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Biomedical subjects

G Heinz-Peer

Publications and source records attributed to G Heinz-Peer.

32 records · Page 2Linked to original sources
PubMed1998

Function of reinserted abductor muscles after femoral replacement.

We compared two methods of reconstruction of the abductor mechanism in 15 patients after prosthetic replacement of the upper femur, to assess abductor strength and function. Six patients in group I had direct fixation of the gluteus medius tendon and a segment of the original bone to the prosthesis. Nine patients in group 2 had the abductor tendon fixed to the iliotibial band. We assessed clinical function, isometric muscle strength and muscle cross-sectional area for each patient. The patients in group 1 had better clinical and functional results (p = 0.059), with average peak torques for hip abduction of 92% of that in the non-operated leg in group 1, and of 57% in group 2. Group 1 had a mean muscle cross-sectional area of 69% and a mean value of strength per cross-sectional area of 134% when compared with the control side. The respective values for group 2 were 52% and 91%. Direct fixation of the abductor muscles to the prostheses gave improved function and higher isometric abductor muscle force.

Adolescent↗
PubMed1996

Effects of umbilical arterial catheterization on mesenteric hemodynamics.

Impairment of mesenteric blood flow due to the use of umbilical artery catheters (UAC) may increase the risk of necrotizing enterocolitis (NEC) in newborn infants. We used Duplex Doppler sonography to investigate the degree of vessel obstruction due to UAC and their effect on visceral hemodynamics in 12 newborn infants. Ultrasonography was performed before and immediately after removal of the UAC, which was positioned above the ostia of the celiac and superior mesenteric arteries (SMA). Vessel diameter, peak systolic blood flow velocity (PSFV), end diastolic blood flow velocity (EDFV), and Pourcelot's resistance index (RI) were measured in the celiac trunk and the SMA within 1 cm of their origins. Removal of the UAC led to a significant increase in mean PSFV (celiac trunk: 50 cm/s +/- 15 vs 62 cm/s +/- 0.22, P < 0.05; SMA: 52 cm/s +/- 0.17 vs 72 cm/s +/- 0.21, P < 0.05). RI increased from 0.7 +/- 0.14 to 0.74 +/- 0.13 and from 0.73 +/- 0.1 to 0.76 +/- 0.13 for the celiac trunk and SMA, respectively. The EDFV and vessel diameters did not change significantly after UAC removal. Our results suggest that UAC cause a decrease in mesenteric blood flow. Therefore, their use in hemodynamically unstable neonates or in those with gastrointestinal disease should be very carefully considered.

Blood Flow Velocity↗
PubMed1996

[Radiation dosage of various CT techniques in diagnostic lung imaging].

Introduction of the computed tomography index CTDI and the multiple scan average dose (MSAD) has led to standardization of the dose description in CT examinations. Despite the use of these dose parameters, many different dosages are reported in the literature for different CT methods. In addition, there is still a wide range of radiation dosimetry results reported for conventional CT, helical CT, and HRCT used in chest examinations. The variations in dosage are mainly due to differences in factors affecting the dose, i.e. beam geometry, beam quality, scanner geometry ("generation"), and operating parameters. In addition, CT dosimetry instrumentation and methodology make a contribution to dosages. Recent studies calculating differences in factors affecting dosage and CT dosimetry and using similar operating parameters, show similar results in CT dosimetry for conventional and helical CT. On the other hand, dosages for HRCT were greatly reduced. This was mainly caused by narrow beam collimation and increasing section spacing.

Heart↗
PubMed1996

[Injuries to the lateral ligaments of the ankle joint: study technic and demonstration by means of MRI].

PURPOSE: To evaluate the visualisation and extent of injury of lateral ankle ligaments using MRI. METHODS: 56 patients with the clinical diagnosis of sprained ankles were investigated. Evaluation of the anterior (AFTL) and posterior fibulotalar ligament (PFTL) was performed with the foot in dorsiflexion (20 degrees) and of the fibulo calcanear ligament (FCL) in plantarflexion (45 degrees). Axial T1w-SE and T2w-TSE images were obtained. Full-length visualisation of ligaments in one slice and the extent of injury were evaluated. 12 ankle injuries were confirmed by operation. RESULTS: With MRI full-length visualisation of lateral ankle ligaments was possible in 86%. A partial/complete rupture of the AFTL was noticed in 33/64% and of the FCI in 29/39%, and of the PFTL in 27/5%. Sensitivity/specificity of MRI when compared to surgery was 100/100% for injuries of the AFTL, 64/100% for the FCL, and 33/78% for the PFTL. CONCLUSION: Full-length visualisation of ligaments, achieved by appropriate combination of foot position and imaging plane is essential for evaluation of injured ankle ligaments on MRI. High assessment for ligamentous injuries on MRI in relation to surgery was found.

Adolescent↗
PubMed1995

[The experiences of a hospital radiology department with outside referrals for the preoperative marking of suspicious breast lesions].

PURPOSE: To outline the experience of a referral radiology department with preoperative localisation procedures on the basic of mammograms obtained by other facilities. MATERIAL AND METHODS: 342 consecutive female patients aged 56.5 +/- 11.9 years underwent preoperative breast localisation procedures prior to surgery. Of these patients 241 had their mammograms obtained in various private practices and 101 in the radiology department. Retrospectively all mammograms were classified by lesions morphology, lesion size and presence or absence of calcifications. RESULTS: The overall benign-to-malignant ratio (B/M-ratio) was 1.7:1. In the referred patient group the B/M-ratio was 1.9:1, compared to a B/M-ratio of 1.3:1 obtained by the radiology department. Referred patients presented significantly (p < 0.001) more often with calcifications that patients from the radiology department. CONCLUSION: Possible factors for the higher B/M-ratio in referred patients are prompt referral to surgical biopsy, misinterpretation of mammograms, failure in the written report, lack of a second opinion and lack of feedback and communication between surgeon, pathologist and radiologist.

Aged↗
PubMed1995

[Malignant neoplasms after kidney transplantation: value of an annual radiological screening program].

PURPOSE: To evaluate the prevalence of malignant neoplasms after renal transplantation by means of a radiological screening programme and to determine the role of some clinical and demographic parameters concerning pathogenesis of these malignancies. MATERIAL AND METHODS: Between November 1992 and June 1994 in a prospective study 504 consecutive renal allograft recipients (331 m, 173 f) aged 51 +/- 13 years underwent routine abdominal ultrasound examinations including the renal transplant and p.a. and lateral chest x-rays once a year. RESULTS: This screening programme revealed 11 malignant neoplasms in 11 patients (2.2%). We detected 6 renal cell carcinomas (RCC) in the patient's native kidneys, two RCCs in two renal allografts, two non-Hodgkin-lymphomas in the liver and the renal allograft, respectively, and one ovarial carcinoma. Patients with renal cell carcinomas in the native kidneys were significantly older than allograft recipients without tumors. The presence of acquired cystic kidney disease (ACKD) seems to be an additional risk for the development of RCC. There were no significant differences in the time on dialysis, the time with functional renal allograft, and the immunosuppressive therapy. CONCLUSION: Yearly abdominal ultrasound screening including the renal allograft is a valuable tool for the early detection of neoplasms in asymptomatic renal allograft recipients. However, routine yearly chest x-rays should not be performed in renal allograft recipients without preexisting tumours.

Adult↗
PubMed1995

Prevalence of acquired cystic kidney disease and tumors in native kidneys of renal transplant recipients: a prospective US study.

PURPOSE: To determine the prevalence of acquired cystic kidney disease (ACKD) and renal neoplasms in the native kidneys of renal transplant recipients. MATERIALS AND METHODS: The ultrasound (US) scans in 385 renal allograft recipients were prospectively studied. In addition, 65 patients with ACKD underwent two additional US examinations on different days to assess intra- and interobserver variability with regard to the number of cysts and their diameter. RESULTS: ACKD was present in 96 of 385 patients. Patients with ACKD were significantly older than patients without ACKD, had undergone hemodialysis for a longer period, and were predominantly men. There was no significant difference in the time with functioning graft. Renal cell carcinoma (RCC) was diagnosed in six patients at histologic examination. Of these six patients, five had evidence of ACKD. CONCLUSION: The frequency of ACKD increases with the duration of hemodialysis. The risk for the development of ACKD is increased in men and older patients. The malignant potential of ACKD persists after renal transplantation.

Adult↗
PubMed1995

[Sinus tarsi syndrome. MRI diagnosis].

Sinus tarsi syndrome is a well-defined clinical pathological entity. The sinus tarsi is an anatomic space between the inferior aspect of the talus and the superior aspect of the calcaneus, anterior to the posterior subtalar joint. The entire space is filled with fat, five ligaments and vessels. MRI demonstrates characteristic findings with obliteration of normal fat and lack of visualization of the ligaments. This syndrome is relatively frequent and is related to trauma in about 70% in association with the lateral collateral ligament and tibialis posterior tendon injuries. In the remaining 30% the reason is an inflammatory condition.

Calcaneus↗
PubMed1994

[Color Doppler ultrasound of gallbladder varicose veins in children. A rare sign of portal hypertension].

In a retrospective study of 21 children with portal hypertension (P. H.) four patients (19.2%) presented with gallbladder varices as documented by colour-coded Doppler sonography (CCDS) gallbladder varices (GV). Three of four patients with GV had portal vein thrombosis, one patient had cholestatic cirrhosis. Thickening of the gallbladder wall with serpentine anechoic structures was visible in all cases. Blood flow could be documented within the widened veins of the gallbladder wall in 3 of the 4 patients with duplex Doppler US, but in all patients with CCDS. US follow-up studies within 3-5 years were done on 2 patients and showed that GV appeared 2 years after the clinical diagnosis of P. H. With CCDS, varices of the gallbladder wall may be diagnosed readily and differentiated from other diseases associated with thickening of the gallbladder wall.

Adolescent↗
PubMed1994

Hypoechoic perirenal fat in renal transplant recipients.

PURPOSE: To evaluate ultrasonographic (US) findings of morphologies, anatomic locations, and causes of hypoechoic rims that mimic disease and appear around native kidneys of asymptomatic renal allograft recipients. MATERIALS AND METHODS: Annual, routine abdominal US examinations of 170 renal allograft recipients were performed. US scans of 23 (13.5%) of these patients showed a hypoechoic rim. CT examination of the perirenal space was performed for 18 of these 23 patients to confirm the US findings. RESULTS: For 11 of these 18 patients, the hypoechoic rims on US scans corresponded to low-attenuation, septated perirenal fat on CT scans; for seven, the perirenal space appeared to be a homogeneous, fat-filled compartment. Low-attenuation fat in the perirenal space was separated by bridging septa. Patients with hypoechoic rims were significantly older than those without (57 years +/- 10 vs 48 years +/- 12, P = .001). CONCLUSION: Hypoechoic rims are frequently found in asymptomatic renal allograft recipients. They correspond not to disease but to low-attenuation perirenal fat divided into compartments by bridging septa.

Adipose Tissue↗