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Biomedical subjects

J Bohl

Publications and source records attributed to J Bohl.

At least 109 records · Page 6Linked to original sources

[Imaging adrenergic tumours with 131J-meta-benzylguanidine].

Pheochromocytoma scanning using 131J-meta-benzylguanidine was done in one patient with metastasizing paraganglioma, one patient with multiple endocrine neoplasia type IIb. No activity of tumour tissue could be demonstrated in the patient with metastasizing paraganglioma, whereas the pheochromocytoma could be clearly defined in the patient with multiple endocrine neoplasia type IIa. The female with multiple endocrine neoplasia type IIb showed a suspect space-occupying lesion of the left adrenal using computed tomography. Pheochromocytoma could be excluded by 131J-benzylguanidine scanning, selective estimation of catecholamines in adrenal venous blood as well as the glucagon stimulation and clonidine suppression.

Adrenal Gland Neoplasms↗

[Massive retroperitoneal haemorrhage in the Bourneville-Pringle syndrome (author's transl)].

Case-report of a 54 year-old patient who was admitted with the clinical picture of an acute abdomen on the basis of intraabdominal haemorrhage. X-ray investigation discounted the diagnosis of ruptured aortic aneurysm, the CAT scan showed a suspected acute haemorrhagic necrotising pancreatitis. At laparotomy, a fatty, bleeding kidney tumour was found growing into the retroperitoneal tissue. The histological frozen-section showed a leimyo liposarcoma of the kidney. Bourneville-Pringle's disease was only afterwards known to be the basic illness of the patient, as was verified at postmortem examination. From the knowledge of these new facts, both the CAT-scan and the intra-operative and histological findings could be correctly interpreted.

Acute Disease↗

CT studies of brain abscesses in cats.

Cerebral abscesses were produced in 56 cats by introducing staphylococcus aureus into the white matter of one cerebral hemisphere, using a stereotaxic apparatus. The cats were treated with antibiotics and/or steroids. The size and density of the inflammatory process and the abscess ring were measured on postcontrast CT scans. Differences were found depending on the stage of the abscess, but the deviation of values were too great for determining the age of the abscess from one measurement, to be able to apply proper treatment. The size and density of the abscesses were the same on CT whether the animals were treated or not. This was contrary to the clinical picture, the measurements of edema, and the histopathological studies.

Animals↗

Central nervous system involvement in Whipple's disease.

A case of Whipple's disease is presented manifesting itself predominantly with neurological and mental symptoms but without gastrointestinal complaints. Although the first cranial CT in the fourth year of the disease was normal, the second, 1.5 years later, revealed intensive hypodensity of the white matter and cortical enhancement. CT findings are compared with autopsy results and a review of the pertinent literature is given.

Adult↗

Evolution of brain abscess in cats formation of capsule and resolution of brain edema.

Brain abscess evolution was studied in an experimental model in the cat correlating the computed tomographic scan appearance with intracranial pressure, brain edema and histopathological findings. Brain inflammation was produced by direct inoculation of Staphylococcus aureus into the white matter. Abscesses developed in all animals. The ring enhancement around the necrotic focus seen at an early stage after contrast-medium injection cannot be equated with capsule formation as long as the abscess diameter increased. Parallel to the acute stage of abscess, the intraventricular pressure increased due to the rising mass effect and the spreading edma. The morphological investigations revealed on the seventh day an extreme enlargement of extracellular spaces with immense amount of edema fluid, rich in protein and fibrin. Some blood vessels in the close vicinity of the abscess showed gaps within the endothelial cell layer. When encapsulation developed, ring enhancement became more homogeneous and decreased in diameter. In spite of encapsulation, a circumscribed disturbance of the blood-brain barrier persisted which was responsible for a belated resolution of edema and a slow decrease of intracranial pressure. Only therapy with dexamethasone could effect a marked change in the course of the disease.

Animals↗

[Trans-catheter embolisation of the spleen with butyl-2-cyanoacrylate. Experimental results and clinical application (author's transl)].

Partial and total trans-catheter embolisation of the spleen with butyl-2-cyanoacrylate-lipiodol in 23 dogs lead to partial necrosis and cicatrisation of the spleen after 3 to 5 weeks. The embolised vessels do not recanalise, but are by-passed by extra- and intra-splenic collaterals. In five animals there was a reduction in the number of erythrocytes; after embolisation there was increase in the number of leucocytes, whereas the thrombocytes were unchanged. The most common complication which occurred in five animals was a 1.5 to 2.5 cm. splenic abscess. The procedure was employed without success in one patient with bleeding oesophageal varices. The procedure was complicated by extensive necrosis of the gastric mucosa. Trans-catheter embolisation of the spleen has significant complications, despite strict asepsis and antibiotic cover. The main indication of the procedure is hypersplenism which cannot be treated surgically.

Animals↗

[Transrenal ureteric embolisation. Experimental and clinical results (author's transl)].

Transrenal ureteric embolisation with the tissue adhesive butyl 2-cyano-acrylate mixed with lipiodol and tantalum powder produces rapid and effective occlusion of the ureter. This can be combined with the use of a Gianturco spiral. In an experimental series of eight dogs observed for 54 days, the adhesive disappeared partly in three animals and totally in a further three. Fibrotic ureteric stenosis was observed in three animals. Clinical results were rather better because of the presence of external urinary drainage. Twenty-one ureters in eighteen patients were occluded either unilaterally or bilaterally, and sometimes combined with percutaneous contralateral renal embolisation. After one to four months, the ureter was still occluded in three out of six cases; after five to 17 months, three out of five cases were no longer totally occluded, but in two cases they were still blocked. The procedure is new and suitable for the treatment of otherwise untreatable conditions, such as extensive urinary fistulae, bladder tenesmus and haematuria due to extensive tumours of the minor pelvis.

Animals↗

[Experimental brain abscess evolution : brain edema and neuropathologic correlation (author's transl)].

In the right hemisphere of rabbits an inoculation of a mixture of agar and bouillon with Staphylococcus aureus was performed to examine brain inflammation, which always led to brain abscess with a spreading inflammatory edema. The size of the acute abcess and the concomitant edema are dependant from the degree of pathogenecity, less from the inoculated quantity of bacteria. In the acute phase, the edema had the tendency to spread towards the ventricular system. When the intracranial pressure exceeds a certain limit by the spreading edema, the mortality increased significantly. With the incipient encapsulation from the 5th day on the accumulation of extracellular fluid decreased but remained recognisable around the encapsulated abscess as long as bacteria maintain a chronic inflammation.

Acute Disease↗

[Cranial mucormycosis with thrombosis of the sinus cavernosus (author's transl)].

A case of mucormycosis in a 45 year-old woman with uncontrolled diabetes is reported. Following dental extractions, the patient presented with total ophthalmoplegia, chemosis and complete sensory loss of the right fifth cranial nerve. Exophthalmus was not present. Although a fungal infection was suspected, administration of Amphotericin B was avoided because of renal insufficiency. After temporary clinical improvement with high doses of antibiotics, signs of right seventh and eighth cranial nerve paralysis and of thrombosis of the right ophthalmic artery developed. The patient expired after six days. Autopsy disclosed extensive mucormycosis with involvement of the nasal cavity and paranasal sinuses, soft tissues and bones of face and orbit, cranial nerves, meninges and base of the brain, as well as mycotic thrombosis of the right cavernous sinus and the internal carotid, ophthalmic and maxillary arteries. The spread of infection is detailed, and the importance of an early diagnosis is stressed.

Carotid Artery Diseases↗

[Local myocardial necrosis and cardiac tamponade due to a central venous catheter (author's transl)].

A case of a paraventricular brain abscess, which favourably responded to conservative intensive therapy, is reported. A central venous catheter was the cause of myocardial necrosis leading to cardiac tamponade. In an attempt to tap the effusion, the partly necrotic cardiac wall was perforated. Only by recognition of the danger, by intensive clinical observation of a patient and by regular checkup of the catheter tip were the fatal complications following central venous catheterization avoided.

Adult↗

Changes of the ratio between myelin thickness and axon diameter in the human developing sural nerve.

Axon caliber and myelin sheath thickness of individual nerve fibers were evaluated in the developing human sural nerve using three different methods of measurement: 1. ocular micrometer evaluation of large fibers, 2. photographic enlargements for evaluating large numbers of nerve fibers of all sizes, and 3. electron microscopic enlargements for more precise measurements in selected nerves. The average axonal diameter doubles from 5 months gestation to about 5 years of age. Large fiber group axons increase, during the same period, by a factor of 3--3.5 with a slight decrease thereafter. The myelin thickness increases more slowly, but continuously, between 5 months gestation until the age of 14. This asynchronous development of axons and myelin sheaths results in a statistically significant change of the ratio between axonal caliber and myelin thickness. The slope of the regression line is steeper in older than in younger individuals, and the correlation coefficient increases during development of the nerve.

Adolescent↗

Transcatheter embolization of the kidney with butyl-2-cyanoacrylate: experimental and clinical results.

The technique and efficacy of therapeutic catheter embolization of the kidney with butyl-2-cyanoacrylate (Histoacryl) were studied in 80 rabbits (including control groups) and in 10 dogs. A mixture of butyl-2-cyanoacrylate, 50% glucose, and tantalum powder was used for the embolization. Complete and permanent vascular occlusion was found in nearly all cases. The main complication observed was a reflux of embolizing material into the lumbar arteries, which occurred in seven rabbits. Clinically therapeutic embolization was performed in six patients with hypernephroma. The indication for embolization in these patients, as well as in two others with iatrogenic lesions, was pronounced hematuria. Cessation of bleeding was achieved in all cases. For embolization the coaxial catheter technique is recommended; in special cases with extensive arteriovenous shunts, adjunctive balloon occlusion would be advisable.

Adenocarcinoma↗

Selective bilateral blood sampling from the inferior petrosal sinus in Cushing's disease: effects of corticotropin-releasing factor and thyrotropin-releasing hormone on pituitary secretion.

We sought to enhance the sensitivity of selective bilateral blood sampling to determine adrenocorticotropin (ACTH) and prolactin levels in the inferior petrosal sinus (IPS) by administering two stimulatory agents--corticotropin-releasing factor (CRF) and thyrotropin-releasing hormone (TRH). We then determined the ACTH and prolactin levels in the IPS of 10 patients with Cushing's disease. After peripheral administration of both CRF and TRH, ACTH levels were significantly higher on the tumor side in all patients. The prolactin level was significantly higher on the tumor side when CRF or TRH was used to stimulate pituitary secretion. Postsurgical immunohistochemistry studies revealed production of both ACTH and prolactin in tumor cells, explaining the abnormal secretion pattern of the pituitary adenoma. The use of CRF and TRH may therefore improve the reliability of selective blood sampling and tests from the IPS in those cases of Cushing's disease for which noninvasive methods have otherwise failed to clarify the diagnosis.

Adrenocorticotropic Hormone↗

Tissue characterization of benign brain tumors: use of NMR-tissue parameters.

To evaluate the potentials of NMR tissue parameters for tissue characterization we investigated 68 patients with benign brain tumors. Tissue parameters were accurately measured by a recently developed interlaced triple sequence. Each individual tumor was characterized by a set of three numbers (relaxation times T1 and T2 and proton density Rho). Different tumors exhibited significant overlaps of the three tissue parameters. Therefore a reliable prediction of the histological diagnosis based on the quantitative analysis of tissue parameters alone was not possible. T2-prolongation correlated well with water content and "regressive changes" in meningiomas and neuromas.

Adenoma↗

Unbiased estimation of neuronal numbers in the human nucleus coeruleus during aging.

The total number of the neuromelanin-containing neurons of the nucleus coeruleus was determined by means of a newly developed unbiased stereological counting scheme and a low-cost apparative set-up. The individuals (n = 20, age from 49-98 years) included in this study were carefully examined for absence of neurological or psychiatric disorders. However, minor Alzheimer's disease-related neurofibrillary changes occurred in some of the individuals of higher age and these changes were staged. The mean number of neurons per side of the nucleus coeruleus was 15,731 +/- 3,408 SD with a range from 11,737 to 25,319. In three individuals, we compared the left and right nuclei and did not observe significant side differences between the numbers of neurons. There was no correlation between the age of the individuals and the cell number. Also, no correlation was detected between the cell number and the staged occurrence of minor neurofibrillary changes of the Alzheimer type. Due to the novel counting method, the determination of the total cell number took less than 2 h per case.

Age Factors↗