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Biomedical subjects

M Uhl

Publications and source records attributed to M Uhl.

At least 91 records · Page 5Linked to original sources

Cine-MR imaging of the shoulder.

PURPOSE: Shoulder lesions are usually examined with the joint in only one or two positions. We examined the shoulder with the joint in a variety of positions. We also assessed the application of cine-MR to the detection of instability and impingement. MATERIAL AND METHODS: The cine-MR examinations were performed in 30 patients and 15 healthy volunteers. We used an open 0.2 T system and a closed 1.0 T system. Spoiled gradient echo 2D T1-weighted images and turbo spin-echo T1- and T2-weighted images were obtained with a field of view of 180 mm. The examinations were videotaped and evaluated later. RESULTS: Normal variations of the glenohumeral joint were easy to recognize. Sub-luxations and luxations of the humeral head as well as rupture of the labrum were identified. It was also possible to identify the labrum with a signal change after arthroscopic refixation. And we were able to objectively assess distances between the osseous structures during dynamic movement. CONCLUSION: Unlike static MR, cine-MR would appear to be useful in visualizing the capsular ligament complex of the gleno-humeral joint in impingement and instability. It also provides information on dynamic changes and may thus prove to be an important tool for shoulder diagnostics. The method may provide an early diagnosis in the sub-acromial impingement syndrome.

Acromion↗

Analysis of fentanyl and sufentanil in hair by GC/MS/MS.

Fentanyl and sufentanil are potent narcotic analgesics used only in hospitals as anaesthetic agents. The dependence potential of fentanyl is known. As they are given in doses at the microgram level and their elimination half-life is in the order of a few hours, detection in body fluids is possible only for a short time after administration. Radioimmunological methods are the only ones capable of detecting fentanyl in hair, as normal GC/MS methods for hair analysis are not sensitive enough to detect the drugs after doses in the order of micrograms. We therefore chose GC/MS/MS to analyse fentanyl and sufentanil in two cases where the drugs were given under controlled conditions over several days. The concentration was in the order of less than 100 pg/mg hair.

Anesthetics, Intravenous↗

[Magnetic resonance tomography of liposarcoma].

PURPOSE: Liposarcoma is the most common soft tissue sarcoma in adults. The purpose of the study was to correlate MR imaging features with the four ICD subclasses. METHODS: 28 patients with liposarcoma were examined preoperatively on a 1.0 T MRI system, using spin echo sequences, gradient echo imaging and STIR sequences. In all patients, classification of the liposarcomas was made by histologic diagnosis (ICD-10-M-classification). RESULTS: Well differentiated liposarcomas (9 patients) showed a number of MRI features consistent with lipoma (well defined mass high signal intensity (SI) on T1 images, low signal on T2 images, no or only little signal increase of tumour tissue after contrast material application, no necrosis). Not well differentiated liposarcomas (myxoid 14 patients, pleomorphic three patients, round cell two patients) revealed the largest part of the mass to be of low SI on T1-weighted images. Only scattered fatty islands and septa (9 patients with myxoid liposarcoma had more SI in T1-weighted images. T2-weighted image showed most of the mass to be of intermediate to high SI are the fatty island of relatively low SI. The probability of tumor necrosis increased with lower tumour grading. CONCLUSION: MRI seems to be valuable to identify well differentiated liposarcomas.

Adult↗

Multicentric reticulohistiocytosis. A report of 3 cases and review of literature.

Multicentric reticulohistiocytosis (MR) is a rare systemic disease of unknown cause. The disease is characterized by tissue infiltration of lipid-laden histiocytes and multinucleated giant cells. Destructive polyarthritis and skin lesions are the most common findings. The disease becomes apparent in adult life. We report on 3 patients and discuss the specific radiographic characteristics of bone and joint involvement. The radiologic feature is a bilateral, symmetric joint involvement with predilection for the interphalangeal and metacarpophalangeal joints. In all of our cases we found an early involvement of shoulder joints. Erosive arthritis begins at the margins of the joints, progressing to osseous defects and to severe joint destruction. In contrast to rheumatoid arthritis, periarticular osteoporosis and early joint space loss are absent in MR. In addition, significant erosions of distal interphalangeal joints are not common in rheumatoid arthritis.

Adult↗

[Postoperative MRI morphology of the anterior cruciate ligament after primary ligament suture or ligament-plasty. A prospective study of 50 patients].

AIM: Identification of typical postoperative change after anterior cruciate ligament reconstruction (sutures, tendon grafts) and comparison with clinical tests and ultrasound. PATIENTS AND METHODS: 50 patients with anterior cruciate ligament ruptures were examinated with MRI (1.0 T, surface coil, sagittal T1-3DFT-Fast and sagittal spin-echo), US and clinical function tests (Lachmann, pivot-shift, anterior drawer test). RESULTS: In 19 of 21 patients with continuous low-intensity ligament structures in the MRI, knee stability was very good or good in the clinical tests and US. In 17 of 20 patients with a diagnosis of partial rupture at MRI, we also found a stable knee. 5 of 7 patients with the MRI-signs of ligament rupture showed knee stability at US and clinical tests. Furthermore, at MRI we found minor effusions in 10 patients, meniscus tears in 8 patients and ligament impingement in 2 patients. CONCLUSION: MRI is a valuable method for evaluating and assessing anterior ligament reconstructions. We found a good correlation between the continuous low-intensity ligaments at MRI and knee-stability. In contrast there is a bad correlation between discontinuous ligament structures at MRI and clinical stability of the knee. MRI seems to provide more information than US and clinical tests (for example: minor effusion, meniscus tears, ligament impingement, bone lesions).

Anterior Cruciate Ligament↗

Hoffa fracture--a radiologic diagnostic approach.

Hoffa fracture is a rare injury consisting of unicondylar tangential posterior fracture of the distal femur. On plain radiographs the fracture line is clearly seen. However, some fractures and musculotendinous injuries may display subtle features and may be difficult to detect even with optimal images. We explain the mechanism of injury, discuss the diagnostic work-up and the operative and nonoperative management.

Adult↗

Origins and clinical implications of aneuploidy in early bladder cancer.

Cytogenetic and flow cytometric studies in a variety of human solid tumors have suggested that gross aneuploidy may arise by a process of abrupt chromosome complement doubling followed by gradual chromosome loss. However, this sequence has not been demonstrated directly in serial studies in individual patients in vivo. The purpose of this study was to search for evidence of chromosome complement doubling and subsequent chromosome loss in flow cytometric ploidy patterns in serial bladder washings and/or biopsies from individual patients with early bladder cancer. Fifty-two patients with noninvasive bladder cancer were followed with serial flow cytometric DNA studies for periods ranging from 5.1 to 42.7 months (median 15.1 months). Serial changes in DNA ploidy and S phase fractions were recorded and correlated with histologic and/or cytologic findings, response to treatment and clinical outcome. The data suggest a series of genetic evolutionary changes in early bladder cancer that include the initial development of peridiploid aneuploidy and repeated rounds of DNA content doubling with chromosome loss in patients with progressive disease. It is likely that gross DNA aneuploidy, and more specifically, DNA multiploidy and DNA hypertetraploidy, all arise by this mechanism. The sequence of DNA diploidy, peridiploid aneuploidy, near-tetraploidy, hypotetraploidy and hypertetraploidy is associated with a progressive increase in S phase fraction, and with increasing tumor grade; late steps in this ploidy sequence were often present in tumors that were refractory to local therapeutic measures and tumors that developed deep tumor invasion and/or distant metastases. We conclude that DNA multiploidy and hypertetraploidy are markers of advanced stages of genetic evolution in human bladder cancer.

Adult↗

[Pulmonary infiltrations in Sjögren syndrome--a radiodiagnostic study].

We report on the radiological findings of 8 female patients with primary Sjögren's syndrome and pulmonary infiltrations. In the chest x-ray, all patients featured an interstitial diffuse bilateral reticular pattern which was most prominent in the bases. The apices of the upper lobes were not involved. There were no pleural effusions. The radiologic appearances changed only slowly. In three cases the lesions progressed to form a patchy confluent pattern. 4 of 8 patients developed within 24 months a nodal or extranodal lymphoma of low-grade malignancy.

Aged↗

[Parapneumonic ARDS. The radiomorphologic transition of a pneumonia into an ARDS].

Serial chest X-rays of 14 patients with parapneumonic ARDS (PARDS) were analysed retrospectively. Typical findings on chest X-ray films occurred after a latency period of 12-24 h following the clinical start of PARDS. We found some "early signs" of PARDS, such as central interstitial paravascular edema (14/14), bilateral hilar infiltrates (9/14) and the absence of pleural effusion (12/14).

Adult↗