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Biomedical subjects

G Mostbeck

Publications and source records attributed to G Mostbeck.

54 records · Page 3Linked to original sources
PubMed1989

Portal venous blood flow in cystic fibrosis: assessment by Duplex Doppler sonography.

Changes of portal venous hemodynamics were investigated in 32 patients with cystic fibrosis (CF) with a mean age of 11.6 years. Hepatic profile of these patients included total bilirubin and albumin together with determination of size and echogenicity of the liver and spleen, determination of the diameter of the portal vein by real-time sonography and quantitation of flow volume of the portal vein using Duplex Doppler sonography. As a control, 35 age matched healthy children were also examined. Diameter of the portal vein was significantly increased in CF patients versus controls. Comparison of the mean flow volume of the portal vein showed a significant increase in CF-patients over 12 y old versus controls. In patients less than 12 y no significant difference of flow volume of the portal vein between CF-patients and controls was noted. The increase of diameter and flow volume of the portal vein suggest an adaptive mechanism in the pressure-volume relationship of the portal venous system in patients with CF.

Adolescent↗
PubMed1989

Sonography of unusual extratesticular lesions.

Sonograms of seven patients with extratesticular lesions are presented because of their relatively rare occurrence or unusual sonographic pattern. The sonographic appearance of a malignant extratesticular liposarcoma is described. Infected sebaceous glands and slow-growing malignant tumors of the spermatic cord are demonstrated as possible problems in differential diagnosis. Extratesticular septated cysts or fluid collections surrounding the spermatic cord are documented as complications in hemophilia and acute pancreatitis. These entities are presented because of their differential diagnostic challenge compared with more common disorders such as infected hydroceles and hernias.

Adult↗
PubMed1989

[Hepatic and splenic abscesses in immunosuppressed patients].

Morphologic characteristics of hepatosplenic abscesses using ultrasound and CT examinations in 13 immunosuppressed patients are presented. Additionally, the results of diagnostic ultrasound and CT guided biopsy procedures (n = 13) are reported. On sonograms, bacterial abscesses were exclusively hypoechoic lesions whereas patients with mycotic abscesses showed additionally target lesions and lesions presenting a "wheels-within-wheels" appearance. Thus, with some limitations, us might help to differentiate between fungal and bacterial abscesses. On CT, all patients presented uniformly with hypodense lesions. Follow-up ultrasound studies showed these abscesses over periods as long as 24 months; biopsy proved some of these as fibrotic lesions without vital bacteria or fungi.

Abscess↗
PubMed1988

Skeletal involvement in hairy cell leukemia.

The clinical and radiographic aspects of two patients with destructive bone lesions, complicating the course of hairy cell leukemia are presented. The findings are compared with those of 27 previously published cases. The most prominent features of this rare skeletal disorder are osteolysis and widespread or localized demineralisation with predilection for the femoral head and neck. Localized persisting pain is the leading clinical symptom in all cases. Magnetic resonance imaging is helpful in evaluating the extent of bone marrow infiltration and demonstrates focal areas of decreased signal intensity in sites of radiographically detectable bone destruction as well as in bones that appear normal on plain films.

Bone Neoplasms↗
PubMed1988

[Ultrasound in terminal renal failure--etiologic conclusions?].

Using standard real time sonography, renal cortical echogenicity, renal length, intrarenal cystic structures and renal calculi were evaluated in 63 patients (30 men, 33 women) in end-stage renal parenchymal diseases (glomerulonephritis n = 21, diabetic glomerulosclerosis n = 9, analgesic nephropathy n = 14, chronic atrophic pyelonephritis n = 19). Patients with glomerulonephritis and diabetic glomerulosclerosis presented with larger kidneys and only slightly increased cortical echogenicity as compared to analgesic nephropathy and chronic atrophic pyelonephritis. In addition, intrarenal cystic structures were found in 50% of the patients with analgesic nephropathy and in 31% of the patients with pyelonephritis, compared with only 14% and 11% in patients with glomerulonephritis and diabetic glomerulosclerosis, respectively. Intrarenal calcifications were more frequent in pyelonephritis and analgesic nephropathy. In end-stage renal parenchymal disease, sonography might be able to distinguish between different types of renal medical disorders.

Adult↗
PubMed1987

Accessory spleen: presentation as a large abdominal mass in an asymptomatic young woman.

Accessory spleen hypertrophy is usually related to hematologic, lymphomatous, and rheumatoid diseases. We describe here the case of an 18-year-old asymptomatic woman who presented with a very large accessory spleen occupying the lower abdomen. Its appearance on abdominal sonogram, computed tomogram, and hepatosplenic scintigraphy is correlated with the resected specimen.

Abdominal Neoplasms↗
PubMed1987

[Relation between pulsed and continuous Doppler velocimetry of the anterior cerebral artery in newborn infants].

Continuous wave (cw) and pulsed wave (pw) Doppler velocimetry are both used to measure blood flow velocity in cerebral arteries. We examined whether data obtained with the two methods are interchangeable and equally useful for clinical application. We studied 20 infants at an age between 1 day and 2 1/2 months and a body weight between 1.2 and 3.4 kg. Cw Doppler measurements were performed using an Angiomatic (Medimatic) and pw measurements using a Mark 600 Duplex Scanner (ATL). We applied both methods within an interval as short as possible. For the data analysis the pulsatility index (PI) was used, a parameter fairly independent of the emission angle. PI was 0.66 +/- 0.06 (mean +/- SD) using the cw and 0.8 +/- 0.08 using the pw method. The linear correlation between the pulsatility indices obtained with the cw and the pw method respectively was statistically significant (r = 0.53, n = 20, p less than 0.0025), the variation around the regression line rather large. The slope of the regression line differed significantly from that of the identity line (y = 0.391x + 0.54). Therefore the PI values obtained with the two methods are not interchangable and require to be judged according to normal values. Both methods, however, yield PI values which correlate and can thus be equally used. The choice of the method rather depends on the goal to be achieved. The pw method seems to be more suitable for precise momentaneous descriptions and the cw method for continuous monitoring of cerebral blood flow.

Blood Flow Velocity↗
PubMed1987

[Duplex sonography of the splenoportal axis].

48 patients with partial or complete portal vein thrombosis or tumor stenosis were examined by pulsed Doppler duplex scanning. In addition to the analysis of morphological changes, the pulsed Doppler duplex system yields functional data on the acceleration of blood flow in stenosis, flow in partial thrombosis and in differentiation between tubular cystic structures like arterial vessels, venous collaterals and dilated bile ducts. Qualitative and quantitative measurements of portal blood flow were performed in 55 cirrhotics and 15 healthy volunteers. Portal venous velocity and portal venous blood flow were significantly reduced in patients with cirrhosis. In 46 cases a hepatopetal blood flow was shown. In five cases a hepatofugal flow and in four cases a stagnant flow was found in the portal vein. Spontaneous portal systemic collaterals with hepatofugal flow were shown in 41% of cases. 11 patients with surgical portacaval shunts were examined. Patency was demonstrated in five patients where the anastomotic site was visible. Pulsed Doppler duplex sonography proved a valuable tool in the assessment of morphologic changes and revealed qualitative and quantitative data of portal venous hemodynamics.

Collateral Circulation↗
PubMed1986

[Complete AV block in a heart catheter study using a Swan-Ganz catheter].

A case of complete heart block during right heart Swan-Ganz balloon-tipped flow-directed catheterization in a patient with intermittent left bundle branch block after aortic valve replacement is reported. After entrance into the right ventricle with the catheter tip as well as after insertion of a temporary balloon-floated pacemaker electrode symptomatic complete heart block occurred. This case demonstrates that in a patient with intermittent left bundle branch block a complete AV block may occur and therefore the possibility of cardiopulmonary resuscitation and temporary pacing has to be taken in account.

Aged↗
PubMed1985

Tracer elimination in I-123-heptadecanoic acid: half-life, component ratio and circumferential washout profiles in patients with cardiac disease.

Sixty patients with different cardiac diseases and healthy volunteers were given omega-I-123-heptadecanoic acid (HDA) intravenously. Tracer kinetics were followed for 90 min, and tracer elimination curves were obtained regionally. In addition, circumferential washout profiles were evaluated for 26 patients and interpolative as well as constant background subtraction was performed for comparison in selected patients. Rest and stress radionuclide ventriculography allowed formation of a group with normal ventricular function (control group); the remaining patients had an abnormal ventricular function at rest or under stress. Regions of patients in the control group were significantly different (P less than 0.005) from regions of patients with CHD or CMP with regard to the initial half-life or the component ratio between a fast and a slow component (Ca/Cb). Regions of patients after MI without exercise-induced angina did not differ strikingly from control regions. Circumferential washout analysis showed homogeneous tracer kinetics in healthy subjects, bus some individuals showed increasing regional activity, mainly by late activity uptake of the stomach. Dynamic heart scintigraphy with HDA is an additional nuclear cardiologic tool that makes possible the classification of patients with myocardial disease and abnormal ventricular function already under resting conditions. Initial half-life allows reasonable discrimination between different severely diseased patient groups; expansion of acquisition time to 90 min refines biexponential tracer analysis which, by means of an altered component ratio Ca/Cb, may allow better clinical judgement of the individual patient. Circumferential washout analysis and interpolative background correction lead to a better specificity of examination.

Adult↗
PubMed1984

Scintigraphic left ventricular function during exercise in elderly patients with coronary artery disease.

Left ventricular performance at rest and during supine symptom-limited exercise was determined by radionuclide ventriculography (RNV) in 65 subjects of the age of 65 years or older. Eleven subjects had no evidence of coronary artery disease (CAD) by history or submaximal stress ECG. In this control group left ventricular ejection fraction (LV-EF) increased from 0.62 +/- 0.09 (mean +/- SD) to 0.69 +/- 0.08 with a further increase in regional wall motion. There were 10 patients with a history of hypertension or atypical angina without infarction. Left ventricular ejection fraction (LVEF) at rest was 0.65 +/- 0.11 and showed no significant increase during exercise (mean exercise tolerance: 73 +/- 33W). Nineteen patients had an anterior infarction. LVEF at rest was 0.44 +/- 0.16 and as a group showed no change during exercise (mean exercise tolerance: 70 +/- 23W). Only two of 19 patients showed an increase of LVEF greater than 0.10. There were 19 patients with inferior infarction. LVEF at rest was 0.49 +/- 0.08 and showed also no significant change during exercise (mean exercise tolerance: 80 +/- 25W). Four of 19 patients showed an increase of LVEF in response to exercise. The five patients with two or more infarctions showed a markedly decreased resting LVEF of 0.28 +/- 0.11 with a further decline (0.22 +/- 0.09) during exercise (mean exercise tolerance: 45 +/- 32W). Therefore, age by itself does not significantly impair left ventricular ejection fraction at rest and during exercise. RNV appears as a valuable method in evaluating left ventricular performance of older patients with a similar response to exercise as in younger persons without or with comparable disease.

Aged↗
PubMedDate not supplied

Contrast MRI in multiple endocrine neoplasia type 1 (MEN) associated with renal cell carcinoma.

The radiologic work-up of a patient with multiple endocrine neoplasia type 1 (MEN 1) syndrome and multiple endocrine nodules, with coincidental renal cell carcinoma, is described. Parathyroid adenoma was differentiated from multiple thyroid nodules by gadolinium-enhanced MRI. Adrenal enlargement due to a nonfunctioning adenoma and a renal cell carcinoma next to a simple renal cortical cyst were identified by typical signal intensities on T1- (pre- and post-Gd-DPTA) and T2-weighted images. Insulinoma was visualized only retrospectively.

Adenoma↗
PubMedDate not supplied

High-dose cyclophosphamide, adriamycin, and vincristine (HD-CAV) in children with recurrent solid tumor.

A dose-intensive regimen of cyclophosphamide (140 mg/kg over 2 days), doxorubicin (Adriamycin, 75 mg/m2 over 3 days), and vincristine (1 mg/m2 on days 1, 2, and 3 and 1.5 mg/m2 on day 9) was tested in 18 children and adolescents with poor-prognosis recurrent or refractory solid tumors. Nine were affected by neuroblastoma, 3 by Ewing's tumors, 2 by rhabdomyosarcoma, 2 by synovial sarcoma, 1 by hepatocellular carcinoma, and 1 by osteogenic sarcoma. All enrolled patients were heavily pretreated, including 2 patients after bone marrow transplantation. Forty courses were applied (median, 2). The overall response rate was 33% (2 complete remissions and 4 partial remissions). Responses were obtained in children with neuroblastoma, Ewing's tumors, and hepatocellular carcinoma. Myelosuppression [World Health Organization (WHO) grade IV after all courses] and cardiac toxicity (3 WHO grade I, 5 WHO grade III, and 3 WHO grade IV) were the main side effects. Nephrotoxicity and hepatoxicity were not observed. With further therapy consisting of surgery, radiotherapy, and high-dose chemotherapy [cisplatin, carboplatin/etoposide (VP16), or ifosfamide/VP16 with or without autologous stem cell reinfusion after conditioning with melphalan/VP16/carboplatin], 3 complete remissions and 5 very good partial remissions were obtained. Ten of 18 patients are alive after a median follow-up of 16 months.

Adolescent↗