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Biomedical subjects

G Sigmund

Publications and source records attributed to G Sigmund.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Pheochromocytoma as dominant manifestation of v. Hippel-Lindau syndrome].

A diagnosis of von Hippel-Lindau syndrome was made in two families originating from the same part of the Black Forest but apparently unrelated. Nine affected persons (seven males and two females) had a total of 17 tumours: retinal angioma (4), haemangioblastoma of the CNS (1), and phaeochromocytoma (12). Three of the affected persons and eight of the tumours (six phaeochromocytomas, two retinal angiomas) were diagnosed by family screening. Phaeochromocytoma was diagnosed in eight persons; in four it was the only symptomatic lesion. After extensive diagnostic tests the phaeochromocytoma was the sole tumour in four. Despite severe symptoms the diagnosis of von Hippel-Lindau syndrome had not been made prior to the screening examinations because either the common aetiology of the tumour was not known or there was insufficient exchange of information between the two families.--It is recommended that in each case of phaeochromocytoma von Hippel-Lindau syndrome should be excluded so that lesions can be discovered early in other organs and in other affected family members. If the syndrome is present, annual examinations are indicated because of asynchronous and multi-focal tumour growth.

Adolescent↗
PubMed1992

[Obstetric pelvimetry using nuclear magnetic resonance tomography (MRI): clinical experiences with 150 patients].

Between Oct. 1987 and Oct. 1991 150 patients of the Frauenklinik Freiburg were examined by MR pelvimetry (MRI), 135 of which were "ante partum", i.e. just before delivery. The indications were: earlier operative or strongly protracted delivery, clinical suspicion of disproportion between head and pelvis, or obstetrical "problem pelvis" indicated by manual pelvic examination or ultrasonic foetometry. Previous experimental measurements with a phantom and the comparison with conventional radiograms by Guthmann and Martius of 10 patients in puerperium have shown, that the mean divergence was +/- 2 mm, the maximum divergence 5 mm. The MRI method for pelvimetry "ante partum" or in childbed, proved to be a method of high accuracy and a very good option to judge the pelvic shape, whilst being well accepted by the patients. Furthermore, it allows to determine the foetal BIP (biparietal head-diameter), to judge the pelvic soft-tissue, as well as the visualisation of the birth canal, all without any exposure to radiation. MR pelvimetry is thus part of today's clinical routine. The disadvantages are still the high costs as well as the fact, that only few centres have access to MRI equipment. Nevertheless, the pelvimetry "post partum" can be safely practised radiologically due to the very low radiation exposure.

Female↗
PubMed1992

[Indications for magnetic resonance tomography of abdominal space-occupying lesions in children].

The frequency of magnetic resonance imaging for investigation of abdominal tumors in childhood is increasing. Malignancies of the liver can be visualized. For benign lesions the accuracy is high particularly in the case of hemangiomas. Magnetic resonance investigations are advisable in the presence of abdominal tumors, in order to differentiate lymph nodes and vascular involvement. Magnetic resonance imaging is mandatory in the case of retroperitoneal and presacral masses to depict any intraspinal tumor spread. RARE myelography can replace computed tomography myelography.

Abdominal Neoplasms↗
PubMed1991

[Magnetic resonance tomography in the diagnosis of peripheral joints].

Magnetic resonance imaging (MRI) provides an excellent soft tissue contrast with high spatial resolution. Using spin echo and fast gradient echo sequences all relevant joint structures such as the hyaline cartilage, the meniscus, the ligaments, the tendons, the capsulae, and their adjacent muscles and their pathology are visualized. Diagnosis of osteonecrosis, meniscal and cruciate ligament lesions, as well as tumors, represents the major current indication for MRI. Due to its high cost MRI should be employed for the diagnosis of joint disease only to clarify equivocal findings of conventional radiographic, nuclear and tomographic methods. Prior clinical examination and laboratory tests are mandatory. As a component of a stepwise diagnostic approach, MRI often provides reliable differential diagnostic information.

Bone Diseases↗
PubMed1991

MRI of knee arthritis in rheumatoid arthritis and spondylarthropathies.

The knees of fifty-two patients suffering from rheumatoid arthritis (RA), 22 patients with seronegative spondylarthopathies (SA) as well as of 20 healthy volunteers were examined by magnetic resonance imaging (MRI). Osseous erosions (RA 52%-SA 18%; P less than 0.005), Baker cysts (RA 56%-SA 12%; P less than 0.005), pannus formation (RA 67%-SA 36%; P less than 0.05), and cartilage thinning with narrowing of the joint space (RA 46%-SA 18%; P less than 0.05) proved to be more frequent MRI findings in patients with RA. Additionally, in patients with RA erosions were more extensive. Follow-up MRI examinations of 19 patients revealed an improvement in MRI changes in SA within an average interval of 6 months. No substantial changes were noted in 7 of 13 RA patients. Quantitative and qualitative MRI findings of knee arthritis differ in patients with RA and SA and this was statistically significant. However, as there is considerable overlap of the MRI and radiographic changes in both groups the discriminating diagnostic value in the individual case was limited.

Adult↗
PubMed1991

RARE-MR-urography in the diagnosis of upper urinary tract abnormalities in children.

RARE-MR-urography (Rapid Acquisition with Relaxation Enhancement) is a fast MR imaging technique (6.4 s/acquisition) that selectively depicts fluid by heavy T2-weighting. From 9/1989 to 11/1990, RARE-MR urograms were prospectively evaluated in the diagnosis of upper urinary tract abnormalities in 55 children. The method is performed in several planes and combined with a coronal, T1-weighted spin-echo sequence. Forty out of 42 kidneys with dilated renal pelvis, and 21 out of 24 dilated ureters were identified, only the mildly dilated ones were missed. Even in non-functioning kidneys the urinary tract was clearly depicted by RARE-MR-urography. However, no differentiation could be made with this technique between vesicoureteral reflux and non-refluxing dilatation of ureter and/or renal pelvis. All 19 pelviureteric obstructions and all eight renal duplications with a dilated segment were identified. RARE-MR-urography is a new tool for diagnosing urinary tract abnormalities in children without having to employ ionizing radiation, contrast media, or general anesthesia. A dilated urinary tract can be shown in one image displaying the entire urinary system, similar to excretory urography. The technique is presently not able to provide the information of voiding cystourethrography or renal scintigraphy, nor is it as easy to perform as ultrasound. However, in certain cases it may replace excretory urography.

Adolescent↗
PubMed1991

Pancreatic lesions in the von Hippel-Lindau syndrome.

Common manifestations of the von Hippel-Lindau syndrome, an autosomally dominant inherited cancer-prone disorder, include retinal angiomatosis, hemangioblastoma of the central nervous system, renal cysts, renal cancer, pheochromocytoma, and epididymal cystadenoma. Multiple cysts and microcystic (serous) cystadenomas of the pancreas have also been reported occasionally in patients afflicted with this syndrome. In the large Freiburg study of the von Hippel-Lindau syndrome composed of 66 affected individuals, pancreatic lesions were systematically studied. Fifty-five living individuals were examined by abdominal ultrasound imaging. Abnormal findings were confirmed by computed tomographic scan and/or magnetic resonance imaging. For an additional 11 decreased patients autopsy data were available. Cystic lesions of the pancreas were found in 10 patients (15%). One of these patients presented with multiple pancreatic cysts as the only manifestation of the syndrome. In one patient, a malignant islet-cell tumor was found at autopsy. Because multiple pancreatic cysts did not cause major clinical symptoms and because follow-up examinations over an average period of 5 years did not show significant progression of the lesions, it is concluded that these patients usually do not require surgical treatment. Abdominal ultrasound screening is recommended for patients at risk as a tool to identify potential von Hippel-Lindau syndrome gene carriers with pancreatic manifestations. In all patients with multiple pancreatic cysts, the von Hippel-Lindau syndrome should be included in the differential diagnosis.

Adolescent↗
PubMed1991

[A technic of magnetic resonance tomographic pelvimetry in obstetrics].

Magnetic resonance imaging (MRL) allows for the first time direct determination of maternal pelvic dimensions without ionising radiation. Phantom measurements and the correlation with traditional pelvimetric measurements in 10 patients after Caesarean section have shown mean differences of +/- 2 mm, with a maximum of 5 mm. The evaluation of pelvic configuration is obtained analogous to the conventional roentgenogram. In addition to conventional or digital x-ray pelvimetry, the soft tissues of the maternal pelvis and the presenting part of the foetus is delineated with high contrast. Positioning in the body coil can be accomplished even late in pregnancy or in impending labour, acceptance by the pregnant women being high. Whereas in a given indication after delivery conventional x-ray pelvimetry continues to be performed, antenatally MRI pelvimetry has now been established in our Departments as the method of choice--based on meanwhile 107 examinations. Present drawbacks are the relatively high cost and the limited availability of MR units.

Evaluation Studies as Topic↗
PubMed1991

[RARE-MR urography: a rapid MR tomographic imaging procedure for the diagnosis of urinary tract malformations in childhood].

RARE-MR urography (so called "water-pictures") is a fast MR imaging technique that selectively depicts fluid without contrast application. Acquisition time is 6.4 s per slice with 1 excitation, or 23 s per slice with 2 averages respectively. From Sept. 1989 to April 1990 24 children with anomalies of the urinary tract have been examined each by RARE MR urography and one T1-weighted spin-echo sequence. Independent of excretory function, the technique can show dilated calices and renal pelvis, pelviureteric obstruction, renal duplication, and megaureter. However, it cannot distinguish between vesicoureteric reflux and obstructive megaureter. Our first results suggest that RARE MR urography combined with ultrasound, reflux cystography and isotope nephrography, can replace excretory urography in certain circumstances--or at least postpone it to the preoperative phase.

Adolescent↗
PubMed1991

[MR tomography of aneurysmal bone cyst].

The preoperative findings of magnetic resonance imaging (MRI) in six histology-proven aneurysmal bone cysts (ABC) are examined and compared with previous publications concerning MRI of ABC. The signal intensities differ considerably, and not all of our cases conform with the literature data. They can be summarised in three different subheadings: one form that is very inhomogeneous in T1- and T2-weighting, with fluid-fluid levels in the cystic spaces; one intermediate form without fluid-fluid levels, which is inhomogeneous only in T2-weighted images; and finally, an unusual form of ABC that has homogeneous low signal both in T1- and T2-weighting, and which has not been described in literature so far.

Adolescent↗
PubMed1991

[MR imaging of a giant solitary trichoepithelioma of the skin].

Magnetic resonance images of a "giant solitary trichoepithelioma" (GST) are presented for the first time. Furthermore, to our knowledge this is the largest GST ever to be reported in the current literature. Magnetic resonance imaging gave information on the origin of the tumor and on the depth of invasion. The signal intensity is non-specific and does not allow histological classification. Preoperatively, the MR examination depicts the extent of the tumor and thus helps in the surgical management that follows.

Aged↗
PubMed1989

Percutaneous sclerotherapy of idiopathic varicocele in childhood: a preliminary report.

Of 31 boys 10 to 16 years old referred for treatment of a left grade II or III varicocele 28 underwent percutaneous sclerotherapy. Due to anatomical and technical obstacles sclerotherapy was not possible in 3 boys. At follow-up 1 of 16 boys (6.2 per cent) had a mild recurrence detected by Doppler sonography of the spermatic cord. Percutaneous sclerotherapy had no serious side effects, and proved to be an efficient and convenient treatment of left varicocele in childhood.

Adolescent↗
PubMed1989

Hemodynamics of varicoceles: venous shunting in grade II and III varicoceles.

In 42 consecutive patients with moderate (grade II) or large (grade III) left-sided idiopathic varicoceles, which were referred for percutaneous sclerotherapy, not only the reflux in the testicular vein but the venous drainage as well was studied by venography. As suggested by bidirectional Doppler sonography the reflux in the testicular vein is always associated with an upward (in physiologic direction) flow in these varicoceles. The draining veins are shown to be the deferential, cremasteric, external pudendal, or any combination of these. Thus, the grade II and III varicoceles are termed shunt-type varicoceles.

Collateral Circulation↗
PubMed1989

[Non-Hodgkin's lymphoma of the descending colon in a 6-year-old girl].

The most common site of non-Hodgkin lymphoma of the intestinal tract in children is the terminal ileum and the ileocecal region; boys are 5- to 10 times more frequently affected than girls, peak incidence is between 5 and 8 years of age. We present a 6-year-old girl with non-Hodgkin lymphoma of the descending colon.

Burkitt Lymphoma↗
PubMed1988

[Cyclophosphamide-induced pneumonitis].

Pneumotoxicity of cyclophosphamide is a rare complication of chemotherapy with this drug. 28 cases have so far been reported in world literature. We add one case in whom lung changes had appeared subacutely, after a single dose of cyclophosphamide, and were reversed by corticoids.

Aged↗