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Biomedical subjects

R Felix

Publications and source records attributed to R Felix.

At least 523 records · Page 29Linked to original sources

[Magnetic resonance tomography and computerized tomography in tumor staging of mouth and oropharyngeal cancer].

30 patients with malignant tumours of the cavum oris and oropharynx were examined by MRI and CT to compare their accuracy for T-staging. There was histological information in all cases. Histological studies showed an accuracy in T-staging of 81% for MRI and 77% for CT. Differentiation between stages T2/T3 and T3/T4 is possible in 80% by CT and 84% by MRI. Tumours of the cavum oris and oropharynx of T1-stage are possible only in 1 of 3 cases. The use of T2-weighted sequences allows the best frequence of tumour representation in 89%. CT shows an earlier bone involvement than MRI. In addition, the ability to produce coronal and sagittal images by MRI makes it superior to CT in judging tumour extension.

Adult↗

[Feasibility of the differential diagnostic imaging of neck lymphomas].

In 51 patients with cervical swellings, pretherapeutic examinations by ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) were carried out for the confirmation of exclusion of cervical lymph node metastases. By use of the M/Q ratio and morphological criteria, it is possible with ultrasound to differentiate between relatively enlarged lymph modes and lymph node metastasis with a certainly of > 90%. This was only possible in CT after administration of contrast media and the success rate was lower (72%). Both by use of the M/Q ratio and contrast medium administration, MRI is able to distinguish between lymph node metastases and reactively altered lymph nodes. Differentiation between Hodgkin/non-Hodgkin lymphomas of the neck and reactively enlarged lymph nodes is also possible with the aid of the M/Q ratio. In such cases, sonography and MRI are superior to CT. A certain differentiation between lymph node metastases and Hodgkin/non-Hodgkin lymphomas is only possible in some cases. However, there are indicative criteria for differential diagnosis. A delineation between specific lymph node inflammations and glomus carotid tumors is also possible because of the differing take-up of contrast medium in CT and MRI and via doppler sonographic criteria.

Diagnosis, Differential↗

[Diffuse demineralization of the lumbar spine. Magnetic resonance tomography studies of osteoporosis and plasmacytoma].

On plain radiographs, diffuse infiltration of the spine in multiple myeloma may present as diffuse demineralization. Differentiation from osteoporotic changes is then difficult. 15 patients with multiple myeloma and 15 patients with osteoporosis were prospectively examined by MRI using plain and contrast enhanced gradient echo techniques. Examinations were evaluated for lesions and diagnosis was made by two independent observers. Contrast enhancement was visible in lesions detected in myeloma patients and in compression fractures. Fractures could be differentiated from malignant lesions by the fact that there was no multiplicity of enhancing lesions. Contrast enhanced opposed phase gradient echo sequences seem suited for the detection of vertebral involvement in myeloma.

Adult↗

[Primary femoral recanalization using a slowly rotating catheter system].

Over a period of 2 years, 26 patients with chronic occlusions of the superior femoral and popliteal arteries were referred for recanalization. In two cases, the origin of the superior femoral artery could not be detected. A primary recanalization was achieved in 21 of 24 patients by the catheter system used by us (Viadyn). A stent (extensor) had to be implanted in one case because of a considerable lesion of the intima. A short-term clot lysis was indicated for another patient. On the basis of our results, rotation angioplasty with a slowly rotating catheter system seems to be the therapeutic method of choice for chronic arterial occlusions in the thigh.

Aged↗

[Gadolinium-DTPA enhanced MRT in the evaluation of the healing of autologous patellar ligament transplants for anterior cruciate ligament reconstruction].

Eighteen patients with autologous patellar tendon transplant for reconstruction of the anterior cruciate ligament were examined postoperatively. The time between operation and MR study was up to 3 weeks in ten patients, between 3 and 35 weeks in three patients and more than 35 weeks in five patients. In all patients, Gd-DTPA enhancement on the surface of the ligamentous transplant was visualized. This enhancement was between 1 and 10 mm thick. In all patients, complete stability of the knee joint was achieved, postoperatively. In 15 patients flexion and extension were normal at the postoperative investigation. Three patients had a limitation of knee movement. In these MR studies, significant hyperplasia of the synovial membrane of the entire joint was diagnosed, explaining the persisting problems. Gd-DTPA-enhanced MR of the knee joint allows non-invasive documentation of remodelling following a patellar ligament transplant and possible complications.

Adolescent↗

[Quantitative 201Tl-scintigraphy of the lower limb in arterial occlusive disease].

201Tl scintigraphy is useful in evaluating the hemodynamic consequences of arterial stenoses in arterial occlusive disease. The aim of the present study was to determine normal values for absolute Tl uptake in the lower leg, for the quotient between left and right lower leg uptake as well as for the redistribution pattern after bicycle exercise. We examined as reference 49 patients without clinical evidence of peripheral or coronary artery disease: absolute Tl uptake in the lower leg in anterior scintigraphy (acquisition time: 120 sec) was 5.02 +/- 1.70 counts/pixel (left) and 5.21 +/- 1.53 counts/pixel (right), the quotient between right and left lower leg was 0.85 +/- 0.09 and the redistribution pattern (quotient of the mean activity exercise/rest) 0.82 +/- 0.17 (left) and 0.83 +/- 0.15 (right). The arithmetic mean minus 2 standard deviations was regarded as the lower limit of normal. In 8 patients with mechanical compression of the left femoral artery before injection at least two scintigraphic parameters were abnormal, in 7 patients with angiographically proven peripheral artery disease at least one scintigraphic parameter was below normal. Quantification of Tl redistribution offers diagnostic advantages in bilateral peripheral artery disease.

Adult↗

[Prophylactic inhalation of amphotericin B in invasive aspergillosis: a distribution study].

Invasive pulmonary aspergillosis (IPA) during periods of immunosuppression or prolonged neutropenia is a serious condition with high mortality. Prophylaxis is unsatisfactory because of the low effectiveness of systemic administration of amphotericin B (AMB) and because of its side effects. Prophylactic inhalation of AMB by means of a nebulizing system may be able to reduce the incidence of IPA. Therefore, we studied the distribution of nebulized 99mTc-labeled AMB and estimated its particle size. AMB is homogeneously distributed in the lung and partly deposited in the terminal respiratory unit; it remains there with a half-life of at least 14 h. Therefore, prophylaxis of IPA with AMB nebulized as described can be recommended.

Administration, Inhalation↗

Detection of transcripts for the receptor for macrophage colony-stimulating factor, c-fms, in murine osteoclasts.

Macrophage colony-stimulating factor (M-CSF), whose action is restricted to the cell populations of the mononuclear phagocyte system, has recently been found to be required for osteoclastogenesis and bone resorption. To investigate the cells involved in the action of M-CSF in these processes, expression of c-fms mRNA, encoding the M-CSF receptor, was studied by in situ hybridization. Paws from murine embryos and newborn mice, tibiae from 2-day-old animals, as well as isolated osteoclasts, were hybridized with a c-fms-specific RNA probe. In bone, c-fms mRNA was detected only in cells at the late stages of osteoclastogenesis and in mature osteoclasts. The findings strengthen the relation between osteoclasts and the mononuclear phagocyte system. Furthermore, they suggest that M-CSF acts directly on osteoclast precursors and on mature osteoclasts during osteoclastogenesis.

Animals↗

[Radioimmunoscintigraphy of colorectal tumors with 99m-Tc marked CEA antibodies. Indications and clinical value].

In Germany, radioimmunoscintigraphy (RIS) (scintigraphic, specific imaging of benign and malignant diseases by radioactively labelled monoclonal antibodies) has been employed since 1985 in clinical trials involving patients with colorectal cancer. After proving successful for identifying primary tumors, RIS is now increasingly being used for the early diagnosis of recurrent and metastatic lesions. In this prospective study involving 75 patients with colorectal tumors confirmed by endoscopy and biopsy, it was shown that RIS using the SPECT technique with 99m-Tc-labelled monoclonal CEA antibodies has a sensitivity of 78% in the detection of local recurrent disease in cases in which diagnostic work-up has been inconclusive.

Adult↗

Transcranial Doppler ultrasound in internal carotid artery and middle cerebral artery disease.

Using noninvasive transcranial Doppler sonography, we studied cerebral collateral patterns in 30 patients with stenosis and/or occlusion of the extracranial internal carotid artery (ICA). All patients with unilateral ICA stenosis less than or equal to 80% had normal transcranial Doppler findings. 80% of patients with unilateral and 50% of patients with bilateral ICA stenosis of more than 80% including those with occlusion showed a collateralization via the ipsilateral anterior and/or posterior cerebral artery. 20% of patients with unilateral and 50% of patients with bilateral ICA stenoses of more than 80% (including occlusion) had two or three collateral pathways, including the ophthalmic artery. Another ten patients with stenosis or spasm of the middle cerebral artery (MCA) showed increased flow velocities with turbulence in the narrow segment. In four patients with severe MCA disease with a systolic peak velocity of more than 200 cm/s, the Doppler waveform distal to the lesion was damped. Decreased regional cerebral blood flow (rCBF) measured by 99mTc-HMPAO-SPECT was found in two patients with severe MCA stenosis. Another patient with moderate MCA stenosis with a systolic peak velocity of 140 cm/s showed a normal cerebral perfusion pattern.

Adolescent↗

[Catheter-induced femoral artery lesions: diagnosis with B-mode ultrasound, Doppler ultrasound and color Doppler ultrasound].

A total of 44 patients were evaluated to compare the value of B-mode sonography, Doppler sonography and colour coded Doppler sonography. All patients were studied because of suspected lesions of the femoral arteries following diagnostic and/or therapeutic cardiac catheterisation. B-mode sonography was unable to reliably differentiate between haematoma and pseudo-aneurysms, a.v.-fistula or combined lesions. Colour coded Doppler sonography can better demonstrate haematoma and thrombi in pseudo-aneurysms. The neck of a pseudoaneurysm can be exactly depicted by colour coded Doppler sonography. A.v.-fistula is shown by colour coded Doppler sonography based on typical colour coding and the Doppler spectrum. Combined lesions of pseudo-aneurysm and a.v.-fistula cannot reliably be detected by colour coded Doppler sonography, duplex sonography and B-mode sonography.

Adult↗

The significance of diagnostic imaging in acute and chronic brain damage in boxing. A prospective study in amateur boxing using magnetic resonance imaging (MRI).

The significance and possible extent of structural damage to the central nervous system (CNS) due to boxing are investigated. Bleeding, especially microhematomas, is considered to be one probable cause of the chronic encephalopathy in boxers. In a prospective study, 13 amateur boxers were investigated with the help of MRI several times before and after their fights. The MRI investigations were accompanied by neurologic examinations before and after the fights. Among the 13 boxes, 5 demonstrated focal neurological signs following the fights, without evidence of small hematoma or other structural alterations. The number of head punches did not correlate with the occurrence of neurologic signs. These results indicate that up to now imaging methods cannot clarify the development of chronic encephalopathy.

Acute Disease↗

[The value of radioimmunoscintigraphy compared to computed tomography in the diagnosis and relapse diagnosis of colorectal tumors].

Radioimmunoscintigraphy (= RIS, scintigraphic "specific" imaging of benign and malignant diseases by means of radioactively marked monoclonal antibodies) has been performed in Germany in clinical studies since 1985 in patients suffering from colorectal cancer. After having been successfully proven in primary studies, RIS is now being used in the early diagnosis of recurrences and metastases. In the prospective study presented here the clinical usefulness of RIS was assessed in comparison against well-tried diagnostic methods including computed tomography in patients suffering from colorectal cancer. It was shown that RIS in SPECT technique (= single photon emission computed tomography) with 99mTc-labelled monoclonal CEA antibodies can visualise local recurrences if diagnostic findings are doubtful, with a sensitivity of 78% versus 50% for CT findings.

Adult↗

[Oral contrast media for the magnetic resonance tomography of the abdomen. A clinical trial of the tolerance for gadolinium-DTPA].

Safety and efficacy of gadopentetate-dimeglumine (Gd-DTPA) as a MR bowel contrast agent were determined in 133 patients with CT-proved abdominal and retroperitoneal mass lesions using a buffered formulation (1 mmol/l Gd-DTPA, 15 g/l mannitol, 25 mmol/l sodium-citrate, 6-17 ml/kg). Short-lived gastrointestinal side effects were noted in 32% of patients. Gd-DTPA provided uniform, hyperintense bowel labelling and contrast enhancement in the region of interest in 81% of patients. Among 78 patients with pre- and postcontrast images lesion delineation was improved in 62%. In 55 studies with postcontrast images only, Gd-DTPA proved useful in 65%. In 105 of 109 cases IV injection of scopolamine or glucagon eliminated image artifacts arising from peristalsis of opacified bowel. The authors conclude that Gd-DTPA is a safe and effective MR bowel contrast agent.

Abdomen↗

[The HR computed tomography of interstitial lung diseases].

In 50 patients with pulmonary disease of varying aetiology and involvement of the pulmonary interstitium, high resolution CT with 1 mm sections have been performed. Various morphological changes within the secondary lobule could be demonstrated which helped in reducing the differential diagnosis. Compared with conventional CT with 10 mm cuts it was also possible to improve the demonstration of pleural lesions by changing window levels.

Asbestosis↗

[Cervical lymph node metastases. The sonographic demonstration of malignancy].

The value of sonography for demonstrating cervical lymph node metastases has been studied, using longitudinal and transverse measurements as criteria for malignancy. A transverse/longitudinal quotient greater than 2 indicates the presence of metastases with a 96% assurance. Using only longitudinal measurements lymph node metastases can be excluded with only a 36% assurance. The sensitivity of both methods also differs (95% for the maximal transverse quotient as against 90% for longitudinal measurements). The use of the maximal transverse quotient increases specificity from 36 to 96%. This gives sonography an accuracy of 95%.

False Negative Reactions↗