PubMed HealthSearch

Biomedical subjects

G Seidl

Publications and source records attributed to G Seidl.

At least 19 recordsLinked to original sources

[Sonographic structural analysis of the Achilles tendon and biomechanical implications].

Ruptures of the Achilles tendon mainly occur on the ground of predisposing destruction of tendon structure. The aim of this retrospective US study was to evaluate the location and extent of tendon abnormalities. 62 patients (49 male, 13 female; 19 to 57 years, mean 38) with achillodynia of short duration and/or clinically suspected tendon abnormalities were evaluated sonographically. Together with a review of the literature, US findings (location, extent, and echo pattern) were compared with clinical findings. With US, abnormalities could be detected with a sensitivity of 0,76 and a specificity of 0.9. Pathologic lesions could be grouped as follows: (1) pain without any clinical signs or US findings (tenalgia); (2) nodular tendinitis which in 52% appeared in the form of a tiny hypoechoic lesion in the ventromedial part of the tendon 2-3 cm proximal to the os calcis; (3) peritendinal oedema; (4) circumscribed tendon swelling, (5) extensive inhomogeneities of tendon structure. With US, abnormalities of the Achilles tendon may be detected at an early stage of the disease and hence the risk of tendon rupture may be predicted to better advantage.

Achilles Tendon

[Renal osteodystrophy: the spectrum of the x-ray symptoms in modern forms of kidney transplantation and long-term dialysis therapy].

Plain film radiography and microradioscopy represent standard imaging for diagnosis and grading of renal osteodystrophy. The aim of this retrospective study was to evaluate the effects of modern therapeutic regimens on skeletal abnormalities as diagnosed radiographically. 198 patients were investigated. X-ray findings of 38 patients from 1981-1983 (16-66 years, 40.1 +/- 13.4; 23 male, 15 female) were compared with those of 160 patients from 1991 (20-71 years, 48.4 +/- 12.5; 98 male, 62 female). We found significant differences in respect of the spectrum and the degree of skeletal abnormalities. The prevalence of phalangeal resorptions lowered from 87 to 50%, the prevalence of soft tissue calcification from 68 to 57%. Therefore, renal osteodystrophy is not as extensive as it was ten years ago, but it still continues to be an unavoidable complication of renal insufficiency.

Adolescent

Comparison of dual energy X-ray absorptiometry of the proximal femur with morphologic data.

Measurements of bone mineral density (BMD) of the proximal femur (including femoral neck, Ward's triangle and trochanteric region) were compared with the Singh index grading in 40 normal subjects (20 male, 20 female) and in 116 patients (18 male, 98 female) referred for assessment of possible osteoporosis. Additionally, the BMD and the Singh index of 12 cadaver specimens (6 male, 6 female) of the proximal femur were compared with each other and with the histomorphology of the femoral necks of the specimens. Although there was a good correlation of Singh index with BMD in the group of male patients with suspected osteoporosis and in the series of bone specimens, there was a poor correlation in the group of female patients as well as in the normal controls and in the patient population as a whole. There was also poor correlation of Singh index values with histomorphologic data, whereas the BMD measurements correlated well with the amount of calcified bone found histologically in the femoral necks of the bone specimens. We conclude that the Singh index cannot be used to predict BMD of the proximal femur accurately.

Absorptiometry, Photon

[DEXA (dual-energy x-ray absorptiometry) and DPA (dual photon absorptiometry) in densitometry of the femoral neck: correlation of the measurements of three commercially available instruments].

The bone mineral density measurements of three different instruments at the femoral head were compared using 12 cadaver specimens. Two of these instruments were operated by x-rays (dual energy x-ray absorptiometry = DEXA), whereas one system was based on a gadolinium source (dual photon absorptiometry = DPA). Although excellent correlation between the measurements was obtained (r greater than 0,9), the measurements of one of the DEXA-instruments were significantly higher than the measurements of the two other systems. We conclude that a comparison of bone mineral density measurements obtained on different densitometry instruments may pose problems. Follow-up examinations should be done on one single densitometry unit.

Absorptiometry, Photon

[Magnetic resonance tomography of the craniocervical junction in chronic polyarthritis].

Magnetic resonance imaging and conventional radiographs and tomograms were correlated in 61 patients with chronic polyarthritis. Radiographs of the occipito-cervical junction only demonstrated bone lesions, erosions were detected on conventional tomograms. MRI was adequate for demonstration of bone abnormalities and soft tissue lesion and was especially suitable for detection of complications at the cervical spinal cord.

Adult

Myocardial surface PO2--an indicator of myocardial tissue oxygenation?

The validity of myocardial surface tissue PO2 (PtO2) as a reliable indicator of transmural myocardial tissue oxygenation was studied in six anaesthetised, open chest pigs. Epicardial surface PtO2 was correlated with other variables of myocardial tissue oxygenation such as regional blood flow, coronary venous PO2, O2 saturation, PCO2 and regional myocardial lactate extraction. The study design was based on an experimental model in which the effects of a pacing induced tachycardia on tissue oxygenation of ischaemic and normally supplied myocardium were measured. Two platinum multiwire surface electrodes were placed on the epicardium, on the areas supplied by the left anterior descending coronary artery (LAD) and the left circumflex coronary artery (CX). The LAD was constricted to reduce mean surface PtO2 in the LAD area to about 50% of its baseline value. This did not affect surface PtO2 in the CX area. The reduction of surface PtO2 in the LAD area was associated with decreases in coronary venous PO2 and O2 saturation and with increases in coronary venous lactate and PCO2. Subendocardial regional blood flow and the subendocardial to subepicardial flow ratio were significantly lower than in the CX area. Increasing the heart rate by pacing (+45 beats.min-1) led to an increased degree of ischaemia as shown by fall in surface PtO2 in the LAD area to values around zero kPa, by marked increase in coronary venous lactate and PCO2, by reduction in total (-10%) and subendocardial (-40%) LAD flow and by deterioration of the subendocardial to subepicardial flow ratio. The increased degree of ischaemia was not accompanied by an increase in O2 extraction. The marked decrease in surface PtO2 occurred in spite of a slight increase in the subepicardial regional blood flow (+10%); thus the increase in O2 delivery was not sufficient to meet the increase in O2 demand. Total flow was increased by 27% in the CX area without changes in the subendocardial to subepicardial flow ratio and in the surface PtO2 values. When pacing was stopped, surface values of PtO2 in the LAD area returned to prepacing values, as did lactate extraction and coronary venous PCO2. Clear and close relationships with surface PtO2 were found for regional lactate extraction, coronary venous PCO2 and the normalised subendocardial RBF. Poor or no correlations were found for the normalised subepicardial regional blood flow, the coronary venous O2 saturation and the absolute values of subendocardial and subepicardial regional blood flow.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals

Regional blood flow and tissue oxygen pressures of the collateral-dependent myocardium during isoflurane anesthesia in dogs.

The authors investigated the effects of isoflurane on blood flow and tissue oxygen pressures of a collateral-dependent myocardium. Seventeen dogs divided into two groups were studied 3-4 weeks after implantation of ameroid coronary artery constrictors to completely occlude the proximal part of the left anterior descending artery. Experiments were performed during anesthesia with an opiate that was infused intravenously throughout the experiments. In Group 1 (n = 9), measurements were obtained during control and during isoflurane- (1.6-2.2 vol%) induced hypotension (mean arterial pressure, 60 mmHg). In Group 2 (n = 8), the identical protocol was applied, but norepinephrine was infused to maintain normotension. Dipyridamole effects were studied in five animals of Group 2 after a second control period at least 1 h after discontinuation of isoflurane. Isoflurane-induced hypotension caused reductions of blood flow and surface tissue oxygen pressures in the collateral flow-dependent area. Vasodilation in the normal left ventricular areas was demonstrated by an unchanged blood flow despite a reduced oxygen consumption and by a significantly increased coronary sinus hemoglobin oxygen saturation. When arterial pressure was maintained at its control level by norepinephrine, tissue oxygen pressures remained constant and collateral as well as normal area flow increased significantly during isoflurane. Coronary vascular resistance was lower during administration of isoflurane and norepinephrine compared with that during isoflurane induced hypotension, suggesting a significant contribution of tissue oxygen demand in regulation of coronary vascular resistance. At comparable levels of arterial pressure and left ventricular oxygen consumption, normal zone blood flow was significantly higher during dipyridamole than during isoflurane and norepinephrine. Thus, isoflurane-induced hypotension decreased blood flow and tissue oxygen pressures of collateral flow-dependent myocardial areas. However, neither isoflurane nor dipyridamole caused such alterations when arterial pressure was normal.

Anesthesia, Intravenous

[Pachydermoperiostosis. Clinical aspects, classification and pathogenesis].

There are 2 different forms of the rare disorder of connective tissue "pachydermoperiostosis": a primary form called Touraine-Solente-Gole (TSG) syndrome, and a secondary one, called Bamberger-Pierre-Marie syndrome (BPM). The manifestations of the two forms are very similar, but differential diagnosis is possible because BPM syndrome occurs in association with certain diseases of internal organs and effective treatment of these is followed by regression of the skin manifestations. Therefore, it seems reasonable merely to refer to primary and secondary forms of pachydermoperiostosis, rather than distinctly named syndromes. The pathogenesis of pachydermoperiostosis is unknown. Obviously a hereditary disturbance of metabolism in the connective tissue is involved, and manifestation of the disease can be either primary or secondary as a result of still unknown triggering factors.

Adult

Diagnostic imaging of the occipito-cervical junction in patients with rheumatoid arthritis. Plain films, computed tomography, magnetic resonance imaging.

Fifty-five patients with confirmed chronic polyarthritis were admitted to this prospective study. The occipito-cervical region was visualized by plain radiography, computed tomography (CT) and magnetic resonance (MR) imaging. These modalities and the results are compared. In the presence of chronic polyarthritis, radiography of the occipito-cervical region visualized only bone lesions, while CT provided a good picture of both bone lesions and soft-tissue alterations. CT is an effective modality for the diagnosis of chronic polyarthritis in the occipito-cervical region. MR imaging was less sensitive in depicting bone lesions. In comparison with CT, however, MR images produced more frequent and more impressive visualization of soft-tissue alterations. MR imaging is most suitable for visualizing complications of the spinal cord.

Adult

A case of decompression sickness in a commercial pilot.

We report a case of decompression sickness (DCS) followed by pulmonary edema in a 47-year-old commercial pilot who operated a non-pressurized turboprop twin at flight level 290. He became unconscious and recovered after an emergency descent. The pilot collapsed and a pulmonary edema occurred 8 h after landing. The patient improved rapidly with fluid replacement and without hyperbaric therapy, which was not available at that time. This course of DCS is unusual because it is reported that fluid replacement without hyperbaric therapy normally cannot recover severe cases of DCS. The considerable increase in body weight of this pilot within the last 6 months may have been a predisposing factor for development of decompression sickness.

Aerospace Medicine

[X-ray diagnosis of renal osteopathy in dialysis patients with reference to clinical aspects].

Pathophysiological histological and radiological findings in renal osteodystrophy are described. Special emphasis is laid on secondary hyperparathyroidism. Preliminary results of the authors' investigations show a good correlation between radiological findings in the phalanges of the hand and the concentration of parathyroid hormone (PTH) in 14 patients. The concentration of the hormone in the blood was measured by a new "two-site" immunoradiometric assay, which is specific for the intact, biologically active hormone. Patients with high concentrations of PTH in the blood tended to have more severe radiological changes. In 4 patients for whom radiographs of the hands revealed no pathologic findings, normal PTH concentrations in the blood were measured by this method, whereas the conventional assay gave elevated hormone concentrations for the same patients. This is due to the lack of specificity of the conventional method for the intact, biologically active hormone. Nevertheless, further investigations are needed to confirm these findings.

Chronic Kidney Disease-Mineral and Bone Disorder

[Quantitative evaluation of knee joint effusions with high resolution real-time sonography].

In three human cadaver specimens an intraarticular effusion of the knee was simulated by injecting sodium chloride in 10 ml portions. The sonographic appearance and quantification as well as the location of the fluid were evaluated. Effusions of the knee joint are a principal sign for many diseases. Their sonographic evaluation is easy and provides valuable clinical information.

Humans

[Angiodynography: technical principles and clinical uses].

Angiodynography is a newly developed system that enables Doppler sonography to be used to obtain a colour-coded real-time image of the blood vessels in the familiar ultrasound slice image. A new computerised technique allows both the familiar pulse echo signal and the Doppler shift of the signal resulting from movement in the body to be displayed for each point on the ultrasound slice plane. Stationary tissue structures are shown as the familiar grey scale image, while movement such as of the blood is shown in colour. 453 patients were examined. Normal and pathological flow measurements were obtained in the carotid artery, the jugular vein, in renal transplants, in the thyroid, the testis and in the urethra. Pathological flow velocities were visualised in stenosis, tumours and diffuse alterations of parenchyma.

Arterial Occlusive Diseases

[Sonography of the Achilles tendon and its bursa].

Pain and disturbed function in the sole of the foot leads to damage of the tendo Achilles and to abnormalities in its vicinity. They are frequent consequences of some sporting activities (jogging). Differentiation between bursitis, fat necrosis, degenerative changes in tendons and their rupture and from abnormalities of the ankle joint is important for treatment. In the symptomatic patients whom we examined, the bursa was involved in 72.9% and lesions of the tendo Achilles were found in 62.1%.

Achilles Tendon

[Aseptic humerus head necrosis--tortuous path of a maker of scythes through expert medicine].

The case report is presented of a 50 year-old scythe smith who produced 1400 scythes daily in piece-work over a period of 17 years. He complained for the first time in 1977 about severe pain in his left shoulder. Six years after the onset of pain aseptic necrosis of the humeral head was finally diagnosed by reviewing old X-rays of 1977, but the patient had meanwhile absolved a troublesome journey through a variety of incorrect-medical diagnostic and therapeutic procedures. The patient's history, previous reports and the actual clinical findings observed in our department are presented in this paper. We consider that this patient is suffering from an occupational disease which should be legally recognised as such.

Agriculture

[Radiologic detection of pulmonary artery hypertension].

In 43 patients with obstructive and restrictive lung disease a catheterisation of the right heart with measurement of pulmonary artery pressure was performed. In a retrospective study several radiological parameters of pulmonary hypertension were evaluated on the chest radiographs of these patients. Considering those parameters on the p.a. and lateral chest radiograph, the diagnosis of pulmonary hypertension in patients with elevated pulmonary artery pressure at rest can be made with great accuracy. When pulmonary artery pressure is elevated only during exercise, the accuracy of radiological diagnosis is much lower.

Female