Biomedical subjects
Publications and source records attributed to H Kremer.
In Real-time Sonography slice-thickness artifacts may lead to misinterpretation, mainly in cystic organs. With in vitro studies it was possible to show the mechanism of this artifact, which is based on beam thickness.
Bow-shaped artifacts can often be seen in B-mode-ultrasound examinations. In order to find out the origin of these artifacts, water tank experiments were carried out and compared with in vivo observations. The studies showed that bow-shaped artifacts are caused by beam breadth, and that their shape is influenced by the type of the B-mode-instrument, the adjustment of the machine, and by the shape of the reflector. In vitro and in vivo, bow-shaped artifacts arise at strong reflectors and are visible in regions of low echogeneity. In vivo bow-shaped artifacts may imitate pathological findings such as septa or sludge.
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A patient with the clinical features of pseudohypoparathyroidism and elevated concentrations of serum CK and LDH, which normalized after successful therapy, is described. Clinical signs of myopathy did not exist. The bioptical material from the m. tibialis anterior was microscopically normal. The biochemical analysis revealed a reduced phosphorylase-a-activity with the total phosphorylase-activity (a and b) being within the normal range. The significance of these findings as well as possible pathogenetic mechanisms are discussed.
The fluid-filled stomach allows visualization of the gastric wall on real-time ultrasonic examination. In four cases with small focal gastric wall lesions (two cases with hyperplastic polyps, one with pseudopolypoid lesions, and one with polypoid infiltration of the gastric mucosa by malignant lymphoma), typical ultrasonic pictures were demonstrated. The polypoid lesions were located on the anterior and posterior gastric walls and at the gastric fundus, respectively. All who use the gastric sonic window for imaging the pancreas or the left upper abdomen should be aware that focal gastric lesions are also observable.
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Account is given of a patient with legionnaires' disease to highlight the increasing significance of this affection. The typical symptoms are described. Under doxycyclin at high dosage (200 mg/day) the patient became afebrile within 36 hours with concurrent improvement of his general condition. Distinct regression of the pulmonary infiltrate was seen within five days.
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In a prospective echographic and radiographic investigation of 281 patients and in a retrospective evaluation of 86 operated patients, echography and radiography gave approximately equally accurate diagnoses. By using both methods no pathological finding will be overlooked. For reasons of radiation protection, echographic examinations should be carried out first. If the echographic results agree with the clinical findings the radiological cholecystography can be dispensed with. Radiological investigation should be carried out if the echographic findings are at variance with the clinical findings. Consequently echographic cholecystography certainly cannot replace radiography, but it does contribute in that radiographic examination can be used selectively.
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The cockade phenomenon in the ultrasound picture is a sign of an infiltration of the gastrointestinal wall caused by tumour or inflammation. In 27 out of 40 patients with known infiltrations of the wall the cockade phenomenon could be demonstrated. In 16 out of 21 patients in whom this ultrasound phenomenon had primarily led to a suspected wall infiltration further diagnostic investigations proved organic wall thickening. Even if the cockade phenomenon is thus neither a specific nor a sensitive sign of gastrointestinal wall infiltrations the observation of this phenomenon is particularly important in patients in whom wall infiltrations of the gastrointestinal tract are not suspected.
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