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Biomedical subjects

J P Hedde

Publications and source records attributed to J P Hedde.

At least 19 recordsLinked to original sources
PubMed2003

Positron emission tomography reveals a leiomyosarcoma causing proteinuria.

Obstruction of the renal veins may result in proteinuria and is frequently caused by thrombosis or tumorous processes. Since thrombosis and malignancy may occur simultaneously in the venous outflow of the kidneys, search for an underlying intraluminal tumor may be impeded by extensive thrombosis in the lumen of renal and caval veins. We report the case of a 30-year-old man with moderate proteinuria which was caused by an obstructing process of the vena cava inferior and the renal veins. While the obstructive mass was initially misdiagnosed as thrombosis, positron emission tomography helped to reveal the tumorous character of the lesion and fine-needle biopsy allowed rapid diagnosis of a leiomyosarcoma originating from the caval or renal veins. We conclude that undelayed diagnosis of the cause of renal and caval vein obstruction is facilitated by early positron emission tomography and subsequent fine-needle biopsy to identify possible tumorous lesions.

Adult↗
PubMed2001

MR imaging of acute intermittent porphyria mimicking reversible posterior leukoencephalopathy syndrome.

Reversible posterior leukoencephalopathy syndrome (PLS) is characterized by headache, altered mental function, visual disturbances and seizures. Neuroimaging studies suggest a white-matter oedema, predominantly in the posterior parietal-temporal-occipital regions of the brain. We present the case of a 30-year-old woman who had suffered her first attack of acute intermittent porphyria (AIP). Following 1 week of abdominal pain she developed several generalized seizures, and hallucinations, and exhibited a progressive deterioration of the consciousness. T2-weighted images, especially fluid-attenuated inversion recovery (FLAIR) sequences showed bilateral lesions in the posterior frontal, parietal and occipital cortex and subcortical white matter. Following treatment with haematin and a high carbohydrate diet the patient's condition improved. Follow-up magnetic resonance imaging (MRI) revealed complete resolution of the lesions. To our knowledge, this is the first report concerning a completely reversible PLS in AIP.

Adult↗
PubMed1999

MRI of acute cerebral infarcts, increased contrast enhancement with continuous infusion of gadolinium.

We compared contrast enhancement on T1-weighted MRI of acute cerebral infarcts after conventional bolus administration and continuous infusion of gadolinium. We examined 12 patients with a history of acute stroke with contrast-enhanced MRI once a week for a 1 month. Only ischaemic lesions were investigated after cerebral haemorrhage had been excluded by CT. Each MRI study included T2- and proton density-weighted sequences for determination of the size and site of the infarct, immediate postinjection T1-weighted imaging after bolus administration of 0.1 mmol/kg gadolinium-DPTA and delayed T1-weighted imaging after additional continuous infusion of 0.1 mmol/kg over 2 h. A total of 42 MRI studies was performed. In the first week after the onset of stroke, most infarcts (8 of 10) did not enhance after bolus administration, whereas all showed distinct contrast enhancement after the infusion. In the following weeks all but two infarcts showed contrast enhancement after bolus administration; after continuous infusion contrast enhancement could be seen in all cases. While contrast enhancement after bolus administration showed the typical gyriform pattern, enhanced areas were more extensive after the infusion and usually covered the entire infarcted area shown on T2- and proton density-weighted images. We presume that the disturbed blood-brain barrier in ischaemic areas favours delivery of contrast medium to the infarcted tissue if it is offered continuously so that a steady state can develop.

Acute Disease↗
PubMed1998

Intracerebral haemorrhage from a venous angioma following thrombosis of a draining vein.

We report a case of putaminal haemorrhage from a venous cerebral angioma following thrombosis in a draining vein. The patient complained of numbness of the right side, followed by headache and aphasia. CT demonstrated an intracerebral haemorrhage due to thrombotic occlusion of a draining vein of the venous angioma. Carotid angiography showed the venous angioma. MRI studies confirmed the diagnosis and demonstrated recanalisation of the draining vein following therapy with phenprocoumon.

Brain Neoplasms↗
PubMed1997

[The value of sonography for the discovery of complications after the implantation of silicone gel prostheses for breast augmentation or reconstruction].

PURPOSE: To determine sensitivity and specificity of real-time ultrasonography in detecting breast implant complications. MATERIAL AND METHODS: The results of preoperative ultrasonography of 121 silicone implants in 65 patients were compared with the results after operative implant removal. RESULTS: With a sensitivity of 89.25% and a specificity of 92.1%, complications such as gel bleeding (n = 43), rupture with leakage (n = 63), and implant dissolution (n = 4) become manifest. Capsule formation, fibrosis, siliconoma and calcifications were often underestimated in their extent. Negative ultrasonography findings were found in 10.7% (n = 13) with positive clinical findings. CONCLUSIONS: The combination of clinical and ultrasonography findings leads to the detection of implant complications.

Adult↗
PubMed1992

Radicular avulsion resulting from spinal injury: assessment of diagnostic modalities.

The diagnostic utility of imaging techniques in injuries to the intramedullary and subarachnoid portions of the brachial plexus, with possibly complete avulsion of one or more nerve roots from the spinal cord and extramedullary meningocoele was compared in 18 patients studied by unenhanced computed tomography (CT), cervical myelography, myelographic CT (MCT) and magnetic resonance imaging (MRI). Emphasis was placed on the lesions of the subarachnoid roots. CM was the only diagnostic modality to show avulsion of 18 nerve roots and their levels in 8 patients (100% = gold standard), and to verify 2 incomplete avulsions. MCT reliably revealed 8 of 18 (45%) and MRI 1 out of 18 (6%) avulsions. Myelography with MCT showed intact subarachnoid nerve roots in 10 additional patients. MRI and MCT (16 out of 16 = 100%) were superior to myelography (14/16 = 88%) for demonstrating 16 traumatic meningocoeles in 8 patients; follow-up MRI (6-24 months) showed no increase in their size. We recommend a subsequent CT to role out fracture to the spinal column; MRI should provide significant information concerning oedema or haemorrhage in the spinal cord. Myelography with segmental MCT is performed to differentiate pre- from post-ganglionic lesions, data which are essential for deciding whether exploration of the plexus or a motor substitution operation is indicated.

Adolescent↗
PubMed1991

[Direct cervical myelography using iotrolan 300].

A prospective study of direct cervical myelography with Iotrolan 300 showed the following advantages: 1. Clear differentiation of the nerve roots. 2. Increased retention of contrast in the cervical region. 3. Improved contrast compared with conventional contrast media. 4. Optimal contrast temperature was found to be between 20 and 22 degrees C. 5. Reduction in non-specific and central nervous system complications.

Adolescent↗
PubMed1990

[Hepatic adenoma and hepatocellular carcinoma in 3 brothers with type I glycogenosis].

We report 2 cases of type I glycogen storage disease (Von Gierke's disease) discovered in 2 brothers at the age of 7 and 5 years, respectively. Both developed hepatic adenoma at the age of 19 and 17. Hepatocellular carcinoma occurred in the older brother the discovery of adenoma 4 years after. The frequency of these tumors in patients with type I glycogen storage disease raises problems concerning the treatment and modality of regular surveillance of the liver in these patients. The policy for the detection and treatment of these tumors, and particularly the indications for liver transplantation are discussed.

Adenoma↗
PubMed1988

Cerebral magnetic resonance imaging findings in multiple sclerosis. Relation to disturbance of affect, drive, and cognition.

Forty-six patients with multiple sclerosis were rated with respect to their psychologic symptoms, and magnetic resonance imaging was performed. A significant correlation between the cerebral multiple sclerosis manifestations and the psychologic scores was found. The periventricular and frontal lesions seem to be the most important lesions for the psychologic symptoms of patients with multiple sclerosis.

Affect↗
PubMed1988

Lissencephaly: diagnosis by computed tomography and magnetic resonance imaging.

A patient with Miller-Dieker-Syndrome, which is associated with lissencephaly, was examined by Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). While CT demonstrated the main features of lissencephaly, MRI detected disturbed myelination and cell migration in the cerebral hemispheres and a normal appearance of the cerebellum. MRI provides more accurate information of the pathomorphologic changes of lissencephaly and is thus superior to CT.

Abnormalities, Multiple↗
PubMed1987

The investigation of dementia syndromes by 133Xenon dynamic single photon emission computed tomography.

The patterns of regional cerebral blood flow (rCBF) in patients with dementia caused by Alzheimer's disease is compared with that of patients with dementia caused by multiple cerebral infarctions. A total of 47 patients were examined with 133Xenon SPECT. The results show that the global CBF correlates with the severity of dementia caused by Alzheimer's disease and that the two forms of dementia show two different patterns of disturbances.

Aged↗
PubMed1986

[Optimization of conditions for detecting density variations in focal activity in SPECT using the rotating gamma camera. Model calculations, phantom measurements and clinical applications].

The signal to noise ratio (quotient of contrast and mean noise) is a quality parameter for identifying activity gaps during single photon emission computed tomography (SPECT). Contrast and mean noise level are site-dependent on the reconstruction plane which is influenced in a complex manner by absorption conditions (strong or weak absorption), modes of rotation (full angle or partial angle imaging), interdependencies of opposing partial projections (arithmetic or geometric mean), magnitude of defect (relative to the resolution of the imaging system), geometry of the object to be measured, and scatter. In the present study the authors performed analysis and graphical representation of the SPECT imaging properties on the basis of model calculations illustrated by phantom measurements. The optimal conditions of examination or evaluation and the diagnostic criteria in SPECT of the heart, liver, brain and pelvis are discussed by comparative calculation of signal to noise ratios in defect identification.

Brain↗