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V Jacobi

Publications and source records attributed to V Jacobi.

At least 55 records · Page 3Linked to original sources
PubMed2000

[Renal parenchymal defects as signs of renal tuberculosis].

Findings of urogenital tuberculosis in computed tomography have been reported seldom although this manifestation of the tuberculous disease is on the second place following pulmonary tuberculosis. We report on a 52 year old women suffering by culturally proven urogenital tuberculosis. The enhanced computed tomography showed hypodense lesions clearly on the cortex border of the kidney. Other findings of renal tuberculosis reported in the current literature as hydrocalices or hydronephrosis were not seen at all. We postulate that the described finding is characteristic for an early stage of renal tuberculosis.

Diagnosis, Differential↗
PubMed1999

Pulmonary lymphangioleiomyomatosis: high-resolution CT findings.

Lymphangioleiomyomatosis (LAM) of the lung is a very rare disease. There are obvious discrepancies in the literature concerning the appearance of LAM on CT scans of the lung. This study adds the imaging findings of 11 patients and demonstrates how the imaging findings changed over time in four patients. Twenty-two CT examinations, and radiographs that had been obtained close to the CT examinations, of 11 patients with LAM confirmed by open lung biopsy were retrospectively evaluated with particular attention to the size of cystic lesions and wall thickness. Furthermore the CT scans were analysed for the type of pulmonary infiltration process and its distribution, presence or absence of pleural effusion, pneumothorax and lymph node enlargement. Clinical and CT follow-up studies were available in four patients. The CT scans revealed an increase in the interstitial pattern in all patients. Architectural distortion was seen in two patients and cystic lesions were present in all. The size of the cysts varied from small lesions to bullous emphysema. The cystic lesions revealed a wall thickness up to 2 mm but a wall was not perceptible in all. Pneumothorax was seen in only two patients; pleural effusion was seen in two patients. CT examination of patients with LAM reveals neither a uniform nor a pathognomonic appearance. In the early stages of LAM or in cases with interstitial changes the differential diagnosis of centrilobular emphysema or idiopathic pulmonary fibrosis seems to be more difficult than most authors believe.

Adolescent↗
PubMed1999

Value of a laser guidance system for CT interventions: a phantom study.

The aim of this study was to check the handling and usefulness of a laser puncture system. The laser has tacking optics and is fastened to a sledge with angle graduation. The sledge runs on a bar fixed to the computerized tomograph (CT) parallel to the scan level. By means of a phantom, three experienced and seven inexperienced physicians made punctures with and without laser, using varying angles in single and double angulation. The distance from needle tip to target was measured. The handling of the puncture system proved to be problem-free. With both single and double angulation, the measurement differences with and without support were so small among experienced puncturers that there was no significant difference, with the exception of one double angulation (10 degrees/45 degrees). Among the beginners, there was a significant difference (P < 0.001, P < 0.05), with both single and double angulation. The accuracy of the beginners improved with use of the laser; experienced puncturers may profit from practice with small and hard-to-reach focuses. In terms of educational benefits, the laser guidance system offers great advantages and increased confidence for beginners.

Biopsy, Needle↗
PubMed1999

Long-term results of endoscopic injection of botulinum toxin in elderly achalasic patients with tortuous megaesophagus or epiphrenic diverticulum.

BACKGROUND AND STUDY AIMS: Recent studies suggest that endoscopic injection of botulinum toxin (BTX) for achalasia is a safe procedure giving short-term relief of symptoms mainly in elderly patients (> 50 years). The aim of the study was to evaluate the clinical efficacy of periodic BTX treatments in high risk achalasia patients. PATIENTS AND METHODS: A total of 20 consecutive achalasia patients, aged > 60 years (11 women; 71+/-11 years), with general (ASA class III or IV) and local risk factors (i.e. tortuous megaesophagus or epiphrenic diverticulum) for complications associated with pneumatic dilation, were treated by local injection of 100 U of BTX into the gastric cardia, using the four-quadrant technique. The patients were prospectively followed for a median period of 2 years (range 5-48 months), using a symptom score (1-14 points) and barium esophagograms. RESULTS: Symptomatic improvement (decrease of the symptom score > or = 3 points) was found in 16/20 patients (80%), 6 weeks after the first BTX injection, and the cardia diameter increased from 2.1+/-0.7 to 3.2+/-1.2 mm (P < 0.01) (data are means +/- SD). Those patients who initially responded to BTX treatment developed a symptomatic relapse after a median follow-up of 5+/-2 months. They were treated by subsequent BTX re-injections (2.5+/-1 sessions per patient, range 1-5) resulting in longer lasting symptom relief (10+/-3 months, P < 0.05 vs. initial BTX injection). At completion of the study, 14/20 high risk achalasia patients (70 %) treated with periodic BTX injections are still in clinical remission. One further patient died without relapse 6 months after a single BTX treatment as a consequence of progressive heart failure. Four patients who did not respond to BTX injection were successfully and uneventfully treated by careful pneumatic dilation (n = 3) or percutaneous endoscopic gastrostomy (n = 1). CONCLUSION: Endoscopic botulinum toxin injection has reasonable long-term efficacy and safety in elderly achalasia patients who are at increased risk with regard to pneumatic dilation.

Aged↗
PubMed1999

Fluorine-18 FDG positron emission tomography for imaging of hepatocellular carcinoma.

OBJECTIVE: The detection of increased fluorine-18 fluorodeoxyglucose (18F-FDG) uptake by positron emission tomography (PET) is based on the enhanced glucose metabolism of tumor cells. Because the detection and staging of hepatocellular carcinoma (HCC) in patients with liver cirrhosis can be difficult, we prospectively evaluated the sensitivity of 18F-FDG PET in 14 consecutive patients with HCC. METHODS: Whole body and regional 18F-FDG PET of the liver were obtained. The results were compared with ultrasonography, contrast-enhanced, helical CT, histological grading, p53 protein expression of HCC, and serum alpha-fetoprotein (AFP) level. RESULTS: In 7 patients PET demonstrated increased tumor 18F-FDG uptake, whereas HCC was not distinguishable from nonmalignant liver tissue in 7 other patients. Hepatic lesions were detected by ultrasonography in all patients, whereas only 11 of 14 HCCs could be identified by CT. In 3 patients extrahepatic spread was demonstrated by 18F-FDG PET. Patients with increased tumor 18F-FDG uptake had significantly larger hepatic lesions and higher serum AFP levels than those with normal 18F-FDG uptake. Lesions could be visualized by 18F-FDG PET in 7 of 8 patients with moderately or poorly differentiated HCC, whereas none of the six well-differentiated tumors was detected. Two patients with strong p53 expression demonstrated increased tumor 18F-FDG uptake and extrahepatic metastases. CONCLUSIONS: The sensitivity of 18F-FDG PET for the imaging of HCC is low. Nevertheless, in patients with moderately or poorly differentiated HCC, tumors >5 cm, or with markedly elevated AFP levels 18F-FDG PET may contribute to an effective noninvasive staging.

Adult↗
PubMed1998

CT findings in extensive tracheobronchial amyloidosis.

Primary pulmonary amyloidosis is a rare disorder that appears in three forms: tracheobronchial, nodular parenchymal, and diffuse parenchymal. We report the case of a 46-year-old women with extensive tracheobronchial amyloidosis which presented with a 2-year history of dyspnea and with signs of severe fixed obstruction in pulmonary function tests. Computed tomography of the thorax demonstrated marked thickening of the trachea and the central bronchial tree with substantial narrowing of the main, lobar, and segmental bronchi. Transbronchial specimen showed typical birefringence under polarizing microscope after staining with Congo Red. We did not find hints for systemic amyloidosis.

Amyloidosis↗
PubMed1998

Development of a multiplex immunocapture RT-PCR assay for detection and differentiation of tomato and tobacco mosaic tobamoviruses.

Immunocapture (IC) RT-PCR assays were developed for detection of tomato (ToMV) and tobacco mosaic (TMV) tobamoviruses in spruce and pine extracts. When purified viruses were diluted in root or needle extracts of virus-free conifer seedlings, both IC-RT-PCR assays detected their respective target viruses at concentrations of 10-100 fg ml(-1). This compared to ELISA detection sensitivities of 1 ng ml(-1). Primers were designed from regions of high sequence diversity. Specificity of all primer pairs was confirmed by sequencing of PCR products. PCR distinguished more reliably between the two viruses than ELISA. Moreover, a multiplex IC-RT-PCR assay for the simultaneous detection and differentiation of TMV and ToMV was developed. When root extracts were seeded with both viruses simultaneously, the multiplex assay detected each virus at concentrations of 1-10 pg ml(-1). Six TMV and 18 ToMV isolates from various hosts, water samples and a soil sample were amplified and differentiated by multiplex IC-RT-PCR. No amplifications were observed against pepper mild mottle and ribgrass mosaic tobamoviruses and against six viruses belonging to other taxonomic groups.

Enzyme-Linked Immunosorbent Assay↗
PubMed1998

[Bronchial carcinoma developing in a tuberculous scar: computer tomographic follow up].

The development of scar is a rare complication of lung tuberculosis which was yet not often demonstrated in the radiologic literature. We report on a 71 year old male suffering by lung tuberculosis in an active stage which developed lung cancer in the region of tuberculotic scar clearly depicted on computed tomography. To the best of our knowledge this is the first reported computed computed tomography control series dealing with this problem. Additionally we report on histopathologic findings showing an early cancer in the surrounding of a tuberculotic scar.

Aged↗
PubMed1998

[Diagnosis of pneumonia in long-term ventilated patients. Value of digital luminescence radiography in comparison with clinical and microbiological monitoring].

PURPOSE: Pulmonary infection is one of the most feared complications in patients receiving long-term ventilation. We evaluated prospectively the diagnostic value of daily bedside chest radiography performed as digital luminescence radiography (DLR) in comparison to clinical findings and quantitative microbial culture. MATERIAL AND METHODS: Prospective evaluation of daily bedside chest radiography (DLR) and clinical parameters such as blood count, body temperature, and microbiological monitoring (quantitative culturing, microscopy) of 20 patients receiving long-term ventilation was undertaken. Altogether 325 chest radiographs were evaluated. RESULTS: 96% of the routine radiographs showed abnormal findings. Nosocomial pneumonia was suspected in 31% of all 330 days of observation by means of clinical and microbiological findings. DLR showed correct findings in 80% of this days (right-positive interpretation); a false-positive interpretation was resulted in 16 radiographs. Most common finding in nosocomial pneumonia was an alveolar pattern with air bronchogram. Fever and leucocytosis often precede radiological evidence of pneumonia. CONCLUSION: Daily bedside chest radiography performed as DLR shows abnormal finding in a high percentage. Bedside chest radiograph is in accordance to clinical and microbiological finding of nosocomial pneumonia in 80%.

Adult↗
PubMed1998

[Pulmonary complications of induction therapy in acute myeloid leukemia in adults. Findings in chest x-rays and computer tomography].

UNLABELLED: To exclude pulmonary complications, 359 chest radiographs and 50 computed tomographs of the lung were performed in 95 patients suffering from acute myeloid leukemia. The radiological findings were registered, described and correlated with clinical findings in the present study on 2395 days of observation. RESULTS: In summary, 52 patients showed alterations of the lung. Pulmonary hyperhydration was seen in 21 cases, bacterial pneumonia was found in 18 cases, invasive pulmonary aspergillosis was documented in 14 cases, and 5 cases of severe haemorrhage were seen. An unexplained pulmonary edema in 13 patients with interstitial and alveolar infiltrates is considered to be a complication of treatment with cytosine- arabinoside. CONCLUSION: The results demonstrate that chest X- ray and computed tomography have a high impact in detection and treatment of pulmonary complications following intensive chemotherapy. We may expect the development of diffuse opacity following administration of cytosine-arabinoside in medium-sized doses.

Adolescent↗
PubMed1998

[Cavitating lung lesions in the course of ANCA-associated vasculitis: differential diagnostic aspects].

Antineutrophil cytoplasmatic antibodies (ANCA)-associated vasculitides (Wegener's granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome) show quite variable courses. Clinical features of the full blown generalized systemic vasculitis are usually found in the respiratory tract and the kidney. Pulmonary involvement of Wegener's granulomatosis shows commonly nodules and cavitations but also diffuse alveolar hemorrhage. We report the case of a 57 year-old man suffering from dyspnea, thoracal pain, arthralgia, purpura, scleritis and tinitus. Specimen of the kidney showed segmental glomerulosclerosis and tubulointerstitial nephritis. Because of the presence of cANCA Wegener's disease was assumed. Pulmonary infiltrates developed under immunosuppressive treatment with cyclophosphamid. As differential diagnosis of the pulmonary infiltrates, we considered invasive pulmonary aspergillosis as well as infiltrates due to Wegener's granulomatosis. In spite of maximal therapeutic management of patient died of respiratory and cardiovascular failure. The findings at autopsy showed distinct invasive pulmonary aspergillosis and perifocal hemorrhage.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1997

Primary congenital pulmonary lymphangiectasia--a case report.

We report on a 22 year-old women with recurrent pleural effusions and shadowing of the right lower lobe, which was refractory to antibiotic treatment. Histologic examination (open lung biopsy) was interpretated as indicating an early stage of lymphangioleiomyomatosis. Because of progression of the pulmonary changes and development of a pericardial effusion in spite of antiestrogen treatment to achieve pharmacological castration, and in view of the atypical findings in high resolution computed tomography (lack of cysts) a second open lung biopsy was performed, confirming the diagnosis of pulmonary lymphangiectasia. The patient was given oral corticosteroids postoperatively and showed almost complete resolution of the pleural and pericardial effusions.

Adult↗
PubMed1997

A large duplication in the 3'-untranslated region of a subpopulation of RNA2 of the UK-M isolate of barley mild mosaic bymovirus.

The UK-M isolate of the bipartite barley mild mosaic bymovirus (BaMMV UK-M) cannot be fungally transmitted, and has previously been shown to have a 1092 nt deletion in the coding region of RNA2. We now report, using sequence and reverse transcriptase-polymerase chain reaction (RT-PCR) data, that a subpopulation of BaMMV UK-M RNA2 contains a direct imperfect sequence repeat of 552 nt in the 3' untranslated region. The secondary structure of the 3' end of RNA2, and its possible effects on replication of the virus, are also discussed.

Base Sequence↗
PubMed1997

[The computed tomographic determination of intra-abdominal fat volume by single-layer measurement].

PURPOSE: Several studies emphasised the importance of the relationship between intra-abdominal and total body adipose tissue as a risk factor for the development of metabolic or cardiovascular diseases. Therefore, the aim of the present study was to examine whether a single-scan computed tomography is able to determine the whole intra-abdominal fat volume with high accuracy and reproducibility. MATERIALS AND METHODS: Regions of interests (ROIs) were drawn manually for measuring intra-abdominal fat in 51 unsuspicious abdominal CT. RESULTS: The sexual differentiation of adipose tissue already described in a lot of studies could be confirmed in this study. Fat still predominates in females in lower half of the body (gynecoid obesity). In men it predominates in the upper half (android obesity). Significant correlation concerning measuring the whole intra-abdominal fat volume could be found in L1-level in women (r = 0.992) and in L2-level in men (r = 0.992). Measurement of a single scan enables us to assess whole intra-abdominal fat volume due to a special formula. CONCLUSION: The determination of intra-abdominal fat measured by a single-scan computed tomography is a procedure associated with high accuracy and reproducibility.

Adipose Tissue↗
PubMed1997

[Teratoma of the mediastinum--detection in conventional imaging and CT].

We report the case of a 20-years old female patient with a tumor in the anterior mediastinum which was coincidently detected by a conventional X-ray of the chest. Differential diagnose were eliminated was constructed by means of computed tomography showing area of fatty density. The tumor was exstirpated because of its possible malignancy as well as the possibility of the development of local complications. Histology confirmed the tentative diagnosis of fatty cystic teratoma.

Adipose Tissue↗
PubMed1997

[Liver transplantation and splenectomy in idiopathic portal hypertension].

Idiopathic portal hypertension (IPH) was diagnosed in a 30-year-old man. Clinical signs were splenomegaly, leucothrombocytopenia, and esophageal varices of fourth degree. The histology of the liver biopsy showed portal fibrosis with no evidence of cirrhosis. No causing agent or known disease could be found for the histopathological and clinical features. Due to a severe deterioration of general condition and a decline of synthetic liver function, liver transplantation and splenectomy were performed. The histological examination of the explanted liver revealed features of IPH, demonstrating portal fibrosis and dilated vessels adjacent to portal tracts; no cirrhosis was found. The postoperative recovery was without any severe complications. The duration of hospitalization was 28 days. Following liver transplantation, the esophageal varices disappeared and leucocytes, platelets as well as parameters of hepatic synthesis reached normal values. Initially, the immunosuppression was composed of prednisolon, tacrolimus, and antibodies against IL-2 receptors (BT 563) and was later continued with prednisolon and tacrolimus. Within the follow-up observation of 26 months, there was no evidence for graft rejection, severe infection, or occurrence of portal hypertension. Up till now the patient is in good condition with normal graft function. Liver transplantation may be a curative therapy for patients with advanced disease of IPH but the long-term follow-up after transplantation has to show whether IPH can reoccur.

Adult↗