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Biomedical subjects

E Dinkel

Publications and source records attributed to E Dinkel.

At least 37 records · Page 2Linked to original sources

Renal growth in patients nephrectomized for Wilms tumour as compared to renal agenesis.

Compensatory growth in 27 undiseased congenital solitary kidneys and in 31 solitary kidneys in patients with Wilms tumour was monitored in long-term follow-up studies by ultrasound volume biometry. In congenital solitary kidneys hypertrophy was not detectable at the time of birth. Parenchymal mass increase achieved 188% of the volume of a healthy kidney within at least 4 years of life and afterwards paralleled the physiological growth documented in healthy kidney pairs. Disease-free kidneys in Wilms tumour patients all developed a similar 180% volume augmentation within 2-4 years after nephrectomy, irrespective of the chosen mode of radiation and single or triple chemotherapy. The age of the patient at onset of surgical and concomitant conservative therapy determined slight differences in kinetics but not in degree of compensatory growth.

Adolescent↗

[Comparative bone density measurements in healthy women and women with osteoporosis].

To compare methods of noninvasive measurement of bone mineral content, 40 healthy early postmenopausal women and 68 postmenopausal women with osteoporosis were studied. The methods included mono- and dual-energy quantitative computed tomography (QCT) and dual-photon absorptiometry (DPA) of the lumbar spine, single-photon absorptiometry (SPA) of the distal third of the radius, and combined cortical thickness (CCT) of the second metacarpal shaft. Lateral thoracolumbar radiographic studies were performed and the spinal fracture index calculated. There was good correlation between QCT and DPA methods in early postmenopausal women and moderate correlation in postmenopausal osteoporotic women. Correlations between spinal measurements (QCT or DPA) and appendicular cortical measurements (SPA or CCT) were moderate in healthy women and poor in osteoporotic women. Measurements resulting from one method were not predictive of measurements obtained by another method for individual patients. The strongest correlation with severity of vertebral fracture was provided by QCT and the weakest by SPA. There was good correlation between single- and dual-energy QCT results. Osteoporotic women and younger healthy women can be distinguished by the measurement of spinal trabecular bone density using QCT, and this method is more sensitive than the measurement of spinal integral bone by DPA or of appendicular cortical bone by SPA or CCT.

Adult↗

[Sonographic imaging and assessment of stomach wall changes].

By the use of a special method of investigation, the true value of percutaneous echography was investigated using 28 patients with primary gastric neoplasms and 3 patients with secondary infiltration of the gastric wall, for the proof and the judgement of the tumors, their extension and their metastases. Tumorous gastric wall thickening could be demonstrated in 87% (27/31), tumor invasion in neighbouring structures in 85% (12/14) and lymph nodes metastases in 66% (10/15). In all patients, who had liver metastases (4) or ascites (5) they were demonstrable. The sonographic appearance of the different gastric wall changes are described and discussed.

Adult↗

[Computerized tomography in thoracic trauma].

Chest CT scans were obtained in 86 patients suffering from serious blunt or penetrating chest trauma. The finding of mediastinal widening was by far the most common CT indication. CT proved to be a more sensitive method for detection of parenchymal lung lesions and occult pneumothorax than bedside radiographs. CT contributed substantially in differentiation of lung abscess and empyema, exclusion of mediastinal pathology and spinal injuries. Aortography is still indicated, even when CT findings are normal if aortic laceration is clinically suspected. Despite all of the technical problems combined with CT examinations in the critically ill patient, we consider CT a valuable diagnostic tool for certain problems in the traumatized patient.

Aortic Dissection↗

[Roentgen diagnosis in diaphragmatic trauma].

The diagnostic value of roentgenology in 85 patients who had to undergo surgery because of diaphragmatic rupture at the university of Freiburg from 1973 to 1985 is reviewed. The ratio of left- to right-sided diaphragmatic rupture is 62 to 23. Preoperatively the following diagnostic procedures were used: chest film examination in 82, plain film of the abdomen in 64, contrast radiographs of the gastrointestinal tract in 21, ultrasonography in 37, computed tomography in 8 and angiography in 9 patients. Sensitivity and specificity of these diagnostic methods depend on an intrathoracic prolapse of abdominal structures and on the existence of concomitant injuries. The combination of all these procedures improved the diagnostic accuracy. In 11 patients a diaphragmatic rupture was only detected by surgery.

Adolescent↗

[The thymus gland in computerized tomography. Normal findings and pathology].

The diagnostic value of CT in follicular thymic hyperplasia and in thymomas in 8 patients with myasthenia gravis and in 12 patients without myasthenia gravis suffering from thymic tumors was evaluated by correlating CT-findings to surgical results and pathological-histological findings. Thymic size of the six patients with histologically proven follicular hyperplasia were scattered within the normal range, but half of them were at the upper limit. Thymic tumors were differentiated between invasive and non invasive tumors by CT staging. Solid tumors with different histology could not be further classified; the attenuation values ranging from 15-55 HU were the same in tumors, follicular hyperplasia and normal thymus.

Carcinoid Tumor↗

Real-time ultrasound in Crohn's disease: characteristic features and clinical implications.

Thirty-two children with Crohn's disease were evaluated by real-time ultrasonography. The typical pattern of Crohn's disease caused by bowel wall thickening is the "bull's eye phenomenon", the elongated tubular stiff bowel loop with narrowing of the lumen and the small bowel conglomerate tumor. In indefinable abdominal complaints sonography may lead to the correct diagnosis. The differential diagnosis of similar sonographic features and the limitations of ultrasound in gastrointestinal disease must be considered. In proven Crohn's disease the findings in follow-up match the clinical course and may delineate complications, such as ileus, abscess, hydronephrosis, gallstones or involvement of parenchymal organs, as seen in 15 patients. Thus ultrasound will restrict repeated x-ray studies and support patient management.

Adolescent↗

Intraarterial digital subtraction angiography of renal transplants.

Nineteen renal allograft recipients with suspected vascular pathology of the graft were examined by digital subtraction angiography combined with intraarterial catheter technique. Image quality was excellent and diagnosis was definite in all cases. Dosages of contrast medium are reduced to a minimum (1.5 g iodine/patient) and the risk of nephrotoxic side effects is virtually negligible with this technique.

Adult↗

Leiomyoma of the bladder.

A case of leiomyoma of the bladder in a 37-year-old man is described. Clinical features and findings on excretory urography resembled a malignant tumor of the small pelvis. Ultrasound, computed tomography, and angiography nevertheless made the correct preoperative diagnosis. Special emphasis is given to the differentiation between benign and malignant smooth muscle neoplasms.

Adult↗

[Sonographic determination of the normal kidney volume in newborn infants and infants].

The kidneys of 211 infants (106 males, 105 females) were measured sonographically. Renal length, width and depth and the calculated kidney volume were correlated to body weight, body length and body surface. It was possible to establish a nomogram, which presented a good correlation between body weight and kidney volume and which can easily be used for routine ultrasound examination. In another prospective study the kidney volumes of 82 young infants were within the normal range of this nomogram.

Biometry↗

Renal sonography in the differentiation of upper from lower urinary tract infection.

Increase in renal volume and asymmetry in kidney size determined by sonography proved to be a valuable diagnostic criterion for differentiation between infections of the upper and lower urinary tract in 175 children: acute bacterial interstitial nephritis (79) and lower urinary tract infection (96). Kidney volume in acute pyelonephritis increased to an average of 175% of normal. In 71% of cases, affected kidneys showed an enlargement of at least 2 SD when compared with a group of 325 children without kidney pathology. Most impressive kidney enlargement was seen during the first year of life. In 50% of cases, acute pyelonephritis caused a bilateral increase in renal size and/or distinct volume asymmetry. Kidneys of patients with lower urinary tract infections had a mean volume of 99.68% and a physiologic volume asymmetry comparable to normal kidneys.

Acute Disease↗

[Morphology and diagnosis of bone tumors of the foot].

We report on 554 bone tumors and tumor-like lesions of the foot, which have been diagnosed within the period from 1945-1985 in the Department of Diagnostic Radiology, in the Surgical and Orthopedic Departments and in the Division of Pathology of Bone Tumors of the University of Freiburg. Schajowicz' WHO classification criteria for bone tumors were used. Morphological aspects, clinical symptoms and pattern of distribution differ widely from lesions of other skeletal regions. Bone tumors of the foot are much more frequently associated with pain caused by the special anatomy of the foot. Malignant lesions are very rare in the foot. We found only 42 malignant tumors corresponding to 1.4% of all malignant bone tumors. By contrast 13% of all benign bone tumors are localized in the foot. However, 90% of them are osteochondromas and chondromas. Other benign lesions are rare, especially tumors arising from connective tissue of bone. In several cases correct diagnosis was only possible by histologic examination whereas modern digital imaging did not substantially add to conventional plain film and tomographic examination. Preoperative CT scans were very useful for exact planning of surgical procedures especially in benign tumors.

Bone Cysts↗

[Sonographic diagnosis of the gastrointestinal tract].

Ultrasound examination is an established screening procedure for illdefined abdominal complaints and is complementary to the abdominal plain film. The bull's eye phenomenon due to bowel wall thickening is the characteristic feature of bowel pathology. Ultrasound is the method of proof for hypertrophic pyloric stenosis, imperforate anus or ascites. Findings of edematous (intussusception), inflammatory (Crohn disease) and neoplastic stomach or bowel disease require confirmation by radiology or endoscopy. Ultrasound of the gastrointestinal tract allows the selection of further diagnostic procedures and thus accelerates the diagnostic work-up.

Anus, Imperforate↗

[Bacterial and abacterial inflammatory kidney diseases. Diagnostic value of the sonographic determination of kidney volume].

The diagnostic value of ultrasound kidney biometry in the diagnosis of parenchymatous kidney disease was evaluated in 277 children. Kidney enlargement of more than 140% of normal volume proved to be a sensitive criterion for differentiation of acute bacterial interstitial nephritis (pyelonephritis) and isolated lower urinary tract infection. Mean kidney volume in acute pyelonephritis was 175%. Normalization of kidney volume under antibiotic treatment required 4-6 days. Kidneys with non-bacterial nephritis and glomerulonephritis showed a 63% pathological size increase at biopsy; the kinetics of kidney volume in the acute phase of the disease paralleled the clinical course.

Adolescent↗

[Preoperative tumor staging in rectal cancer--a prospective study].

A precise preoperative tumor staging is the prerequisite of distinct treatment planning and subtle operative regimen. Diagnostic contribution of the various examination techniques especially of imaging modalities were determined in a prospective study and correlated to intra- and postoperative findings. The TNM classification of malignant tumors of the UICC, both in its present valid and the modified form to be introduced in January 1987, formed the basis of our clinical diagnostic staging. Diagnostic accuracy in tumor staging increased significantly from 63.4% to 83.9%, if digital rectal examination, rectoscopy and barium enema were accompanied by computed tomography. Staging prediction solely concerning the surgically important differentiation between tumors "organ limited" (T1/T2 stage) and "organ extended" (T3/T4 stage) achieved an accuracy of 91/4 (97.0%).

Adult↗

Kidney size in childhood. Sonographical growth charts for kidney length and volume.

Kidney size was determined in a sonographic study of 325 children without kidney pathology. Real-time ultrasound equipment adjusted for the pediatric age group, provided standardized renal biometry. Outer kidney diameters showed a linear correlation to somatic developmental parameters. Renal volume was established by the formula for an ellipsoid and showed good correlation to body weight. Growth charts for kidney length and volume in childhood are constructed and provide the basis for objective intra- and interindividual determination of renal size.

Adolescent↗

Sonographic biometry in obstructive uropathy of children: preoperative diagnosis and postoperative monitoring.

Renal sonography was performed in 92 children with obstructive uropathy or vesicoureteral reflux preoperatively and at follow-up. Renal volume and the anteroposterior diameter of the renal pelvis proved to be the most reliable morphometric criteria for objective sonographic staging and follow-up of urinary tract obstruction. If transient obstruction occurred after uncomplicated antireflux ureterovesico-plasties (n = 41), it lasted at most 4 weeks. Kidneys with transient postoperative ureterovesical junction obstruction (n = 21) reverted to normal sonographic pattern within 4 weeks following ureteral reimplantation. In cases of ureteropelvic junction obstruction (n = 30), it took up to 6 months for the majority of kidneys to present almost normal sonographic findings. Sonographic biometry and the knowledge about the uncomplicated postoperative course render postsurgical monitoring easier and more reliable.

Adolescent↗