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Biomedical subjects

G Brinkmann

Publications and source records attributed to G Brinkmann.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Castleman's disease: evaluation of 338 cases].

PURPOSE: To evaluate a large group of patients with Castleman's tumours (Castleman's disease = MC) with regard to age, sex and tumour localisation. PATIENTS AND METHODS: 338 cases of MC were evaluated. All cases were registered by the Lymphknotenregister of the German Society of Pathology, Kiel. RESULTS: 292 MC of the hyaline vascular type (MC-HV) and 46 of the plasma cell type (MC-PC) were found, 259 (76.6%) in nodal and 79 (23.4%) in extranodal localisation. Main nodal localisation were the neck (25.5%) and the axilla (12.8%). The mediastinum was involved in only 6.2%. There was a slight preference of female (56%) compared to male (44%). Patients with MC-PC (mean age: 50 +/- 16.9 years) were significantly older (p < 0.001) than patients with MC-HV (mean age: 39 +/- 18.9 years). CONCLUSIONS: The main localisation of MC is the neck. MC-HV is more common than MC-PC. There is a slight preference for women. Mean age of patients with MC-PC is approximate 10 years higher than for MC-HV.

Adolescent↗
PubMed1995

In vivo P-31-MR-spectroscopy of focal hepatic lesions. Effectiveness of tumor detection in clinical practice and experimental studies of surface coil characteristics and localization technique.

RATIONALE AND OBJECTIVES: The influence of partial tumor sampling in a volume of interest (VOI) on the ratios of phosphorus metabolites was examined by localized phosphorus magnetic resonance spectroscopy (P-31-MRS). Experiments were performed to investigate the characteristics of the surface coil used and precession of spatial localization. METHODS: A total of 24 patients with liver metastases and 20 volunteers were studied by P-31-MRS. Patients were divided in two groups: VOI < 50% (n = 8) and VOI > 50% (n = 16) occupied by tumor. For evaluation of the surface coil and localization method (image selected in vivo spectroscopy), phantom studies were performed. RESULTS: Superficial focal liver tumors were detectable with a surface coil at a distance within the coil radius. The image selected in vivo spectroscopy permitted the study of phosphorus metabolism in a defined VOI, phosphomonoester/beta-adenosine triphosphate and phosphodiester/beta-adenosine triphosphate were elevated significantly in spectra of both patient groups. CONCLUSIONS: Detection of small tumor volumes within a VOI filled by less than 50% of the tumor is possible, with results statistically different from that in normal volunteers.

Adult↗
PubMed1995

Application of the maximum entropy method for evaluating phosphorus-31-magnetic resonance spectra in patients with liver metastases.

RATIONALE AND OBJECTIVES: The clinical feasibility and application of the maximum entropy method for data analysis from in vivo phosphorus-31-magnetic resonance (P-31-MR) spectra of the liver were determined. METHODS: Image-guided localized P-31-MR spectroscopy was performed in 24 patients with liver metastases and in 20 healthy volunteers. The spectra were obtained with a whole body scanner operating at 1.5 T using a surface coil. Phosphomonoester/beta-adenosine triphosphate (ATP), phosphodiester/beta-ATP, and inorganic phosphate/beta-ATP were calculated from the maximum entropy method-spectra and from spectra evaluated with standard data processing (Fourier transformation spectra). RESULTS: Phosphomonoester/beta-ATP and phosphodiester/beta-ATP were increased significantly with both methods in patients' spectra. Maximum entropy method spectra showed a distinct pattern with low noise. It was easier to determine peak borders and to attach resonances to the different metabolites using this method. CONCLUSIONS: Maximum entropy method is an alternative method for evaluation and quantification of P-31-MR spectra data and is preferred to standard data processing with Fourier transformation in cases of reduced signal-to-noise ratio of spectra.

Aged↗
PubMed1994

[Magnetic resonance tomography and computerized tomography of Wegener's granulomatosis of the orbits].

Of a total of 121 patients with histological proven Wegener's Granulomatosis, orbital involvement occurred in 12 cases. Eight of them underwent magnetic resonance imaging (MRI) of the head and brain, in 2 cases computed tomography (CT) was additionally performed. With MRI orbital granulomas had a low signal intensity in T1- and T2-weighted spin-echo sequences. After i.v. contrast medium administration an inhomogeneous enhancement was found. Because of the multiple imaging planes and high soft tissue contrast, orbital granulomas were better delineate with regard to the intraorbital muscles and the optic nerve using MRI than with CT. Osseous destruction and sclerosis of the orbital walls were demonstrated more effectively using CT. MRI and CT are thus complementary for diagnosing and staging, of orbital granulomas and periorbital involvement in Wegener's Granulomatosis.

Adult↗
PubMed1993

Cognitive skills in achondroplasia.

Increased intracranial pressure and ventricular and subarachnoidal dilatation are common manifestations in achondroplasia. They rarely lead to major neurologic and/or psychomotor deficits and neurosurgical intervention is seldom needed. The present study was undertaken to detect signs of minor cerebral dysfunction and discuss possibilities of their prevention. Thirty children with achondroplasia were compared to 3 control groups: their next-born sibs, 30 children with other forms of dwarfism, and 30 children with normal height. Early development was assessed by means of questionnaires. Cognitive skills were evaluated with the German version of the Cognitive Abilities Test and the Lorge-Thorndike Intelligence Test. Personality data were tested using standardized neuroticism, extraversion, and anxiety scales. Children with achondroplasia had more frequent histories of delayed motor development, retarded speech development, and lower school grades in language-related specialties. Psychometric testing disclosed total and subtest scores in the population-based normal range. In comparison with their sibs and matched controls children with achondroplasia had significantly lower total scores mainly caused by low scores in the subtest "verbal comprehension." We conclude that verbal comprehension is significantly impaired in children with achondroplasia. This partial deficiency is probably related to frequent middle ear infections and resulting conductive hearing loss. Hypotonia with delayed oropharyngeal muscle coordination and parental response to an altered, more infantile instinctive releasing pattern may be contributing factors.

Achondroplasia↗
PubMed1993

[31P-MR spectroscopy of liver diseases with reference to variable pulse recovery times].

The value of 31P-MRS for different types of liver disease and the effect of repetition time (TR) on measurements of relative phosphor metabolite concentrations was studied. Spectroscopy was performed on 26 patients with predominantly focal liver disease and on 14 normals, using a 1.5 Tesla clinical MR system. In all cases, (TR) of 2,400 ms was chosen and in 11 patients and 10 normals additionally shorter (TR) of 600 ms (with T1 weighted spectra) was chosen. The results show that PME/beta-ATP and PDE/beta-ATP are sensitive indicators of liver disease and differ widely from the findings in normal livers. In patients with liver metastases, the long (TR) of 2,400 ms (16 cases) showed an increase of PME/beta-ATP (0.96 +/- 0.32) and significant reduction of PDE/beta-ATP (1.89 +/- 0.47) as compared with normals (PME/beta-ATP = 0.75 +/- 0.26 and PDE/beta-ATP = 2.27 +/- 0.41), for a (TR) of 600 ms, PME/beta-ATP (0.87 +/- 0.47) and PDE/beta-ATP (1.82 +/- 0.67) are significantly increased. T1 weighted spectra showed more significant differences in phosphometabolites between patients and normals than density weighted spectra. The spectra in patients showed a significantly reduced signal to noise ratio independent of the (TR).

Adolescent↗
PubMed1992

[Liver infarction after Whipple's surgery. Diagnosis based on clinical course and imaging procedures].

A 59-year-old woman who had undergone a Whipple's operation for carcinoma of the head of the pancreas, developed septic fever of up to 40 degrees C on the fourth postoperative day, accompanied by severe upper abdominal pain and local guarding on palpation over the liver. Her general condition markedly and quickly deteriorated. Liver abscess was suspected. Computed tomography demonstrated a hypodense, wedge-shaped lesion in the right lobe of the liver without any abscess capsule. Liver infarction was diagnosed when injection of contrast medium failed to show any increase in density. Magnetic resonance imaging confirmed the wedge-shaped signal-rich lesion. Laboratory tests revealed a leucocytosis of 30,000/microliters, a postoperative rise in serum alkaline phosphatase activity (up to 800 U/l), gamma-glutamyl transaminase (up to 190 U/l) and lactate dehydrogenase (up to 320 U/l), while GOT and GPT activities remained within normal limits throughout. Fever subsided within 3 weeks. --It is stressed that, if a patient's condition worsens after a major abdominal operation, liver infarction should be considered in the differential diagnosis. Modern imaging methods have increased the frequency of this diagnosis. They, together with the clinical picture and the pattern of biochemical tests, make it possible to distinguish reliably infarction from liver abscess.

Adenocarcinoma↗
PubMed1992

A study of T1-weighted 31phosphorus MR-spectroscopy from patients with focal and diffuse liver disease.

31P-MR-Spectroscopy was performed in 28 patients with focal (n = 23) and diffuse (n = 5) liver disease and in 18 healthy volunteers. The spectra were obtained with a whole body scanner operating at 1.5 T by using a surface coil. To get T1-weighted 31P-spectra a short TR of 600 msec was taken, because T1-weighted spectra of focal liver disease were more significantly different from spectra from healthy volunteers than density weighted ones. The VOI from patients with focal superficial alterations showed a mean volume of 172 ml, with diffuse liver disease 196 ml, and from volunteers 158 ml. Focal tumors filled up the VOI on an average of 70%. This investigation demonstrated that PME/beta-ATP- and PDE/beta-ATP-ratios were sensitive indicators for focal liver disease. As a result of this study we could establish a significant increase of PME/beta-ATP- (0.75 +/- 0.30) and PDE/beta-ATP-ratios (1.68 +/- 0.62) in patients with superficial focal liver metastases (n = 19) compared to the control group (PME/beta-ATP: 0.49 +/- 0.17, PDE/beta-ATP: 1.24 +/- 0.24; t-test: p < 0.02). Patients with a hemangioma (n = 1), liver infarction (n = 1), empyema of gallbladder (n = 1) and a hepatic involvement by a malignant lymphoma (n = 1) showed a similar increase of PME/beta-ATP and/or PDE/beta-ATP. Up to now spectral changes seemed to be non-specific. The ratios of 31P metabolites of the cirrhoses (n = 4) and the fatty liver (n = 1) did not show any characteristic changes versus the volunteers.

Adult↗
PubMed1992

[In vivo 31-phosphorus MR spectroscopy of the calf musculature in arterial occlusive diseases].

Muscle metabolism was measured in 7 patients with arterial occlusive disease and symptoms of intermittent claudication both before and after percutaneous vascular neurolysis by means of dynamic 31P-MR spectroscopy. Phosphorus spectra of the involved calf muscles were determined before, during and after defined treadmill exercise. In addition to pH values the phosphocreatine content was measured during activity and recovery phases. There was close correlation in these patients between the increase in claudication distance and more rapid regeneration of phosphocreatine following neurolysis. However, none of the patients achieved normal values of phosphate metabolism. By means of the non-invasive 31P-MR spectroscopy it was possible for the first time to demonstrate the biochemical changes associated with neurolytic lumbar sympathetic blockade.

Adult↗
PubMed1992

[The effect of Belzer and Bretschneider cardioplegia solutions on myocardial energy metabolism. A study with 31phosphorus magnetic resonance spectroscopy in an animal model].

The aim of our study was to test the effectiveness of two cardioplegic solutions and to compare the level of high energy phosphates in the myocardium. We investigated 18 hearts of pigs (obtained from a slaughter-house) with 31phosphorusmagnetic resonance spectroscopy (31P-MRS) In this experiment coronary arteries were cannulated and reperfused with arterial blood to revitalize the heart. When the heart showed regular pulsations coronary arteries were perfused for cardioplegia either with the UW-(Belzer-) or with the HTK-(Bretschneider-)solution. For 31P-MRS, a magnet with a magnetic flux density of 4.7 Tesla (T) was available. Relative concentrations from phosphocreatine (PCr/beta-ATP; high-energy phosphate) and inorganic phosphate (Pi/MDP; MDP = methylendiphosphonat = reference solution; low-energy phosphate) were calculated from the spectra. As a result of this study, the HTK-solution showed a significantly higher PCr/beta-ATP-ratio in the myocardium than the UW-solution during the examination time of 3 h. After plegia of the myocardial area from the right coronary artery PCr/beta-ATP-ratios were lower in comparison with the left coronary artery distribution area. The calculation of Pi/MDP-ratios proved that Pi was higher in the myocardium after application of the UW-solution compared to HTK-solution. The kinetics of the metabolites showed an approximately linear and parallel decrease of PCr/beta-ATP-ratios after cardioplegia with both solutions during the examination time.

Animals↗
PubMed1991

[Diagnostic imaging and treatment of an invasive thymoma together with myasthenia gravis].

A 40-year old woman with an invasive thymoma and myasthenia gravis is described in this article. Chest-x-ray, CT and MRI of the mediastinum could not offer definite results on tumour malignancy. Radical surgical removal was the consequence. This revealed a tumour infiltration of the pleura and pericardium; hence an adjuvant irradiation must have been performed. Mestinon--treatment was afterwards gradually reduced.

Adult↗
PubMed1990

[In vivo 31-phosphorus magnetic resonance spectroscopy of liver diseases].

31P-MR spectroscopy was performed in 12 patients with focal and diffuse liver disease and in ten normal controls, using surface coils. Results so far show a significantly increased concentration of PME/beta-ATP and of PDE/beta-ATP in patients with liver metastases and in one patient with hepatic involvement by malignant lymphoma. The spectra of liver cirrhosis and fatty livers showed no characteristic changes.

Adult↗
PubMed1990

[Ultrasound, computerized and nuclear magnetic resonance tomography of soft tissue processes of the head and neck].

14 patients with a space-occupying growth in the head and neck region were examined via sonography, CT and MR to explore and demonstrate by means of a prospective comparative study the possibilities offered by these three imaging methods. Stages are best diagnosed by means of sonography; the leading role of this method is undisputed. To clarify sonographically unclear findings and especially in pre-surgery planning, MR offers advantages over CT on account of the high soft-part contrast and multiplanar visualisation. However, it is impossible or very difficult to differentiate abscesses and lymphadenitides from malignant growths with these three methods solely on the basis of image-morphological criteria.

Abscess↗
PubMed1989

[Myelolipoma of the adrenals].

A 47-year-old man reported increasing feeling of fullness in the upper abdomen and pain in both flanks, radiating to both groins. Physical examination did not reveal any abnormalities. Biochemical tests demonstrated hypertriglyceridaemia and hypercholesteremia. Urography, abdominal ultrasound, computed and magnetic resonance tomography revealed a large, fat-containing tumour of the right adrenal. At operation a soft, somewhat elastic adrenal tumour, about 10 cm in diameter, was removed. Histologically it proved to be a myelolipoma. The correct preoperative diagnosis of such a tumour is possible in about 90% of cases.

Adrenal Gland Neoplasms↗