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Biomedical subjects

M Caselitz

Publications and source records attributed to M Caselitz.

23 records · Page 2Linked to original sources

3D-ultrasound in imaging, diagnosis and follow-up of an atypical hydatid cyst.

Abdominal ultrasonography is the procedure of choice to diagnose hydatid cysts caused by Echinococcus granulosus. Recently three-dimensional ultrasonography has become available for clinical application. We report a case of an atypical seronegative hydatid disease, in which the additional use of 3D-sonography improved the sonographic diagnosis, which was confirmed by a fine needle biopsie complicated by an anaphylactic reaction. In addition the potential advantage of 3D-ultrasonography in diagnosis and follow-up hydatid disease will be discussed, especially in the context of new alternative therapeutic options like chemotherapy with benzimidazoles or the percutaneous drainage by the PAIR procedure (puncture-aspiration-injection-re-aspiration).

Adult↗

Hepatitis B associated liver failure following bone marrow transplantation.

BACKGROUND: Several cases have been reported showing clearance of HBsAg in chronic hepatitis B carriers due to adoptive transfer of immunity by an hepatitis B immunised bone marrow. CASE REPORT: We report on a 27-year-old man with chronic myelocytic leukemia and asymptomatic chronic hepatitis B who received allogeneic bone marrow transplantation (BMT). The donor was his HLA identical brother with natural immunity against hepatitis B. Before BMT the donor had received an additional dose of recombinant hepatitis B vaccine. Twenty days after BMT alanine aminotransferase levels increased and graft versus host disease of the skin was observed. Elevation of liver enzymes was initially attributed to graft versus host disease of the liver and the patient received high doses of steroids in addition to standard immunosuppression. Alanine aminotransferase levels increased up to a maximum on day 52 while the HBV DNA level peaked on day 38 after BMT. A liver biopsy showed reactivation of hepatitis B and treatment with steroids was tapered down. Although alanine aminotransferase and HBV DNA levels decreased, liver function deteriorated. The patient died 130 days after BMT due to liver failure. CONCLUSION: This report indicates that disturbance of the balance between HBV replication and immune control after BMT may result in fatal reactivation of hepatitis B. Careful monitoring, including HBV DNA level and early liver biopsy, of patients with chronic hepatitis B undergoing BMT as well as determination of the HBV immune status of the BMT donor is suggested and necessary.

Adoptive Transfer↗

[Approaches to objective assessment of differences in tissue textures by ultrasound equipment as a contribution to quality assurance].

PURPOSE: For clinical investigators the increasing number of ultrasonic machines with different technological equipment makes it difficult to reliably assess their ability to differentiate between the textures of various tissues. We investigated a procedure for a standardised method to measure the tissue texture when using different ultrasonic machines. METHODS: The texture parameters concern brightness, standard deviation, coefficient of variation and spatial coefficient of variation. These were calculated for three tissue phantoms with changing levels of gain and distance. These parameters, well established in literature for speckle detection, texture differentiation and contrast monitoring were useful for rapid comparison of the texture differentiation achieved by several ultrasonic machines. RESULTS: A linear relationship between standard deviation and mean image brightness seems to be an important factor for the detection of small changes in ultrasonic textures. We noticed great differences between the various ultrasonic machines tested by us. The best parameter in our set was the spatial coefficient of variation. CONCLUSION: The method allows rapid orientation regarding the ability of a machine to distinguish between several textures depending on the brightness, and offers an opportunity of determining the best working point for a given machine.

Equipment Design↗

Perihepatic lymphadenopathy: a marker of response to interferon alpha in chronic hepatitis C.

BACKGROUND/AIMS: Recently it was shown that perihepatic lymphadenopathy (PHL) correlates with histological activity in chronic hepatitis C. However, the question whether there is a correlation between the response to interferon alpha and PHL has not yet been raised. METHODOLOGY: We examined 103 patients who had been treated with interferon alpha for hepatitis C. Prior to treatment all patients had undergone high resolution ultrasonography. Thirty-six patients had follow up ultrasound scans during the course of the treatment. According to size and number of lymph nodes we introduced a grading of the PHL and determined grade I as minimal, grade II as medium and grade III as extensive PHL. RESULTS: Classification of PHL prior to treatment revealed 40 patients with PHL I, 30 with grade II and 33 with grade III. Hepatic inflammatory activity according to the Ishak score was increased in patients with PHL III (9.1+/-2.4) compared to PHL II (6.7+/-2.9) and PHL I (7.3+/-3.1) (p=0.01). In patients with PHL grade I prior to treatment 45% were initial responder, patients with grade II or III showed response rates of 40% and 33%, respectively. During therapy we found an increase of PHL in one out of 13 primary responder vs. 10 out of 23 non-responder (p=0.03). CONCLUSIONS: In conclusion, monitoring of PHL by abdominal ultrasonography is a simple, non-invasive and cheap additional marker of response to interferon alpha.

Adolescent↗