Biomedical subjects
Publications and source records attributed to W Buchberger.
The case of a 30-year-old man with posttraumatic syringomyelia involving the cervical and upper thoracic spine is reported. The patient was followed clinically and with magnetic resonance (MR) imaging over a 3-year period. Spontaneous complete remission of the syrinx-related symptoms correlated with a partial collapse of the syrinx, as proved by serial MR imaging.
Whole blood selenium status of 299 persons, 144 women and 155 men, with a mean age of 62 +/- 10 years, has been determined. The individuals came from all Austrian provinces to Bad Hall to improve their heart and circulation disorders. The mean selenium content was 95 micrograms/l. We found no correlations between selenium levels and GSH-peroxidase, cholesterol, HDL-cholesterol and triglycerides.
We describe 2 cases of retroperitoneal hematoma after lumbar disc surgery following injury to retroperitoneal vessels. One patient sustained a partial tear of the right common iliac artery during left L4/5 discectomy, the other a complete tear of the lowest lumbar artery during left L5/S1 discectomy. Both patients developed hypovolemic shock 4-5 hours postoperatively, with acute abdominal symptoms and signs; the former patient also showed signs of ischemia of the right lower extremity. Both recovered completely after surgical intervention with vascular repair and evacuation of the retroperitoneal hematoma.
In a retrospective study of 125 patients, symptoms, diagnosis, and clinical course of 64 cases of cerebellar infarction and 61 cerebellar hemorrhage were studied retrospectively. Neurologically, cerebellar signs were present in 50% of hemorrhages and 7%, of infarctions, while 50% of patients with cerebellar hemorrhage and 37% of patients with cerebellar infarction showed brain stem symptoms or cranial nerve deficits; at least slight disturbance of consciousness was present in all patients. The state of consciousness, as estimated by the Innsbruck Coma Scale, together with diagnostic imaging (CT and/or MRT) allowed precise indication for surgical intervention. Over-all lethality was 11% for cerebellar infarction, and 31%, for cerebellar hemorrhage. Comparison of clinical outcome and state of consciousness at time of surgery suggests, that decompressive craniotomy should be performed even in deeply comatose patients with signs of decerebration.
Reversed-phase packing materials with restricted access of proteins to the hydrophobic sites were tested for their applicability in the ion-interaction chromatography of anions. Especially C8-modified silica, which had been coated with a hydrophilic polymer acting as a semi-permeable barrier, could be used successfully for the separation of several anions in a proteinaceous matrix without removing the proteins prior to injection. In combination with UV or conductivity detection, this technique allows the determination of some physiologically important anions in serum samples.
Induratio penis plastica (Peyronie's disease) is a chronic fibrotic process involving the penis. Proper treatment of the disease requires assessment of the degree of inflammation preceding or accompanying the fibrous Peyronie's plaques. Owing to its high tissue contrast and its multiplanar capability, MR imaging offers excellent visualization of penile anatomy. To determine the usefulness of MR imaging in the diagnosis and staging of Peyronie's disease, we used MR imaging with a surface coil to examine 28 consecutive patients with clinical evidence of the disease. Eighteen patients had contrast-enhanced MR imaging with gadopentetate dimeglumine. In seven patients who subsequently had surgery or biopsy, MR findings were correlated with histopathologic findings. On unenhanced images, fibrous plaques were shown in 20 patients. Enhanced MR images showed focal contrast enhancement around or within the plaques in seven patients. Images in three patients with plaques showed no enhancement. Images in five patients showed focal areas of contrast enhancement without evidence of plaques. Histologic studies demonstrated that the degree of contrast enhancement correlated with the extent of inflammatory cell infiltration. In two patients with unenhancing plaques on MR, histology confirmed the absence of inflammation. Our results suggest that MR imaging not only depicts the localization and extent of fibrous plaques in patients with Peyronie's disease but also reveals the presence of inflammation. This makes MR imaging the technique of choice for planning therapy and for evaluating the response to conservative treatment.
OBJECTIVE: Carpal tunnel syndrome is characterized by typical anatomic changes that can be shown with high-resolution sonography. To determine whether these findings are reliable and can be used to establish the diagnosis, sonograms of patients with the disease were compared with sonograms obtained in patients with normal wrists. Also compared were sonograms and MR images obtained in the patients with carpal tunnel syndrome. SUBJECTS AND METHODS: Twenty wrists in 18 consecutive patients with clinical symptoms of carpal tunnel syndrome and with abnormal nerve conduction studies were examined with real-time sonography and MR imaging. The sonograms and MR images were evaluated quantitatively by two unbiased observers with regard to the size and shape of the median nerve and the palmar bowing of the flexor retinaculum. A t test was used to compare these data with those from previous sonographic studies of 28 normal wrists. Correlation coefficients for the measurements obtained with sonography and with MR were calculated. The relative accuracies of different diagnostic criteria for the diagnosis of carpal tunnel syndrome were assessed by using receiver-operating-characteristic analytical techniques. RESULTS: Characteristic findings on both MR and CT scans of the 20 wrists with carpal tunnel syndrome included swelling of the median nerve in the proximal part of the carpal tunnel in 16 wrists, flattening of the median nerve in the distal part of the carpal tunnel in 13 wrists, and increased palmar bowing of the flexor retinaculum in nine wrists. Comparison with the data of 28 normal wrists proved that these findings were significant (p less than .01 to p less than .001). Receiver-operating-characteristic analysis showed that the discrimination between wrists in normal subjects and in patients with carpal tunnel syndrome achieved with each of the three diagnostic criteria was not significantly different. Measurements of the size and flattening of the median nerve obtained from sonograms were similar to those on MR images, whereas sonography was less accurate for measuring the palmar bowing of the flexor retinaculum. CONCLUSION: We conclude that the results of sonography are reliable, and that the diagnosis of carpal tunnel syndrome can be established on the basis of sonographic findings.
MRI aspects of olivary pseudohypertrophy (OH) following pontocerebellar lesions of different etiology and localization are reviewed. OH is characterized by unilateral or bilateral enlargement of the inferior olivary nucleus and increased signal intensity in T2- and, especially, in proton-density (PD)-weighted images. Correlations between the extent and the uni- or bilateral presence of olivary hypertrophy and the localization of the primary pontocerebellar lesions are discussed.
An ion-chromatographic method is described for the analysis of free nitrilotriacetic acid in water samples. Separations are achieved on a polymer-based anion-exchange column with 6 mM nitric acid as eluent. Both potentiometric and amperometric detection have been applied using metallic copper as the indicator electrode. Detection limits are at about 500 ng injected in the potentiometric mode and 100 ng in the amperometric mode. On-line sample preconcentration is possible for volumes up to 2 ml of river water samples. The response of the detector to other aminopolycarboxylic and aminopolyphosphonic acids has been investigated.
89 patients, who underwent conservative surgery for breast cancer were followed up with mammography and real-time sonography. 78 patients underwent postoperative irradiation. Depending on the time interval between irradiation and examination various alterations in mammographic and sonographic patterns were evident. Of 14 biopsy-confirmed local recurrences, 11 were diagnosed by mammography and 12 by sonography. Sonography was superior in the diagnosis of small recurrences in breasts with radiation-induced increased density, whereas mammography showed better results in the detection of tumours with microcalcifications. As a result of the different sonographic aspect of recurrent tumours and scar tissue, the number of false positive diagnoses of sonography was markedly lower compared to that of mammography (2 versus 18). Combined use of mammography and sonography should therefore lead to better results in the diagnosis of local recurrences and to a reduction of unnecessary biopsies.
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61 men with breast enlargement underwent mammography; complementary sonography was performed in 34 cases. Diagnoses included gynaecomastia in 53 cases, pseudo-gynaecomastia in 9 cases, 3 carcinomas, 2 inflammatory lesions and 1 lipoma. Gynaecomastias of up to four month's duration are histologically of the florid type and show a nodular or nodular-dendritic mammographic pattern; sonography usually demonstrates a focal hypo-echogenic area. Gynaecomastias of longer duration representing the fibrous type show mammographically a dendritic or diffuse pattern and sonographically a hyper-reflexive breast parenchyma. Mammography and sonography can differentiate reliably true gynaecomastia from pseudo-gynaecomastia. Gynaecomastia and especially inflammatory lesions may not always be readily differentiated from carcinoma. Sonography can be helpful by demonstrating hyper-reflexive glandular tissue, whereas carcinomas are usually hypoechoic.
Cataract development was studied in two groups of Emory mice by periodical biomicroscopic examinations (beginning at 5 weeks of age) and by a final evaluation of water-soluble SH groups in the lenses. The experimental group was given 256 micrograms iodide/kg body weight with the drinking water throughout the study. The untreated control group received tap water. Iodide treatment induced a delay of cataract formation, resulting in a significant reduction of the time to progress from cataract degree 1 to degree 2 (iodide-treated group 12.8 +/- 1.7 weeks, untreated group 9.9 +/- 1.0 weeks; p less than 0.025). A still significant difference in the degree of cataract was also found between the two groups at week 47 of age. No difference was found in the content of water-soluble SH groups. The results are discussed in relation to the known antioxidant and .OH-scavenging effect of iodide and to the oxidative changes in the lens occurring during progression of cataract development.
Phylloides tumor is a rare fibroepithelial breast tumor that occasionally has unpredictable clinical behavior. In nine cases of histologically benign tumors and one case of malignant phylloides tumor, the findings on physical examination, mammography, sonography, and aspiration biopsy were correlated retrospectively with the histologic diagnosis of resected specimens. Mammograms showed a round or lobulated benign-appearing opacity in nine cases; one small tumor was missed mammographically. Sonography depicted all tumors as mostly solid masses. Sonographic features included low-level internal echoes, either uniform or scattered; smooth contours; and no significant posterior shadowing. Intramural cysts were shown in six cases. Neither mammography nor sonography allowed reliable differentiation between benign and malignant phylloides tumors. Aspiration biopsy permitted accurate diagnosis of seven benign tumors. The malignant phylloides tumor was classified as a malignant tumor, but the definite differentiation from a carcinoma could not be made. Two histologically benign phylloides tumors were misdiagnosed as carcinomas. Although uncommon, phylloides tumor should be considered in the differential diagnosis of mammographically benign-appearing breast masses, especially if sonography shows intramural cysts within a well-defined solid lesion. Aspiration cytology is unreliable because of the inhomogeneity of the tumor; both intraoperative frozen section and permanent sections are needed for correct histologic diagnosis.
Twenty-eight wrists of 25 patients with carpal tunnel syndrome (CTS) and 28 wrists of 14 normal control subjects were studied with high-frequency real-time ultrasonography. Three general findings could be observed in CTS, regardless of its cause: swelling of the median nerve at the entrance of the carpal tunnel; flattening of the median nerve in the distal carpal tunnel; and increased palmar flexion of the transverse carpal ligament. Quantitative analysis proved these findings to be significant. We conclude that high-resolution sonography is able to diagnose median nerve compression in the carpal tunnel syndrome and to detect some of its potential causes.
The influence of a 4 week course of balneotherapeutic treatment in Bad Hall on different blood parameters and on the activity of the antioxidative enzymes glutathione peroxidase (GSH-Px), catalase and superoxide dismutase (SOD) was examined in diabetics. The patients were divided into 2 groups. One group underwent an iodine-balneotherapeutic programme (therapeutic exercises, baths, packages, inhalations), the other group additionally received an iodine brine drinking cure. At the end of the cure, the cholesterol, triglyceride and glucose levels had fallen to normal values in both groups due to the diabetic diet and, if required, drug therapy. Erythrocyte SOD was also reduced in both groups. Plasma catalase and plasma GSH-Px were significantly raised only in the group drinking iodine brine, while erythrocyte GSH-Px and the amount of the lipid peroxidation product malonyl dialdehyde were unchanged. The observed improvements in the parameters are considered unspecific cure effects, which lead to a desirable normalisation and homogenisation. Only the enhancement of plasma GSH-Px activity can be interpreted as an iodine specific cure effect.
65 patients with penetrating or blunt scrotal trauma underwent scrotal ultrasound. High-resolution real-time sonography was able to differentiate testicular from extratesticular lesions in all cases. Lesions of the epididymis were diagnosed in 14 cases. In epididymal haematoma sonography revealed an hyperechoic enlarged epididymis whereas posttraumatic epididymitis was demonstrable as hypoechoic swelling. 14 testicular ruptures and 6 testicular haematomas without disruption of the tunica albuginea were correctly diagnosed. Diagnosis could be confirmed at operation in 12 cases and by clinical and sonographic follow-up in 8 cases. A heterogeneous parenchymal pattern, contour abnormalities, poorly defined margins and obvious fragmentation of the testicle strongly suggest testicular rupture.
The influence of bromide on thyroid function was studied in iodine-deficient rats, fed on a diet containing 4-16 g/kg sodium bromide for 4 weeks. Measurement of total and free thyroxine and thyroid-stimulating hormone in blood, as well as the thyroid hormones in the thyroid gland, revealed typical signs of hypothyroidism, which were significantly enhanced by bromide intake. Special attention was paid to the possible formation of bromo/iodosubstituted thyronines in the thyroid. These measurements were performed by high-performance liquid chromatography with off-line radioimmunoassay detection. Such thyroid hormone analogues could be detected in all groups of animals with additional bromide intake, but the amounts were found to be too low to compensate adequately for the reduced amounts of thyroid hormones. The results of this study also indicate that bromide toxicity is dependent upon the state of the iodine supply, which should be taken into account for evaluation of acceptable daily intake values for bromide.