recovered fully and was discharged at the 14th postoperative day. Two years later, she required endovascular repair of an aortic rupture during which the inferior mesenteric artery was preserved. Conclusion This case underlines the natural potential of the human body to adapt to chronic arterial malperfusion by creating a collateral circulation and supports the need for adequate preoperative imaging, including a proper arterial phase before upper abdominal surgery.
    Keywords: Pancreaticoduodenectomy ; Mesenteric Arteries ; Occlusion ; Celiac Trunk
    E-ISSN: 1471-2482
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  • 7
    Language: English
    In: Journal of Vascular Surgery, June 2015, Vol.61(6), pp.33S-34S
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jvs.2015.04.057 Byline: Bernhard Dorweiler, Marwan Youssef, Achim Neufang, Florian Jungmann, Christian-Friedrich Vahl Author Affiliation: University Medical Center, Division of vascular Surgery, Mainz, Germany Article Note: (footnote) Author Disclosures: B. Dorweiler: Nothing to disclose; M. Youssef: Nothing to disclose; A. Neufang: Nothing to disclose; F. Jungmann: Nothing to disclose; C. F. Vahl: Nothing to disclose.
    Keywords: Medicine
    ISSN: 0741-5214
    E-ISSN: 1097-6809
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  • 8
    Language: English
    In: Langenbeck's Archives of Surgery, 2012, Vol.397(1), pp.69-74
    Keywords: Achalasia ; Minimally invasive Heller myotomy ; Dor semifundoplication ; Eckardt score ; Gastrointestinal quality of life index (GQLI)
    ISSN: 1435-2443
    E-ISSN: 1435-2451
    Source: Springer Science & Business Media B.V.
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  • 9
    Language: English
    In: European Radiology, 2017, Vol.27(12), pp.5049-5055
    Description: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00330-017-4923-8 Byline: Daniel Pinto dos Santos (1,2), Jonas Welter (1), Tilman Emrich (1), Florian Jungmann (1), Evelyn Dappa (1), Peter Mildenberger (1), Roman Kloeckner (1) Keywords: Quality Assurance, Health Care; Radiography; Fractures, Bone; Diagnostic Imaging; Computer Terminals Abstract: Objective To compare the diagnostic accuracy of medical-grade and calibrated consumer-grade digital displays for the detection of subtle bone fissures. Methods Three experienced radiologists assessed 96 digital radiographs, 40 without and 56 with subtle bone fissures, for the presence or absence of fissures in various bones using one consumer-grade and two medical-grade displays calibrated according to the DICOM-Grayscale Standard Display Function. The reference standard was consensus reading. Subjective image quality was also assessed by the three readers. Statistical analysis was performed using receiver operating characteristic analysis and by calculating the sensitivity, specificity, and Youden's J for each combination of reader and display. Cohen's unweighted kappa was calculated to assess inter-rater agreement. Subjective image quality was compared using the Wilcoxon signed-rank test. Results No significant differences were found for the assessment of subjective image quality. Diagnostic performance was similar across all readers and displays, with Youden's J ranging from 0.443 to 0.661. The differences were influenced more by the reader than by the display used for the assessment. Conclusion No significant differences were found between medical-grade and calibrated consumer-grade displays with regard to their diagnostic performance in assessing subtle bone fissures. Calibrated consumer-grade displays may be sufficient for most radiological examinations. Key points AaAaAeAccents Diagnostic performance of calibrated consumer-grade displays comparable to medical-grade displays. AaAaAeAccents There is no significant difference with regard to subjective ima quality. AaAaAeAccents Use of calibrated consumer-grade displays could cut display cos by 60-80%. Author Affiliation: (1) Department of Diagnostic and Interventional Radiology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany (2) Department of Radiology, University Hospital Cologne, KAaAaAeA ln, Germa Article History: Registration Date: 01/06/2017 Received Date: 19/12/2016 Accepted Date: 01/06/2017 Online Date: 28/06/2017
    Keywords: Quality Assurance, Health Care ; Radiography ; Fractures, Bone ; Diagnostic Imaging ; Computer Terminals
    ISSN: 0938-7994
    E-ISSN: 1432-1084
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  • 10
    Language: English
    In: RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, March 2018, Vol.190(3), pp.237-249
    Description: Coronary artery bypass grafting (CABG) is still an important therapeutic approach in the treatment especially of advanced coronary artery disease. In this study, we elucidate the current role of multidetector computed tomography angiography (MD-CTA) in imaging patients after CABG surgery. This study is based on recent reports in the literature (2007 - 2016) on imaging of CABG using 64-slice MD-CT scanners and beyond. We included 13 reports that compared ECG-gated MD-CTA with conventional invasive coronary angiography (ICA) as the reference standard for the assessment of graft patency and for the detection of 〉 50 % stenoses. These studies had to provide absolute values for true-positive, true-negative, false-positive and false-negative results or at least allow calculation of these numbers. In total, 1002 patients with 2521 bypass grafts were the basis for this review. The sensitivity and specificity for the assessment of graft patency or the detection of 〉 50 % graft stenosis were 97.2 % and 97.5 %, respectively. The negative and positive predictive values were 93.6 % and 99 %, respectively. By using prospective ECG-gating and an increasing pitch factor, the radiation dose exposure declined to 2.4 mSv in the latest reports. ECG-gated MD-CTA provides a fast and reliable, noninvasive method for assessing patients after CABG. The most substantial benefit of the newest CT scanner generations is a remarkable reduction of radiation dose exposure while maintaining a still excellent diagnostic accuracy during recent years. · MD-CTA using 64-slice MDCT scanners and beyond is a reliable, noninvasive method for evaluating CABGs.. · Technical advances such as prospective ECG-gating, iterative reconstruction algorithms and high-pitch scanning lead to a remarkable drop-down in radiation dose exposures as low as 2.4 mSv.. · Despite significant dose reductions, MD-CTA could maintain a high diagnostic accuracy in evaluating CABGs in recent years.. · Jungmann F, Emrich T, Mildenberger P et al. Multidetector Computed Tomography Angiography (MD-CTA) of Coronary Artery Bypass Grafts - Update 2017. Fortschr Röntgenstr 2018; 190: 237 - 249.
    Keywords: Coronary Artery Bypass ; Computed Tomography Angiography -- Methods ; Coronary Angiography -- Methods ; Coronary Disease -- Diagnostic Imaging ; Graft Occlusion, Vascular -- Diagnostic Imaging ; Multidetector Computed Tomography -- Methods ; Postoperative Complications -- Diagnostic Imaging
    E-ISSN: 1438-9010
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