Biomedical subjects
Publications and source records attributed to G Alzen.
Unusual sonographic behavior of intussusception is demonstrated in 4 cases. The results of 54 well-documented cases have shown two possible deviations from the normal sonographic pattern of an intussusception. The first was a highly reflective target sign, and the second a loss of regular sonographic structure in a tumor-like mass.
A 27-year-old Columbian male was arrested in Aix la Chapelle at the border to Belgium, as he was suspected, of smuggling drugs in his body. Ultrasonographic and radiographic examinations revealed numerous packets in the colon descendens and the ampulla recti. After administration of laxatives, 70 packets were excreted that had been swallowed 3 days before in Bogota, Columbia. Each packet consisted of two rubber bags that were separately knotted with cord, layers of plastic foil, two further knotted rubber bags; the pressed core of cocaine was an average 3.8 cm in length, 1.9 cm in diameter, and 10.2 g in weight. The cocaine hydrochloride content ranged from 75.7% to 100%, with an average of 81.9%. The total net weight came to 714 g. Urine analysis revealed no cocaine metabolites, but metamizole and metamizole metabolites were present as a result of administration of Buscopan compositum during the flight to prevent premature excretion of the packets.
Digital electronics now play a role in every branch of diagnostic imaging. One of the most recent methods, digital radiography (DR) makes it possible to store and view radiographs in the form of a matrix of discrete values. The present review describes the components needed for DR imaging and archiving as well as the advantages and disadvantages of the system. The use of storage phosphor is hereby of special interest. By enableing the viewer to process the images, it is hoped that DR will open up new possibilities for projection radiography and strengthen its position as a routine method in comparison to other digital imaging systems, e.g. CT. It remains to be seen whether or not DR, as an isolated system, will be widely used. But in any case it represents the missing link in the chain of digital imaging methods and opens new ways of imaging archiving and administration.
A new method for analysis and documentation of tongue movements was used in 24 healthy volunteers. This method enables direct digitalization of the information obtained from sequences of B-Mode pictures. Besides of allowing to further digital evaluation of the findings, it offers the facility of "pseudo 3D"-reconstruction of the tongue movements occurring on swallowing. The method appears to be of particular value for therapy control in neurological and phoniatric patients.
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The radiological and clinical features of two families with a nail-patella syndrome are described. Our findings emphasize the varying expressivity of the syndrome, which has an autosomal dominant mode of inheritance and a penetrance of 100%. It is important for the radiologist to be aware of the syndrome's stigmata so that renal failure can be detected as early as possible after the diagnosis of skeletal dysplasia.
Sonography of the rotator cuff with measurement of relevant soft tissue structures was performed in 120 persons without evidence of shoulder pathology. Although the extension of all structures varied markedly, no significant differences were found on comparing both sides. However, with regard to the variability of side differences, a limited side difference must be accepted as a normal finding. Sex, age and other body-related variables did not correlate well and were not useful in the assessment of the dimension of rotator cuff structures.
A "body-pack" is a swallowed plastic or rubber container used by drug smugglers to carry drugs. We report our experience in diagnoses of such packs in vivo. We simulated the pack by stuffing a fingerstall of a latex handglove with a mixture of 10% barium powder and flour to render it radiopaque. Eight serial examinations were made. In each series, an adult Alsatian dog was fed upto 10 such "body-packs". The passage of these packs through the gastrointestinal tract was followed with ultrasound examinations made at 2, 24, and 48 hours postprandially. Immediately after each sonographic localisation of "body-pack" was made, an x-ray examination of the abdomen in this region was also carried out. Ultrasound correctly determined the position of the "body-pack" in 20 out of 24 examinations as compared to x-ray results. In 4 cases ultrasound could not confirm the location of the "pack".
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Fifty-five congenital malformations of the urinary tract (25%) were among 220 antenatally diagnosed malformations. Accuracy of diagnosis was 63.8% (44 cases); 20 infants had to be operated on. Good morphological and functional results could be obtained in 82% of the cases. Prenatal diagnosis of congenital uropathies provides early treatment burdened with less risk.
A neonate born after 35 weeks' gestation developed thrombosis of the right external iliac artery after removal of an umbilical artery catheter. Digital subtraction angiography was utilized to demonstrate the site of obstruction and the effect of fibrinolytic therapy with streptokinase.
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.
A very soft and homogeneous plastic material has been developed from polyvinyl chloride with acoustic properties similar to those of human tissue. During an evaluation period of nine months, the material has proved excellent for the sonographic investigation of subcutaneous tissue, even at high frequencies. Significant advantages of the new material as compared with previously available substances depend on its stability, low sound attenuation and absence of reverberations. In order to achieve these desirable properties, twenty plasticisers of different type and concentration were used and the resulting compounds examined for their acoustic properties.
At the Gynaecologic Clinic of the University of Milan/Italy from 1979-1983, pathological changes of the urinary tract were diagnosed in 55 foeti on the occasion of routine sonography of pregnants. In 23 children prenatal diagnosis was confirmed. 5 neonates had another disease than the disease of the urinary tract assumed during the prenatal period. In 19 neonates the first diagnosis had to be rescinded because of a second examination showing normal findings. 8 neonates could not be examined a second time. Advantages of an intrauterine diversion of urine could not be verified. Therefore, the following diagnostic and therapeutic consequences from the prenatal examination by sonography are recommended: Immediate check and analysis of prenatal findings in the neonatal period by further examinations. Short-term checks to clarify indication for operation. Avoidance of early complications and other kidney changes by early therapy.
A simple and cheap method is described for the manufacturing of individual positioning aids made of foamed polyurethane. Some examples are given to demonstrate the applicability of these positioning aids for the irradiation of different body regions. The reproducibility of the radiation field in the head and neck area was investigated with and without positioning aid. It was proved that the field is adjusted more exactly when positioning aids are applied. The dosimetric investigations performed showed a negligible influence of foamed polyurethane on the radiation quality. So the positioning aids could be left within the radiation field when drawing the field borders.
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Ultrasonic examinations were performed at weekly intervals in 8 patients with Wilms tumors Stage II-V during the period of preoperative therapy. Measurements of the maximum expansion of the tumors were made and expressed in an ellipsoid formula. The tumor volume was thus calculated. A description of the compactness of the tumor as well as the bordering of the tumor were done. This was followed by a photographic documentation. The mean value of the initial tumor volume in the 8 patients was 551 ml. At the end of the preoperative therapy, an average volume of 305,1 ml was recorded. One week after beginning the therapy, 25-40% diminution of the initial tumor volume was noted in 5 patients. The diminution in volume till tumor extirpation was in all 49%. In 3 patients, the reduction of tumor mass through therapy was only 27,8%. The histological examinations revealed a fetal rhabdomyomatic nephroblastoma in one case. The second case was massive tumor haemorrhage and in the third case a considerable formation of cysts.