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Biomedical subjects

B Hünermann

Publications and source records attributed to B Hünermann.

At least 19 recordsLinked to original sources
PubMed1988

Magnetic resonance (MR) imaging of prostatic tumours, a comparison with X-ray CT and transrectal sonography (TRS).

A total of 7 healthy volunteers and 31 patients have been examined clinically, by MRI, TRS, and biopsy. In those patients with established carcinoma, a CT examination was also performed. For the MRI study, a superconducting MR 2000 imager (Picker International) operated at 0.15 T was used with multiplanar SE and IR sequences. SE sequences with long echo times detected prostatitis, adenoma and carcinoma of the prostate with a high degree of sensitivity. However, at present, differentiation between adenoma, prostatitis and carcinoma is not possible with sufficient accuracy. In these studies we were unable to establish a correlation between the signal pattern and staging and/or grading of the carcinoma. Reliable diagnosis of a prostate carcinoma still requires a biopsy. Because of the high soft tissue contrast and the possibility of selecting any orientation for the plane under investigation, however, MRI represents an improvement in the preoperative diagnosis of local spread.

Aged↗
PubMed1987

Evaluation by MRI of paraparesis and tetraparesis of undiagnosed aetiology.

The clinical, neuroradiological, electrophysiological and CSF findings of seven patients with slowly progressive paraparesis or tetraparesis are presented. In all patients, the results of the tests performed, including evoked potentials, CT scanning, oligoclonal bands in the CSF and myelography, were normal or inconclusive and did not lead to the correct diagnosis of the aetiology. In contrast, magnetic resonance imaging (MRI) provided the diagnosis of the causative process: multiple sclerosis in four cases, meningioma of the craniocervical junction or upper thoracic spinal cord in two cases, and upper cervical cord low-grade astrocytoma in one case. The patients with tumour could be treated effectively. Without MRI, however, the correct diagnosis would have been delayed. T2-weighted spin-echo scans provided maximal sensitivity for the detection of MS plaques, although they lacked specificity for a special disease. Several morphological criteria during MRI were helpful in differentiating Binswanger's disease, leucodystrophy and adrenoleucodystrophy from MS. It is concluded that at present MRI is the only non-invasive test with which to screen reliably the craniocervical junction and the upper cervical level, both of which are diagnostically difficult regions. The case histories also demonstrate that MRI is essential in all patients where a full clinical evaluation of the suspected spinal segment is not possible. "Pure spinal MS" is a misleading diagnosis and should not be accepted without confirmation by MRI. MRI has to be performed early enough to permit timely treatment of spinal and brain-stem disorders.

Adult↗
PubMed1987

The diagnostic significance of magnetic resonance imaging in prostatic tumours.

Looking for better diagnostic methods of prostatic tumours the pelves of 38 males (22 of them suffering from prostatic carcinoma) were examined by magnetic resonance imaging (MRI). This new technique helps to distinguish between healthy and pathological prostatic tissue. It is a non-invasive method, which seems to gain improved significance in the preoperative delineation of prostatic cancer; it is a valuable tool for an accurate preoperative T-staging.

Humans↗
PubMed1984

MR imaging of familial basilar impression.

Basilar impression was found in three members of one family. The mother showed an asymptomatic deformity, her eldest son complained of headache, drop-attacks, nystagmus, unilateral ophthalmoplegia, and ataxia; the middle son presented with headache, nystagmus, and hemiparesis. Magnetic resonance (MR) imaging demonstrated convexobasia of various degrees with elevation of the upper spine and malformation of the occipital bone. The medulla oblongata and the pons were flattened and dislocated backward in two cases. Chiari malformation was present in one case and mild hydrocephalus in another. A comparison of MR with CT imaging demonstrates some advantages of the former method in the assessment of the neural structures directly involved in basilar impression.

Adult↗
PubMed1984

[Significance of nuclear magnetic resonance in current diagnosis].

Up to now, a total of 500 patients were examined using a nuclear magnetic resonance imaging system which utilizes a 0.3 Tesla magnet. These data together with others reported in the literature show the possible clinical applications of this technique. Images in 3 projections, high soft-tissue contrast, and different NMR signals lead to outstanding diagnostic visualization of regular tissue and malignant lesions. NMR is currently centred on the central nervous system. Of great importance is its ability to detect lesions in the posterior fossa and in the spinal canal as well as malformations in the cervico-cranial area. The routine use in clinical practice is limited by the lack of standardized imaging parameters and of experience by the examiner himself. But because NMR has the advantages of not being an invasive technique and avoiding radiation or iodine-containing contrast media, patients should, even at this early stage and given a clear indication, not to be deprived of these advantages.

Bone Diseases↗
PubMed1983

[Immuno-elimination and clearance of Rh-positive erythrocytes in Rh-negative volunteers following administration of anti-D-immunoglobulin].

The prophylactic treatment of Rhesus-negative women to prevent Rhesus-sensitization has been accepted worldwide, although the working mechanism of the anti-D-immunoglobulin is still unknown. We have used Cr-51-labelled red blood cells to investigate the immune clearance of the cells in Rhesus-negative volunteers following injection of anti-D. Intravenous application of anti-D-immunoglobulin resulted in an accelerated elimination of the Rhesus-positive erythrocytes from the peripheral blood in contrast to the intramuscular treatment with the same dosage. But we had not been able to investigate whether the intravenous route might result in a more effective prophylaxis. In result of the application of IgG-anti-D sequestration can be observed in the spleen. This organ seems to be of great importance for the working mechanism of the anti-D-immunoglobulin. On the other hand splenectomized patients showed reduced clearance rates. In these cases the liver may be involved in the elimination of the red blood cells. F(ab')2-fragments, which cannot pass the placental barrier, seemed to be ineffective with respects to immunosuppression. As patients showing the Du-variant can be sensitized against -- D -- they also should receive anti-D-immunoglobulin for prophylaxis.

Adolescent↗
PubMed1978

[On the clinical significance of sequential scintigraphic examinations of the uteroplacental perfusion (author's transl)].

The utero-placental perfusion was examined by means of the method of Hünermann (1972) in a group of 74 patients with toxemia of pregnancy, diabetes mellitus, or intrauterine growth retardation. The perfusion measurements were categorized and evaluated according to the clinical findings. The correlation between single values deriving from the time-activity curves and their clinical predictive value was ascertained. A strong correlation between the parameters and the clinical findings resulted when several criteria were considered simultaneously. Among the single values resulting from the perfusion curves, the Tmax (placenta) and Tmax (uterus) (time of activity maximum) as well as the quotient of both revealed the highest significance. Pathological time-activity-curves were found in 16 of 19 patients with moderate and severe intrauterine growth retardation, and in all patients with moderate and severe toxemia, or diabetes mellitus. The limited clinical value of the used method is discussed.

Asphyxia Neonatorum↗
PubMed1977

[Studies on amino acid kinetics in rats without and with interference of the pregnancy using 75-Se-methionine (author's transl)].

A collective of 60 rats was divided into 3 groups of 20 non-pregnant, 20 pregnant without interference of the pregnancies and 20 pregant with ligature of the uterine vessels to induce an intrauterine growth retardation. The organ distribution of 100 muC intravenously injected 75-Se-methionine, which is actively transported from the placenta into the fetal circulation, was computer-scintigraphically measured. After 30 minutes and 6 hours typical differences, amongst the 3 groups, between the liver and foetoplacental unit methionine uptake were demonstrated both visually and quantitatively. On the basis of this experimental animal model, it should be attempted to measure quantitatively the placental disorders which are not caused primarily by perfusion of the uteroplacental unit.

Animals↗
PubMed1976

[Scanning in progessive pulmonary failure (shock-lung): preliminary results of a clinical study].

Lung scanning was performed on five patients with shock lung. It gave no evidence of morphological (pre-capillary) arterio-venous shunts or of increased pulmonary arterial pressure. Nor was there evidence of perfusion-ventilation inequality in the scan. The cause of the progressive pulmonary insufficiency was most likely due to maldistribution of gases in the microscopic region and to diffusion abnormalities.

Adult↗
PubMed1976

[Significance of inhalation and perfusion scintigraphy for the diagnosis of pulmonary embolism (author's transl)].

Inhalation and perfusion scintigrams, general radiological examination of the thorax and an EKG were done on 43 patients with clinically suspected pulmonary embolism. In 11 cases, the clinical diagnosis could be confirmed on the basis of the scintigraphic examination. In the remaining 32 patients, an embolich event could be excluded by pulmonary scintigram, radiological examination and later the clinical course. A synopsis of clinical observations, X-ray and scintigraphy, therefore, permitted a basically reliable diagnosis of pulmonary embolism; selective pulmonary angiography should be used only in exceptional cases.

Adult↗
PubMed1975

[Non-invasive myocardial scanning with thallium-201: basic principles and methods (author's transl)].

201Tl scanning demonstrated viable myocardium in the area supplied by the anterior interventricular branch (on frontal scanning) and viable myocardium in the interventricular septum and left ventricular lateral wall (scanning in the second oblique position) in 9 of 11 patients. Akinetic myocardial segments in the left ventricular anterior wall and left ventricular apex could be recognized by absent activity when scanning from in front. But hypokinetic segments, which contrary to the appearance with akinesia cannot be equated with myocardial scar, could not according to present experience be recognized by 201TL scanning. The special advantage of 201Tl scanning is is that, except for its intravenous injection, no further invasive procedure has to be undertaken, and it can be repeated. No side effects of complications have been observed.

Angiocardiography↗
PubMed1975

The renogram and individual 131I-hippuran clearances in experimentally controlled renal perfusion.

The radioisotope renogram and renal clearances using 131I-Hippurate were studied during experimentally controlled renal perfusion. In the first series of experiments, renograms were recorded during variations in renal blood flow produced by an extracorporeal pump circuit. There was a close correlation between renal blood flow and renogram parameters. These characteristics were also related to urine flow rates. In the second series of experiments, unilateral renal damage was produced either by ischaemia or obstruction. Individual clearances using 131I-Hippurate and the gamma camera were compared with standard clearances obtained during a steady state. There was a close correlation between these methods and the results emphasise the importance of subtracting background radioactivity. It is concluded that the main value of the renogram is to provide a left to right comparison of renal tubular function whereas the value of corrected 131I-Hippuran clearances is to provide an absolute measure of individual effective renal plasma flow.

Animals↗
PubMed1975

[Cancer arising on cirrhosis of regenerative node (author's transl)].

12 patients with cancer arising from a cirrhosis of the liver and 8 patients with regenerative nodes in a cirrhotic liver have been examined with scintigraphy, serial scintigraphy, angiography and biopsy. The results show that defects in the parenchyma of the liver can be shown with relative certainty using conventional scintigraphy with radiocolloids. But nothing can be said about their nature. Because of the simplicity of this technique and the minor claims on the patient scintigraphy should be the first diagnostic step. If angiography is contra-indicated serial scintigraphy may further elucidate the effects. When, however, angiography can be done, it will offer the best chance of differentiating between cancer and regenerative nodes on the basis of cirrhosis.

Angiography↗