[CT diagnosis of phlebothrombosis in Baker's cyst].
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Biomedical subjects
Publications and source records attributed to M Reiser.
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The regional distribution and the cellular localization of insulin-immunoreactive material in the rat brain has been studied during postnatal ontogenesis by use of radioimmunoassay and immunocytochemistry. It could be shown that there is a decrease in the amount of the peptide in the rat brain during postnatal maturation of the organ. This decline in insulin concentration is morphologically evident by a strong reduction of insulin positive nerve cells. Our findings support the hypothesis that insulin might play important roles as a nerve growth-promoting factor.
In 10% of the cases, phaeochromocytomas are extra-adrenal. This is a report on an 18 year old patient in whom the tumour was identified via sonography and computed tomography in the urinary bladder wall.
New methods of examination are measured in terms of the efficiency of their predecessors. The introduction of endoscopic retrograde cholangiopancreatography (ERCP) and computerised tomography (CT) constituted a turning point in the diagnosis of pancreatic disease. In its incipient stages as a clinical diagnostic method, the question is raised whether or not there is evidence that magnetic resonance (MR) can supplement, improve upon or replace the customary methods. It must, however, be taken into account that the technical development of MR is still in progress and that clinical experience with MR in the diagnosis of pancreatic disease, as in other areas, is still insufficient. At this point it is only possible to survey the trends.
Nine patients with malignant, peripheral soft-tissue tumours were examined using a 0.35 T MR equipment. In 7 cases in which tumour presence was surgically verified, a definite identification as well as an exact determination of tumour extension was achieved using MR. The various tumours exhibited a particularly high degree of contrast when using a T2-weighted Spin-Echo-(SE) as well as the T1-weighted Inversion-Recovery-(IR) mode. The T1- and T2-relaxation times of the soft-tissue malignancies evaluated in this study were markedly longer than those obtained for normal tissue. In 2 patients within the collective, a definite exclusion of tumour recurrence was possible.
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Computed tomography (CT) provides axial slices plane and shows excellent details of bones and different soft tissues, favoring its use in traumatic lesions caused by sporting activities. Complex anatomical structures such as the shoulder, the vertebral column, the pelvis, the knee, the tarsal and carpal bones are often better recognized in detail than by conventional radiography. Fracture lines, localization of bone fragments and involvement of soft tissues are clearly demonstrated. Luxations and bone changes leading to luxations can be shown. CT arthrography provides for the first time a direct visualization of joint cartilage and of cruciate ligaments in the knee joint, so traumatic lesions such as chondropathia patellae or rupture of the cruciate ligaments are shown with a high degree of reliability.
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Three patients undergoing haemodialysis, who had extensive calcified pseudo-tumours, were examined by computer tomography. In two patients bone destruction was present, which was obscured by the calcification on conventional radiographs. In one patient an abscess in the vicinity of the pseudo-tumour was discovered by CT. CT enables exact localisation of the calcified areas to be achieved and aids therapy.
One hundred and nine patients have been examined with NMR tomography, including 44 examinations of the abdomen. In 35 cases, different sequences were used. In 28 patients it was possible to determine the relaxation times T1 and T2. Pathological processes showed not only different T1 and T2 values, but also different pictorial contrast. In order to extract the maximum amount of information, it is necessary to carry out NMR tomography with varying sequences.
The value of nuclear magnetic resonance (NMR) tomography in the skeleton is analysed in 27 patients who had been examined by a prototype NMR scanner (resistive magnet, 0.2 Tesla). Anatomical structures and detail can be seen using the spin-echo mode and brief sequences. There is marked contrast difference between normal and abnormal tissues. Pathological changes lead to marked alterations in relaxation times. Inflammatory conditions, tumours and aseptic bone necrosis are demonstrated with a high degree of sensitivity. Tomography in the three geometric planes, with any desired additional plane, shows the extent and localisation of bone abnormalities.
Value and indication of computerized tomography in diagnostic procedures after trauma of the musculoskeletal system is shown analyzing the case material with CT in traumatized patients. In general CT is not to take place of conventional X-ray methods. We feel CT is indicated in evaluation of: intraarticular fragments, congruity of joints, lesions of the cruciate ligaments and osteocartilagineous fractures, if conventional X-ray procedures prove insufficient.
In 69 patients with extrahepatic biliary obstruction a specially designed teflon tube, the endoprosthesis, was inserted across the ductal stenosis either by percutaneous or by endoscopic route to reduce jaundice. After gaining experience our success rate of stent placement was more than 90%. Compared with catheter drainage the endoprosthesis worked faster and more efficiently, while in palliative treatment the quality of life of the patient improved and secondary cholangitis was prevented. The rate of significant long-term stent obstruction can be tolerated in view of the expected life span of four months as average in our material.
NMR examinations were performed on a total of 109 patients using a resistive magnet. In 67 patients various organs and tissues of the face and neck the trunk and the limbs were evaluated in axial, sagittal and coronal planes. The use of more than one sequence time is essential for adequate representation of the anatomical structures and for detection and evaluation of pathological processes. They are the base to compute "secondary" T1- and T2-images, in order to obtain numerical values of both relaxation times. Thus a better understanding of the morphology of structures within the images is obtained. NMR appears to represent a sensitive method of tissue characterization: Specific changes in the T1- and the T2-pattern were found in pathological conditions, e.g. longer T1-times with normal or moderately longer T2-times in tumors compared to healthy tissue and extremely long T1- and T2-times typical of fluid accumulations.
One of the main problems encountered in cryosurgery is that of controlling the amount of tissue that is irreversibly destroyed by cooling. In vitro-experiments in which the homogeneous cooling of various substances, as well as "ice-ball" propagation within different tissues of animals via a cryotip were evaluated. In vivo experiments, on an anaesthetized pig, indicate CT to be a useful continuous-monitoring technique with a high spatial resolution. Using CT simultaneous localization of pathological tissue and measurement of temperature distribution is possible. The density changes induced by cooling were visualized on CT and the corresponding temperature changes were measured using thermocouples. The greatest decrease in density was observed as a change of phase took place. The speed of ice-ball propagation as well as the diameter of the ice ball generated varied considerably depending on the type of tissue. Construction of cryoprobes of a very small diameter could facilitate the percutaneous treatment of lesions within the body.