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Biomedical subjects

G Sommer

Publications and source records attributed to G Sommer.

At least 55 records · Page 3Linked to original sources
PubMed1988

Influence of fluid replacement on extravascular lung water (EVLW) in patients with diabetic ketoacidosis.

Fluid replacement is a major issue in the treatment of patients with diabetic ketoacidosis. During this therapy, development of pulmonary edema has been reported and attributed to an increase in pulmonary microvascular pressure and a decrease in colloid-osmotic pressure (COP). Because clinically apparent pulmonary edema is associated with an increase in extravascular lung water (EVLW) and impairment of pulmonary gas exchange, we studied the effect of fluid replacement on EVLW, COP, pulmonary hemodynamics and gas exchange parameters in 8 patients with diabetic ketoacidosis (blood glucose greater than 300 mg/dl, pH less than 7.1). EVLW was estimated by the thermal-dye technique. All variables were successively determined upon admission (A), after initial fluid replacement (IFR), when glucose had fallen below 180 mg/dl, after 8 h of intravenous glucose treatment (G), and after 24 h of total parenteral nutrition (TPN). Despite a total net fluid intake of 6.0 +/- 1.61, a significant decrease (p less than 0.001) in COP from 29.6 +/- 5.5 at A to 18.8 +/- 2.2 mmHg after TPE and a significant increase (p less than 0.001) in PCWP from 4 +/- 2 at A to 10 +/- 3 mmHg after TPE, EVLW remained almost unchanged. EVLW was 5.1 +/- 2.8 at A, 5.3 +/- 2.1 after IFR, 4.8 +/- 1.4 after G, and 5.3 +/- 1.7 ml/kg after TPN. However, PaO2 decreased from 137 +/- 17 at A to 87 +/- 10 mmHg after TPE (p less than 0.001), while Qs/Qt increased significantly (p less than 0.05). The alterations in gas exchange may be indicative of pulmonary dysfunction but as they were not associated with accumulation of EVLW, they may as well reflect the compensation of metabolic derangements in diabetic ketoacidosis.

Adult↗
PubMed1988

Noise-reduced prostatic MR imaging. Work in progress.

Measurement-dependent filtering, a nonlinear noise-reduction technique, was used to improve the signal-to-noise ratio of in vivo T2-weighted magnetic resonance images of the prostate gland. In both normal and abnormal prostates, the technique considerably reduced noise in T2-weighted images. The technique may provide more accurate depiction of regions of benign prostatic hyperplasia and carcinoma in the prostate.

Filtration↗
PubMed1987

[Effect of high-dose prednisolone on lung fluid in patients with non-cardiogenic lung edema].

The influence of high-dose prednisolone on extravascular lung water (EVLW) was studied in a randomized trial in patients with noncardiac pulmonary edema. The patients were treated every 6 hours for 48 hours with 2 g of prednisolone-hemisuccinate or placebo. In the prednisolone-group (n = 7) EVLW decreased from 16.4 +/- 6.2 before to 11.8 +/- 5.1 ml/kg after treatment (p less than 0.05). Additionally alveolar-arterial oxygen gradient (AaDO2/FiO2), pulmonary vascular resistance and heart rate decreased, while arterial oxygen tension (PaO2/FiO2) and mean arterial pressure increased (p less than 0.05). In the placebo-group (n = 7) EVLW increased slightly from 17.5 +/- 3.1 before to 19.3 +/- 10.3 ml/kg after treatment. Additionally all other parameters did not change significantly in this group. Although no statistical significant difference was found between the two groups of treatment, a decrease in EVLW was observed in all prednisolone-treated patients, whereas a pronounced increase in EVLW was found in 3 placebo-treated patients. Probably, those patients would have benefited from high-dose prednisolone treatment. High-dose prednisolone reduced EVLW and improved hemodynamics and gas exchange in patients with noncardiac pulmonary edema, whereas placebo did not achieve comparable effects. Therefore, high-dose prednisolone appears beneficial in noncardiac pulmonary edema in respect of EVLW, hemodynamics, and gas exchange.

Adult↗
PubMed1987

[Hemofiltration for the reduction of lung fluid in ARDS?].

Hemofiltration has been advocated for reduction of extravascular lung water (EVLW) in both clinical and experimental ARDS. The influence of hemofiltration on EVLW was studied retrospectively in 10 patients with this syndrome. After 2 to 38 hours' hemofiltration net fluid balance was -3640 +/- 3609 ml. EVLW remained almost unchanged (from 17.6 +/- 5.4 before to 15.6 +/- 4.1 ml/kg after hemofiltration). In 4 patients a reduction of over 15% in EVLW was achieved, whereas in the remaining 6 patients EVLW changed within a range of +/- 10%. However, hemofiltration caused a decrease in cardiac output and oxygen delivery, thereby adversely affecting its benefits on EVLW and gas exchange. In ARDS hemofiltration should be performed under careful hemodynamic monitoring and only in some of the patients an immediate reduction in EVLW can be achieved.

Adult↗
PubMed1987

Accessory spleen: presentation as a large abdominal mass in an asymptomatic young woman.

Accessory spleen hypertrophy is usually related to hematologic, lymphomatous, and rheumatoid diseases. We describe here the case of an 18-year-old asymptomatic woman who presented with a very large accessory spleen occupying the lower abdomen. Its appearance on abdominal sonogram, computed tomogram, and hepatosplenic scintigraphy is correlated with the resected specimen.

Abdominal Neoplasms↗
PubMed1987

[Differential diagnostic problems of subtotal hepatic steatosis in the sonogram].

The authors describe the appearance of focal sparing in otherwise diffuse fatty infiltration of the liver found in 35 patients. These are pseudotumours which are less echogenic than the surrounding abnormal parenchyma. They are sharply marginated, of triangular shape and show no mass effect--neither by displacement of vessels nor by deformity of the contour of the liver. These characteristic morphologic features allowed a differentiation from neoplasms or abscesses in 80% of our cases. Hence, biopsies are rarely indicated in these patients.

Adult↗
PubMed1987

Cirrhosis: US images with narrow band filtering.

A new type of ultrasound (US) image was created by first recording unfiltered, backscattered ultrasonic amplitudes to a standard dynamic range prior to narrow band digital filtration of the ultrasonic signal and mapping of the resultant filtered ultrasonic envelope amplitudes. Unlike unfiltered images, those created by narrow band digital filtration permit differentiation between phantoms with different scattering characteristics and normal from cirrhotic human liver in vivo. Significantly different image statistics for normal and cirrhotic liver (P less than .002) were demonstrated in preliminary clinical trials.

Humans↗
PubMed1987

Breast calcifications in renal hyperparathyroidism.

A prospective mammographic study was performed on 151 women to determine the prevalence of breast calcifications in patients with chronic renal failure. Frequency, size, structure, and location of calcific lesions were assessed in 15 patients with compensated renal insufficiency, 22 on hemodialysis, 14 who had renal transplants, and 100 who had normal kidney function. Serum levels of calcium, phosphorus, alkaline phosphatase, and parathyroid hormone were determined for all 151 women. The calcific lesions occurred preponderantly in dialysis patients (arteries, 55%; parenchyma, 68%; and ducts, 36%). Next in order were those with renal transplants (43%, 64%, and 29%, respectively) and those with renal insufficiency (33%, 53%, and 20%, respectively). Patients with renal disease had significantly more calcifications (p less than .001) than the patients with normal kidney function: arteries, 45% vs 8%; parenchyma, 61% vs 27%; and ducts, 29% vs 9%. Frequencies of calcifications correlated with serum levels of parathyroid hormone. None of the calcifications induced by renal disease simulated those seen in carcinoma of the breast.

Adult↗
PubMed1987

[Occult and clinically suspected testicular tumor. Assessment using real-time sonography].

The diagnostic value of real-time-sonography was evaluated in 62 patients with suspected and occult testicular tumors. In 28 patients intratesticular tumors were identified on real-time-sonograms. In addition 7 clinically occult tumors were diagnosed by real-time-sonography. It was not possible to differentiate between orchitis and tumors on sonograms (3 cases). There was correlation only between the morphologic appearance of tumors on sonograms and the corresponding histology. Using high frequency transducers sonography proved to be an useful diagnostic modality to identify or to rule out occult intratesticular tumors.

Diagnosis, Differential↗
PubMed1987

Acute renal failure in children. An ultrasonographic-clinical study.

Acute renal failure (ARF) may be due to obstructive uropathy or renal parenchymal disease. Twenty-five children with acute renal failure secondary to renal parenchymal disease underwent ultrasonographic examination of the kidneys. Changes of renal size and cortical echogenicity were correlated with renal function. All patients presented with bilaterally enlarged kidneys with the exception of those in the neonatal age group (12%). Improvement in renal function resulted in normalization of renal size. With regard to cortical echogenicity two groups were formed. Group A comprised 11 patients whose kidneys had the same echogenicity as the liver, while in group B the kidneys were more echogenic (14 patients). Cortical echogenicity was always increased. Determination of creatinine levels showed a statistically significant difference between group A (3.32 mg% +/- 1.40 S.D.) and group B (5.95 mg% +/- 1.96 S.D.), p less than 0.001. Changes in renal function were paralleled by rapid changes in renal size and cortical echogenicity.

Acute Kidney Injury↗
PubMed1987

[Sonography of the scrotal contents].

In 394 patients with various urological symptoms, the content of the scrotum was examined sonographically. 71 testicular lesions were found, 194 extratesticular pathologies were diagnosed. In 69% the enlargement of the testicle was due to a tumor, in 4 patients due to acute orchitis and in 3 patients due to acute torsion. An unilateral smaller sized testicle was found in chronic inflammation [5], cryptorchism [9], hypoplastic testicle [2] and after corticoid medication [1] and radiation therapy [1]. In normal sized testicles 8 tumors, 19 fibromas of the tunica albuginea, 2 scars after trauma and 1 haematoma were found sonographically. In 91% of patients with epididymitis the epididymis was enlarged. The echo structure was altered in 74%, in 13% abscesses were found. Sonography was useful in evaluation of scrotal herniation, especially when combined with hydroceles. Varicoceles were better detected and graduated by sonography than by clinical examination.

Genital Diseases, Male↗
PubMed1987

[Analysis of errors in imaging diagnosis of varicocele. Duplex sonography, plate thermography and phlebography].

Comparative investigations were done by duplex sonography, thermography and phlebography in 142 patients with 158 varicoceles. Verification of clinical varicoceles (130/158) was performed by duplex sonography in all cases and by thermography in 93%. Measurement errors were due to dorsally located varicoceles near the radix of the penis (3/130) and by small, two-sided varicoceles (6/130). Small subclinical varicoceles (28/158) were detected by real-time sonography in 89%, by Doppler sonography in 64%, and by thermography in 53%. In three patients with normal real-time sonography, subclinical varicoceles were found by Doppler sonography alone. The combination of both sonographic methods is highly sensitive for the detection of subclinical varicoceles and should be done in all cases without therapeutic results.

Humans↗