[Diagnosis of neurofibromatosis by nuclear resonance tomography].
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Biomedical subjects
Publications and source records attributed to M Reiser.
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The cruciate ligaments of the knee joint can be demonstrated by magnetic resonance tomography, without using invasive methods. High resolution coils and section thickness of less than 5 mm are necessary. Sixty-six patients and volunteers were examined; the results show that the normal cruciate ligaments present as homogeneous zones of low signal intensity within the surrounding fat. Injuries to the cruciate ligaments interrupt the image of the ligaments, change their anatomical position or produce a signal of intermediate intensity. Eighteen operations were carried out on fifteen patients with cruciate ligament injuries and there was good agreement between the MR and the operative findings. Sixteen patients had had previous cruciate surgery and in these there was only partial correlation with the clinical findings.
The results of MR tomography in 13 patients with specific and nonspecific spondylitis are reported. There were characteristic changes in signal intensity and in the configuration of the vertebral bodies and the intervertebral discs. The extent of intraspinal stenosis can be demonstrated accurately by MR. Paravertebral abscesses can be shown accurately and their position can be clarified by means of multiplanar sections. The early diagnosis of spondylitis by MR tomography is discussed.
Selective arterial DSA of the arteries of the femoral head was carried out in 39 patients. The appearances were studied in nine patients without any hip abnormality, in 13 idiopathic and eight post-traumatic cases of femoral head necrosis and in nine patients with recent fractures. In every patient the vessels were well demonstrated. In the presence of idiopathic aseptic necrosis there was always hypervascularity around the necrotic area. As in the normal controls, pathological findings were seen in the deep branch of the medial circumflex femoral artery and in the nutrient artery in one-third of patients. Post-traumatic aseptic necrosis, recent fractures and dislocations always showed abnormalities of the vessels to the femoral head. The changes in the femoral head vessels demonstrated by DSA are probably not of great significance for the development of idiopathic aseptic necrosis, however they are found regularly following trauma.
The findings on MR tomography in fourteen patients with osteomyelitis and eight patients with arthritis are described. A retrospective analysis showed that MR was superior in demonstrating changes in the bone marrow and spread of infection round the bone. These changes are shown more accurately and with better contrast after the use of gadolinium DTPA. T1 and T2 sequences appear to be necessary.
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Ten cases displaying a focal area of increased echogenicity in the lower fetal abdomen on prenatal sonography are reported. This was an isolated finding in each case. Nine cases were noted early in the second trimester. The last case corresponded to a postmature gestation. In all cases, a normal lower abdomen was documented on follow-up prenatal sonography, at birth, or at autopsy. The authors believe that increased echogenicity in the lower fetal abdomen represents a normal variant that is more common than suggested by the literature. A possible explanation of this pattern is offered.
A case of occult gastrointestinal bleeding due to jejunal metastases of a primary lung carcinoma in a 53-year-old man is reported. When after healing of a large gastric ulcer melena persisted, a subsequently performed double contrast enema of the small bowel revealed evidence of several jejunal tumors. This was confirmed by angiography of the superior mesenteric artery and computed tomography of the abdomen. After resection of the tumor-bearing jejunal loop, histological evaluation revealed metastases secondary to a large-cell bronchogenic carcinoma which had been resected 1 year previously.
Thiol: Protein-disulfide oxidoreductase (TPO) was localized in the brain of juvenile and adult rats by use of the unlabeled immunoperoxidase technique. In the brain of adult animals, TPO protein was revealed in neurons of Nucc. supraopticus and paraventricularis as well as in the subcommissural organ. In the developing rat, TPO seems to be a constituent of almost all neurons. The roles played by the enzyme remain to be elucidated, however.
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Intracerebroventricular (i.c.v.) administration of a low dose of insulin strongly increased hot-plate latencies in rats, while no alteration was found in the duration of hexobarbital-induced sleep of the animals. The amount of insulin applied did not significantly change blood glucose and insulin levels and did not evoke any apparent effects on body temperature of animals.
The authors report on a patient of 31 years of age with bilateral necroses of the head of the femur and of the humerus. Internistic and neurological examinations did not yield any pointer to an existing symptomatic bone necrosis, so that this case--not described in literature so far--represents an aseptic, idiopathic necrosis of both femoral and humeral heads. The findings obtained with plain radiography, computed tomography, selective angiography of the femoral head and magnetic resonance tomography are presented.
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X-ray studies of the ankle joints of 209 patients with operatively certified ankle joint instability were examined retrospectively in order to estimate the importance of lateral instability in causing degenerative osteoarthritis of the ankle joint. The patients were distributed into two groups: group A (126 patients with chronic fibular instability; 98 were up to 29 years of age and 28 between 30 and 40 years) and group B (83 patients with a fresh fibular rupture: 70 up to 29 years and 13 between 30 and 40 years). For more subtle differentiation of the grades of osteoarthritis, a new score system was developed. The results were tested statistically. In the patients with chronic instability in the younger group signs of degenerative arthritis could be seen twice as frequently as in the recently injured patients; in particular, higher grades of arthritis were found five times more frequently than in the recently injured. All patients with chronic instability in the older group had signs of degenerative arthritis. Higher grades of degenerative arthritis occurred ten times more frequently than in the recently injured. Regarding the recently injured patients, there was no significant difference between the younger and the older group. It is concluded that chronic fibular instability is an important factor in the development of degenerative arthritis, which shows the importance of early stabilization in order to prevent the development of degenerative arthritis.
Aortic aneurysms can be visualised in the transverse, sagittal and coronary planes using magnetic resonance (MR) thereby enabling their cranio-caudal distension as well as their breadth and depth to be accurately determined. The important question concerning the vessel exits of the main branches of the aorta and their involvement in the aneurysm can be reliably answered. In the case of dissecting aortic aneurysms, the two lumina as well as the dissected vessel wall can be seen in the image. By choosing suitable recording parameters it is possible to differentiate between flowing blood and a thrombus attached to the vessel wall. The thrombus is recognisable from the decrease it causes in the signal intensity of the T2-selected image, whereas flowing blood emits a stronger signal in the T2-selected image than in the T1-selected image. An indication of the flow behaviour and flow rate of blood can be obtained from the differences in the signal intensity distribution in the vessel lumen.
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