Biomedical subjects
Publications and source records attributed to H G Schulz.
Density-time-series after intravenous injection of a contrast bolus allow a noninvasive evaluation of portal circulation function. Diagnostic accuracy was above 90%. We are reporting the diagnostic capabilities and limitations of CT in portal circulation disorder with special regard to a statistical evaluation of density-time-diagrams of liver and spleen by multivariate discriminant analysis.
The theoretical and methodical base of computed tomography evaluation of the myocardial function are demonstrated. The possibilities and limits of this investigation method are discussed and compared with the results of numerous own examinations and the literature. Present indications for cardiacomputed tomography are deduced with consideration of other noninvasive imaging techniques in cardiology.
While the diagnosis of the acute pancreatitis is now as ever made clinically, the significance of ultrasound and computed tomography (CT) lies above all in the demonstration of morphologic changes and their extent. When the statements of the ultrasonic diagnosis are sufficient in easy stages of the acute pancreatitis and for the recognition of a more severe stage as well as for the control of the course, an evident assessment of the haemorrhagic necrotizing pancreatitis, in particular before operation, is possible only with the help of the CT. Only with its help we succeed in a comprehensive demonstration of the necroses, formations of abscesses, haemorrhages as well as of the ways of necrosis. The better availability and the riskless possibility of carrying out the ultrasonic diagnosis with altogether high evidence allow a narrow-meshed control of the course of the acute pancreatitis.
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The systemic character of the rheumatoid arthritis and the collagenoses includes an extraarticular organ manifestation. Since the symptomatology of an organ participation is often covered over with dominating joint troubles its diagnostics is difficult. In 34 patients (22 with rheumatoid arthritis, 12 with collagenoses) with the help of non-invasive methods (computed tomography and sonography) is tried to recognize a participation of the heart--particularly of the pericardium. Our examinations show that by means of the computed tomography in 13.6% of the cases an effusion in the pericardium (9.1% of them clinically not conspicuous) could be proved in rheumatoid arthritis, however, the frequency of 30% of the echocardiographically diagnosed pericardial effusions described in the literature could up to now not be confirmed. The classification of the changes of the pericardium as a complication of a rheumatoid arthritis or a collagenosis may be performed only in connection with the adequate clinical and biochemical immunological findings excluding other cardiac diseases.
It is reported on an at present 32-year-old male patient, in whom at the age of 30 years an excessive mediastinal lipoma was excised. For 12 years the cardiological diagnosis was not clear and could completely be clarified only with the help of the computed tomography of the heart.
Variations in the area and dimensions of the liver and spleen in the craniocaudal direction show a similar behaviour despite individual differences in the size and shape of the organs. The liver has its largest areal extent in the upper half of the organ. In the case of the spleen, it is not possible for the largest areal extent to be assigned to a particular region of the organ. The 5-type liver classification of FROMMHOLD and KOISCHWITZ (1982) provided the basis for a study of the frequency distribution of those types among a total of 116 organs. Type 2 (location of the greater part of the liver to the right of the vertebral column) was found to be the most frequent type, whereas type 5 (left lobe of the liver larger than the right one) could not be found. Of the 183 splenic organs included in these studies, 21% showed lobulation and 6%, an accessory spleen. The morphological studies of 334 adrenal glands enabled the most frequent variants of form to be represented summarily. The determination of liver dimensions, which was done on 37 organs, yielded a mean value of 16.6 cm for the craniocaudal extent, 15.5 cm for the dorsoventral extent, and 16.6 cm for the lateromedial extent. From the examinations performed on 38 individuals it was possible to determine a mean value of 11.1 cm for the craniocaudal extent of the spleen, 11.8 cm for the anatomical length of the spleen, 10.4 cm for the width of the spleen, and 4.2 cm for the thickness of the spleen. The mean value of the width of pancreas was 20.5 mm at the head, 19.6 mm at the corpus, and 18 mm at the tail. The mean length of pancreas was of the order of 129 mm. These results were obtained from examinations made on 96 pancreatic organs. Evaluation of a total of 200 computer tomograms yielded mean values of 22 mm for the length. 14 mm for the width, and 5 mm for the leg thickness of the left adrenal gland. The respective mean values obtained for the right adrenal gland were 28 mm, 9 mm, and 4 mm respectively. Determination of the volume of liver on 37 organs yielded a mean value of 1,331 cm3. For the spleen, examinations performed on 38 organs showed the mean volume to be in the order of 169 cm3. For the volume of pancreas, a mean value of 40.4 cm3 was determined.
In individual cases the computed tomography renders possible the ascertainment of the coarctation of the aorta. Despite modified examination method (secondary section technique, continuous application of contrast medium) the reliability is insignificant. Therefore, the method cannot be recommended for the primary diagnostics of the coarctation of the aorta. The computed tomography is extraordinarily suited for the detection of aneurysms of anastomoses after operation of coarctations of the aorta. In 50 computed-tomographic examinations of 48 patients 11 times an aneurysm could be ascertained. This high proportion of late postoperative complications is above all to be traced back to the surgical suture material used in the sixties. There were only two falsely positive findings, in which cases also here relevant pathological changes were present. The computed tomography can more exactly than the aortography adopt a definite attitude to the question of the dissection of prostheses or to pseudoaneurysms.
Cardial and paracardial space occupations need a rapid, possibly non-invasive diagnosis. The echocardiography and the computer tomography are practically available. At the instance of 17 intracardial space occupations (4 solid tumours and 13 thrombi), which were found in a total number of 600 cardio-computer-tomographies, and several selected peri- und paracardial space occupations the high diagnostic significance of the computer tomography is demonstrated. With the computer tomography a standardized method independent of the investigator is available which in qualitative respect appears of the same value as to echocardiography in the diagnostics of the intracardial space occupations and in the peri- and paracardial space occupations the non-invasive method is the method of choice.
Calcification of the media of the arteries of the lower limbs, giving a linear type of calcification roentgenologically is typical for diabetic arteriosclerosis. Spotty calcification of the arteries of the lower extremity, which histologically is found in the intima, is also seen a little more often in diabetics with gangrene. There are no major differences between the other histological vascular structures of diabetics and arteriosclerotics. Maximal stenosis of the lumen is found more peripherally in diabetics than in persons with normal carbohydrate metabolism. The results favour the idea of predominant femoropopliteal occlusion in arteriosclerosis and popliteal-tibial occlusion in diabetics.
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The judgment of the function of the left ventricle is computer-tomographically possible using the ECG-regulated cardio-computer-tomography in a temporary resolution of about 0.1 sec. The qualitative and quantitative evaluation of the systolic and diastolic changes of the ventricle in patients with normal CT-findings, with idiopathic hypertrophic subaortic stenosis and with disturbances of motility in chronic ischaemic heart disease confirms the possible functional evidence known from literature. The quantitative parameters, in particular the systolic abbreviation of the axis, allow an estimation of the motility. The measurement of the thickness at the interventricular septum and at the lateral wall of the myocardium as well as the systolic abbreviation of the axis and the left-ventricular ejection fraction are essentially higher in the idiopathic hypertrophic subaortic stenosis than in the normal group. The values of the patients with disturbances of motility in the ischaemic heart disease were clearly below. The diagnosis of the idiopathic hypertrophic subaortic stenosis with response of the size of obstruction by the telesystolic and telediastolic pictures is possible in a high percentage. Sequelae of the chronic ischaemic heart disease, e.g. scars, become visible by a narrowing or an absence of the normal edge of the myocardium. Global and localized disturbances of motility are diagnosable by phase-referred systolic and diastolic ECG-regulated pictures.
Estimations of mineral content of normal human skeletons using three radiological methods have led to the following conclusions: 1. Bone density of vertebral bodies increases from T.6 to L.5. Average values for thoracic and lumbar vertebrae are 0.71 and 0.88 g./cm2. 2. There is no linear correlation between the mineral content of an easily accessible peripheral bone and of the vertebrae. 3. The method for bone mineral estimation, using thulium170, which was developed in Dresden, can be used for the peripheral and central skeleton. 4. 125-photon absorption us useful for measurements on the peripheral skeleton, where it is the most elegant and accurate method. It is, however, useless for measurements of the central skeleton.
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