Biomedical subjects

B Kreuzberg

Publications and source records attributed to B Kreuzberg.

At least 19 recordsLinked to original sources

PubMed2006

[Giant bilateral adrenal myelolipoma associated with congenital adrenal hyperplasia].

BACKGROUND: Myelolipoma is a rare benign tumor formed by mature fat tissue with strata of haematopoiesis. It is mainly asymptomatic, only large myelolipomas manifest themselves by abdominal discomfort, bleeding or by symptoms of oppressing adjacent organs. It is usually localized in the region of the adrenal gland. Myelolipomas are mostly clinically inert, only a small number of them are associated with Cushing's type of endocrine disorders, Conn's syndrome, Addison's disease, etc. PATIENT AND METHODS: The authors present a rare case of a giant bilateral myelolipoma emerging out of the adrenal gland cortex in a congenital adrenal hyperplasia, with steroid 21-hydroxylase deficiency, in a woman with pronounced virilism. The principal diagnostic methods include sonography and computer tomography. The therapy available is either a surgical extirpation in the case of large or growing myelolipomas or observation in the case of small ones (< 5 cm). RESULTS: The condition was resolved by bilateral adrenalectomy with extirpation of both myelolipomas and subsequent hormonal substitution treatment during which there was a gradual regression of virilising symptoms. CONCLUSIONS: The coincidence of myelolipoma and congenital disorder with subsequent overproduction of the adrenocorticotropin hormone and androgens, might be explained by the incipient of myelolipoma through chronic hormonal stimulation of the adrenal gland cortex. However, the etiopathogenesis of myelolipoma is still unclear.

Adrenal Gland Neoplasms↗

PubMed2006

[Massive breast angiomatosis with dramatic course leading to acute total mastectomy--a case report].

OBJECTIVE: On the background of clinical, radiological and morphologic settings presented is unusual case of the rare angiomatosis of the female breast. Discussed are both clinicopathological aspects and differential diagnosis from the morphological point of view. DESIGN: Case report. SETTING: Biopsy Lab s.r.o. and Sikl's Department of Pathology, Charles University and Faculty Hospital, Pilsen. METHODS: As a case report described is a rare case of the angiomatosis of the female breast. Implemented illustrations consist of local findings, CT scan, specimen gross appearance and histological pictures including immunohistochemistry. Applied antibodies and detection system LSAB+ were provided by Dako, visualization was performed by chromogen DAB (diaminobenzidin tetrahydrochlorid). RESULTS: 30-year-old woman suffering of painful, enormous breast asymmetry underwent core needle biopsy of the right breast. The mastogram showed diffuse process of ambiguous significance. During the next few days her condition dramatically changed and under the circumstances of florid apoplexy and suspicion of tumor of her right breast, total mastectomy was carried out. Histological picture revealed widespread, unlimited vascular lesion dissecting throughout the stroma of the entire gland. Bland morphology and the nature of tissue involvement eventually led to diagnosis of benign angiomatosis. The woman underwent several local plastic operations but is out of final reconstruction of her breast so far. Thirteen months after mastectomy there are no signs of recurrence.

Adult↗

PubMed2005

[Injuries to the biliary tract during cholecystectomy].

Injuries to the biliary tract during both the laparoscopic or the open cholecystectomic procedures, remain among the most serious iatrogenic injuries with high morbidity and mortality rates. The higher the number of the laparoscopic cholecystectomies, the higher the number of the injuries to the biliary tract. Early peroperative recognition of these injuries is a prerequisite for successful biliary tract reconstructions. Mucosal hepaticojejunoanastomosis according to Roux is the golden standard of the reconstrucion treatment. Stenoses in anastomoses followed by development of cholangitides are considered serious postoperative complications. In these cases, endoscopic and transparietal dilation with plastic stents implantation is the method of choice. Technically exacting reoperations then follow. The authors present a trial group of 11 patients, who were treated in the Surgical Clinic of the Faculty Hospital in Plzen for biliary tract injuries during cholecyctomic procedures (8 were laparoscopic and 3 open), from 01-01-2000 to 01-09-2004. Severe inflammatory changes in the region of the Calot triangle, were the commonest cause of the biliary tract injuries during primary operations. In most cases (N = 8) the injury was diagnosed and managed immediately during the primary procedure. Hepaticojejunoanastomosis according to Roux was the principal procedure used to repair the biliary tract (N = 8). Postoperative morbidity reached 36.4%, 2 elderly patients exited (18.2%) due to septic multiorgan failure on the 15th day and the 7th month after the surgical procedure. Multidisciplinary approach of a team of experienced surgeons, endoscopists and radiologists in the hepatobiliary region is a fundamental prerequisite for long-term successful outcomes of technically exacting reconstructive procedures of the hepatobiliry tract.

Adult↗

PubMed2004

The contribution of MRI to the diagnosis of diffuse meningeal lesions.

We analysed MRI findings in patients in whom a diffuse abnormality of the meninges was revealed by MRI. We looked at T1 and T2-weighted spin-echo or fast spin-echo images and contrast-enhanced T1-weighted images. There were 15 patients with abnormalities on MRI, clinically suspected in ten. Four had meningoencephalitis, one meningeal and subcortical sarcoidosis nodules, four meningeal malignancies--one disseminated oligodendroglioma, one with meningeal infiltration around an adenocarcinoma, three meningeal infiltration by a haematological malignancy, and one a chronic subdural haematoma without a history of injury. We excluded patients with primary meningeal tumours and typical injury-related meningeal bleeding. The relatively small number of patients is due to both the infrequency of diffuse meningeal disease and to the low frequency of suspected meningeal pathology as an indication for MRI. The latter's diagnostic contribution is greatest in infectious disease and neoplastic infiltration, and less obvious in haematological malignancies. Contrast-enhanced T1-weighted images are most useful.

Adenocarcinoma↗

PubMed2003

[Primary hyperparathyroidism (osteitis fibrosa cystica generalisata Recklinghausen)].

The case of a 67-year-old man presenting with parathyroid gland adenoma associated with multiple organ manifestations of a rare normocalcemic form of primary hyperparathyroidism is described. The authors draw attention to the importance of correlating clinical and laboratory examinations with histological, radiological and scintigraphic findings for the establishment of diagnosis. They emphasize the role of two-phase 99mTC-MIBI (methoxyisobutyl-isonitril) scintigraphy not only for diagnostic purposes but also for exact localization of the adenoma by means of a gamma probe during surgery. They also point out the possibility of accompanying pathological conditions, in this case, the development of a tumor described as "brown tumor". This was shown by angiography as a hypervascularized and strongly stained expanding lesion. The authors conclude that the early surgical removal of this parathyroid gland adenoma was important for the patient's successful recovery.

Aged↗

PubMed2002

[Periosteal desmoid].

The authors describe a rare benign disease occurring in children and adolescents with an increased physical activity at the age of 8-20 years. It is a tumour-like lesion developed by a repeated micro-trauma of the origin of distal fibres of adductor magnus and aponeurotic origin of the medial head of the gastrocnemius. This disease must be paid increased attention as in the region of the knee joint in children it is a location of a frequent development of sarcoma and osteomyelitis. With the knowledge of this lesion such cases may be diagnosed merely by a classic radiograph, preferably in external rotation and CAT and MRI examinations. Of the highest value for the examination is the CAT examination. Radiograph changes are located in the region of the distal part of the medial crest of linea aspera, tuberculum adductorium and posteromedial part of the medial epicondyle of femur.

Adolescent↗

PubMed1998

Gastric lipoma presenting as upper gastrointestinal obstruction.

A 61-year-old man presented with an upper gastrointestinal obstruction caused by a submucosal gastric lipoma in the prepyloric area. The diagnosis was made coincidentally during his admission for another disease. Gastric resection was performed because of a large lipoma combined with florid gastric ulcers. The frequency of gastric lipoma, its differential diagnosis, means of diagnosis, and treatment are discussed.

Diagnosis, Differential↗

PubMed1994

[Rheumatoid arthritis--a diffuse connective tissue disease].

The authors describe in a group of 100 patients, mostly with a severe form of rheumatoid arthritis, subjects with so-called "severe" extraarticular affections which can threaten the patients' lives or cause substantial deterioration of its quality, and those subjects where rheumatoid arthritis was the cause of death. These affections were associated--directly or indirectly--with the basic disease. From the absolute number of revealed affections the authors do not want to draw any conclusions as they are aware of various factors which could influence them. They assume, however, that the assembled data provide evidence that the American Rheumatological Association was right to include rheumatoid arthritis among diffuse connective tissue diseases and that it must be considered not only a disease of the locomotor apparatus but a potential disease of the organism as a whole.

Arthritis, Rheumatoid↗

PubMed1993

[Hereditary pancreatitis].

The authors describe a family with hereditary pancreatitis where in three generations in five subjects in the same line complete penetrance of the disease was found. It is the first report on this disease in Czech republic.

Adolescent↗

PubMed1991

[Incidence of aneurysms of the abdominal aorta in the Czechoslovak population and possibilities of its detection].

A significant increase not only in the number of operations for AAA but also in the incidence of autopsy findings of AAA from 1.5 per cent to 4.5 per cent has been observed during the last 20 years. Ultrasound screening of the abdominal aorta in patients examined for other reasons revealed asymptomatic dilatation of the infrarenal aorta to more than 4 cm in 3.8 per cent of men older than 60 years. AAA should be actively searched for at every physical and ultrasound examination of the abdomen in men over 60 years of age.

Aged↗

PubMed1990

[Nonspecific spondylodiscitis in childhood. New findings about the disease].

Nonspecific spondylodiscitis at the child age represents a distinctive disease of intervertebral disc and adjacent subchondral parts of vertebral bodies. Their early diagnostics may be difficult due to latency of radiographic manifestation of the finding and possible mistaking for other pathological conditions, especially tuberculosis spondylitis. The paper demonstrates several cases of the disease which we encountered recently. The authors discuss clinical and X-ray symptoms of the disease with a particular attention to modern methods of visualization, especially computer tomography. Etiopathogenesis of the disease is analyzed and some new knowledge of the disease is presented, differential diagnosis is discussed. In the conclusion attention is paid to early diagnosis of the disease and introduction of proper therapy.

Adolescent↗

PubMed1989

[Bone changes in tuberous sclerosis (Bourneville-Pringle disease)].

The tuberous sclerosis is a rare hereditary disease which mostly becomes manifest in a triad of symptoms: epilepsy, mental defects and skin changes of the adenoma sebaceum Pringle type. There may be an atypical clinical picture without neurological or psychiatric signs, in 50% of cases also without skin changes. Bone changes in tuberous sclerosis are asymptomatic and present in up to 50% of patients. Their finding in patients without basic known symptoms may be the cause of mistaking it for osteoplastic metastases. A case like that was described in the case history part of the communication. The knowledge of the possibilities of these changes in tuberous sclerosis may considerably ease differential diagnosis by suitable indication of computer tomography of the brain with the finding of typical calcifications.

Bone and Bones↗

PubMed1988