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Biomedical subjects

F Kainberger

Publications and source records attributed to F Kainberger.

At least 109 records · Page 6Linked to original sources
PubMed1994

[Color Doppler ultrasound of kidney transplants. Does the resistance index facilitate diagnosis of chronic kidney failure?].

The retrospective study under report assessed the diagnostic capability of colour Doppler sonography (CDS) with measurement of the resistive index (RI) in the long-term follow-up of patients with renal allografts. 210 CDS examinations were performed in 115 patients. The time since transplantation ranged from 6 months to 22 years. The RI was correlated to laboratory parameters of renal allograft function (serum creatinine, urinary protein levels and serum-cyclosporine). In 97 of 210 examinations, serum creatinine was elevated (> 1.5 mg% or an increase of more then 0.3 mg% within the last 6 months). In 35 out of these examinations RI was > 70%, in 62 RI was < or = 70%. Thus, with a threshold RI of 70%, sensitivity of the RI in the diagnosis of renal allograft dysfunction is 36% and specificity 62%, respectively. There was no significant difference in the RI between examinations of allografts with normal function (68.2% +/- 7.5%) and those with dysfunction (68.5% +/- 8.5%). Furthermore, there was no significant correlation between the RI and any of the laboratory parameters. CDS with calculation of the RI cannot differentiate in the long-term follow-up between allografts with normal function and those with dysfunction.

Adolescent↗
PubMed1993

Colour Doppler imaging of partial subclavian steal syndrome.

The case of a 67-year-old woman with symptoms related to the vertebro-basilar system and blood pressure difference of the upper extremities is presented. Colour-Doppler imaging (CDI) with additional spectral tracing revealed partial subclavian steal syndrome with retrograde flow in the left vertebral artery during systole, which could be significantly enhanced by reactive hyperemia after left arm exercise. Angiography confirmed a high-grade stenosis of the proximal subclavian artery and balloon angioplasty was performed. Noninvasive follow-up by CDI demonstrated regular antegrade vertebral artery flow at rest, but minimal retrograde systolic flow after left arm exercise.

Aged↗
PubMed1993

[Modern intervertebral disk diagnosis].

Recent advances in our knowledge of the pathophysiology and function of the intervertebral disc, in combination with the use of CT and MRI have changed radiological diagnostic algorithms and enlarged our diagnostic scope. Microfissures in the cartilage endplates of the disc and in the endplates of the vertebral bodies and anulus fibrosus are the sequelae of loss of hydration of the nucleus pulposus leading to instability and abnormal load stress. MRI shows these early degenerative changes in the disc, but also reactive processes in the disc and the neighbouring vertebral bodies. On conventional X-rays only segmental malfunctions are visualized. Protrusion and prolapse can be recognized very well by CT, but best of all by MRI. Myelography and discography are very invasive and rarely used. Very important is that protrusion and prolapse are very often diagnosed without any clinical symptoms and that both may heal without any treatment. Therefore conservative treatment of prolapse and/or protrusion is the management of choice. Blastoma and infection of the disc are found in the vast majority of cases only in combination with corresponding diseases of the vertebral bodies. The only important exception are small children, in whom primary bacterial infection of the disc is well known.

Humans↗
PubMed1993

[Diagnostic imaging following surgery of spinal disk herniation].

The magnetic resonance imaging findings recorded in patients after surgery for degenerative disc disease in the lumbar and cervical spine are discussed in comparison with conventional radiographs and computed tomography findings. In the lumbar spine normal postoperative findings in the immediate postoperative period can be demonstrated by MR imaging. Contrast-enhanced MR imaging can differentiate disc herniation from postoperative scar formation with a greater degree of confidence than other imaging modalities. MR imaging improves differentiation between other causes of failed back syndrome such as postoperative hematoma and infection, lateral spinal stenosis and arachnoiditis. In the cervical spine types of operative approaches, the appearance of bony stenosis and disc herniations by MR imaging are discussed. Computed tomography still has a role in the assessment of osseous complications such as central or foraminal stenosis.

Humans↗
PubMed1993

Ultrasonography of the Achilles tendon in hypercholesterolemia.

The ultrasonographic (US) appearance of Achilles tendon was examined in 34 patients with hypercholesterolemia (10 with familial (FH), and 24 with secondary hypercholesterolemia (SH)), and in 22 patients with normal tendons. US findings were compared with clinical, laboratory, and radiologic results. In patients with FH, typical xanthomas in the form of hyperechoic tendinal tumors were found in only 15% while various forms of inhomogeneity of tendon structure without xanthoma formation were found in 75%. The high rate of tendon inhomogeneity may be due to the concomitant occurrence of both xanthomas and degeneration of tendon fibers. Physical examination revealed abnormalities in 60% of these patients. At CT of the tendons, abnormalities were found in 65% of the FH patients and in 40%, abnormalities were shown by plain radiography. In SH, the results did not differ significantly from normal controls. In our opinion US should be used to prove or rule out Achilles tendon abnormalities in patients with FH for prophylaxis and treatment of tendinitis and tendon rupture.

Achilles Tendon↗
PubMed1993

[Systematic strength training in the postmenopause: accompanying densitometric control with DXA].

Of all the forms of osteoporosis, the postmenopausal type is the most important in social medicine due to the potentially high fracture risk in aging. The positive effects of physical activity on bone density have been emphasized in several studies. In this study on 31 female volunteers (minimum age 50 years), who had been postmenopausal for at least 2 years, 16 underwent systematic strength building (training group). They were compared with a control group consisting of 15 female volunteers. The parameters of success were physical strength and bone mineral density (BMD) before and after training. BMD was measured by dual-energy X-ray absorptiometry. The subjects in the control group showed significant decrease in bone density after 6 months: between 6.7 and 22.3% of the values measured at the beginning. The loss was more evident in the proximal femur than in the lumbar spine. In contrast, the subjects in the training group only showed a marginal decrease in bone density in the proximal femur: 0.8 to 3.8% of the earlier values. In the lumbar spine there was even a slight increase (+0.3%) in bone density.

Absorptiometry, Photon↗
PubMed1992

Renal transplant hemodynamics in children: prospective analysis of colour coded versus pulsed Doppler sonography.

In 30 children with renal allografts the diagnostic validity of pulsed Doppler (PD) versus colour coded Doppler (CD) sonography was assessed prospectively. 46 PD examinations were performed calculating the resistive index (RI) in the segmental arteries in comparison to 46 CD scans, where renal blood flow throughout the grey-scale image was displayed. In addition, point-spectral analysis with calculation of the RI was also performed on the CD scans. The time for examination ranged from five to ten minutes for the PD and from three to five minutes for the CD study. Concordant findings for the PD and CD technique were generally obtained (normal blood flow pattern on PD-excellent visualization of renal blood flow on CD, reduced or reversed diastolic flow on PD-poor visualization of renal blood flow on CD). There was close correlation of the RI values obtained by the PD and CD scans. CD sonography facilitated point-spectral analysis in shortening the time for examination. The ability to visualize focal hemodynamic alterations provided a higher diagnostic accuracy in comparison to PD sonography.

Adolescent↗
PubMed1992

[Sonographic structural analysis of the Achilles tendon and biomechanical implications].

Ruptures of the Achilles tendon mainly occur on the ground of predisposing destruction of tendon structure. The aim of this retrospective US study was to evaluate the location and extent of tendon abnormalities. 62 patients (49 male, 13 female; 19 to 57 years, mean 38) with achillodynia of short duration and/or clinically suspected tendon abnormalities were evaluated sonographically. Together with a review of the literature, US findings (location, extent, and echo pattern) were compared with clinical findings. With US, abnormalities could be detected with a sensitivity of 0,76 and a specificity of 0.9. Pathologic lesions could be grouped as follows: (1) pain without any clinical signs or US findings (tenalgia); (2) nodular tendinitis which in 52% appeared in the form of a tiny hypoechoic lesion in the ventromedial part of the tendon 2-3 cm proximal to the os calcis; (3) peritendinal oedema; (4) circumscribed tendon swelling, (5) extensive inhomogeneities of tendon structure. With US, abnormalities of the Achilles tendon may be detected at an early stage of the disease and hence the risk of tendon rupture may be predicted to better advantage.

Achilles Tendon↗
PubMed1992

[The screening of renal artery stenoses. The initial results with the value of color Doppler sonography].

The value of colour Doppler sonography in the diagnosis of renal artery stenosis has been studied retrospectively. 17 patients were examined (34 main renal arteries and 7 accessory renal arteries; ages 37 to 84 years; 7 males and 10 females). We studied 1) ability to study the main renal arteries, 2) visibility of accessory renal arteries and 3) the sensitivity and specificity of colour Doppler sonography for the diagnosis of renal artery stenosis. The results were compared with intraarterial angiography. Demonstration of the main renal arteries with colour Doppler sonography was possible in 23 of the 34 vessels. Not a single of the 7 accessory renal arteries was demonstrated by colour Doppler sonography. Of 8 angiographically demonstrated stenoses (more than 50% narrowing) 2 were missed by colour Doppler sonography. One stenosis was correctly diagnosed and 5 were incorrectly evaluated by sonography. 16 out of 18 angiographically normal main renal arteries were correctly evaluated by colour Doppler sonography but 2 showed a false positive finding. This results in a sensitivity of 17% and a specificity of 89% per kidney. Colour Doppler sonography cannot be recommended as a screening method for renal artery stenosis in view of its limited accuracy.

Adult↗
PubMed1992

[Renal osteodystrophy: the spectrum of the x-ray symptoms in modern forms of kidney transplantation and long-term dialysis therapy].

Plain film radiography and microradioscopy represent standard imaging for diagnosis and grading of renal osteodystrophy. The aim of this retrospective study was to evaluate the effects of modern therapeutic regimens on skeletal abnormalities as diagnosed radiographically. 198 patients were investigated. X-ray findings of 38 patients from 1981-1983 (16-66 years, 40.1 +/- 13.4; 23 male, 15 female) were compared with those of 160 patients from 1991 (20-71 years, 48.4 +/- 12.5; 98 male, 62 female). We found significant differences in respect of the spectrum and the degree of skeletal abnormalities. The prevalence of phalangeal resorptions lowered from 87 to 50%, the prevalence of soft tissue calcification from 68 to 57%. Therefore, renal osteodystrophy is not as extensive as it was ten years ago, but it still continues to be an unavoidable complication of renal insufficiency.

Adolescent↗
PubMed1992

Comparison of dual energy X-ray absorptiometry of the proximal femur with morphologic data.

Measurements of bone mineral density (BMD) of the proximal femur (including femoral neck, Ward's triangle and trochanteric region) were compared with the Singh index grading in 40 normal subjects (20 male, 20 female) and in 116 patients (18 male, 98 female) referred for assessment of possible osteoporosis. Additionally, the BMD and the Singh index of 12 cadaver specimens (6 male, 6 female) of the proximal femur were compared with each other and with the histomorphology of the femoral necks of the specimens. Although there was a good correlation of Singh index with BMD in the group of male patients with suspected osteoporosis and in the series of bone specimens, there was a poor correlation in the group of female patients as well as in the normal controls and in the patient population as a whole. There was also poor correlation of Singh index values with histomorphologic data, whereas the BMD measurements correlated well with the amount of calcified bone found histologically in the femoral necks of the bone specimens. We conclude that the Singh index cannot be used to predict BMD of the proximal femur accurately.

Absorptiometry, Photon↗
PubMed1991

Color-coded Doppler sonography of vertebral arteries.

Color-coded Doppler sonography of the vertebral arteries was performed in 86 patients who had a history of vertebrobasilar disease. The origin of the artery was visualized in 87.2% on the right and 70.9% on the left side. The inter-transverse portion of the vertebral artery was visualized in 95% on the right and 97% on the left side. The atlas loop could be visualized in 88.4% on the right and 84.9% on the left side. Pathologic findings were hypoplasia (n = 4), stenosis (n = 19), dissection (n = 2), occlusion (n = 7), kinking (n = 12), cervical tumors (n = 3), and subclavian steal syndrome (n = 3). Nine postoperative patients had subclavian and vertebral artery reimplantation to the common carotid artery. The characteristic color-coded Doppler sonographic features of these findings are presented and discussed.

Angiography↗
PubMed1991

[Pseudotumor of the orbit in pediatrics. Diagnostic imaging].

Orbital pseudotumor is an inflammatory lesion with increased orbital mass and a typical rapid onset. It is very uncommon in children. Diagnosis is difficult and there is no uniform procedure. Two patients with different forms of this entity are presented, and their clinical symptoms and CT and ultrasonographic features are discussed. We found the CT and US findings to be important for the differential diagnosis. Therefore, these diagnostic modalities should be applied immediately on the onset of typical clinical symptoms, because the condition can result in ophthalmoplegia and amaurosis if not treated at once.

Child, Preschool↗
PubMed1990

[Velocity variance function: additional information in color-coded Doppler sonography of the carotids].

A new software, called the velocity variance programme, by which flow disturbances are additionally colour-coded, was systematically applied with colour Doppler sonography in 59 patients with stenotic atheromatous lesions of different grades in the carotid bifurcation. A direct comparison with and without using this programme was made. In group 1 (n = 23) with stenosis of the internal carotid artery of more than 50% it could be demonstrated that flow disturbances were maximally in the region immediately downstream of the stenosis and complete dissipation of these effects occurred within 8-10 vessel diameters downstream. Moreover, a direct correlation between the size of the region of disturbed flow and the irregularity of the stenotic plaque surface within the stenosis could be demonstrated. Distal to the stenosis there was an inverse relationship between the extension of disturbed flow and the length of the stenosis and a direct relationship to the grade of the stenosis and the irregularity of the plaque surface. In patient group 2 (n = 36) with less than 50% diameter reduction, a local flow disturbance near the atheromatous plaque was shown in 27 patients. In eighteen of these patients the region of disturbed flow could be revealed only by using the velocity variance programme. The importance of this non-invasive in-vivo visualisation of flow disturbances in the carotid bifurcation is discussed.

Arteriosclerosis↗
PubMed1990

[Sonographic localization of the kidneys for the purpose of radiation treatment of the abdomen: how accurate is this method?].

In 31 patients, the kidneys were located with ultrasonography before urography was carried out. The projection of the medial, lateral, cranial and caudal margins of the kidney were marked on the patient's back with a pellet. On X-ray film, the mean distance between the pellet and margin of the kidney varied from 0.12 to 1.13 cm; nevertheless the standard deviations were high (up to 2.63 cm). In 11 patients, more than one-third of the kidney was located outside the sonographically determined borders; on the left side this happened in 10 patients. We conclude that sonographical localization of the kidneys for protection during irradiation of the abdomen should only be used when other localization procedures cannot be carried out.

Abdomen↗
PubMed1990

Renal osteodystrophy. Radiological diagnosis compared with a new radioimmunoassay method of parathyroid hormone.

The parathyroid hormone concentration in the blood measured by the 'two-site radioimmunoassay', which is specific for the biologically active parathyroid molecule (parathyrine), was compared with the radiological manifestations of secondary hyperparathyroidism (HPT) on magnification radiographs of the phalanges in patients undergoing maintenance hemodialysis and in patients with renal allografts. Sensitivity of radiology for the diagnosis of HPT proved to be high (88%), whereas specificity was low (30%). Statistical analysis showed that there was a good correlation between the parathyrine levels and the intensity of radiological changes in the phalanges in patients with renal allografts (coefficient of Krueger-Spearman = 0.65). In patients undergoing hemodialysis the correlation between laboratory parameters and radiological changes was poor.

Adult↗