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Biomedical subjects

J Scheidegger

Publications and source records attributed to J Scheidegger.

8 recordsLinked to original sources
PubMed1992

Impact of dialysis modality on body composition in patients with end-stage renal disease.

Loss of muscle mass and altered body fat distribution (i.e. increased central fat stores in the presence of normal peripheral fat stores) have been reported in patients on hemodialysis (HD), when compared to normal volunteers. Whether treatment of end-stage renal disease (ESRD) with continuous ambulatory peritoneal dialysis (CAPD) would alter body composition in a different manner than HD is unknown. To answer this question, two groups (n = 11 each) of male patients with ESRD (matched for age, residual renal function, body weight and body height as well as physical activity) were studied. Muscle mass and body fat distribution were assessed using computed tomography. Mid-thigh muscle area, peripheral and central fat stores were similar between the two groups of dialysis patients. In both patient groups muscle mass and fat stores were independent of duration of dialysis, age, daily protein intake and residual renal function. In CAPD-patients mid-thigh muscle area was correlated with plasma albumin (r = 0.56, p < 0.05), while serum cholesterol level was correlated with mediastinal fat area (r = 0.81, p < 0.01). The present results indicate that both treatment modalities of ESRD (HD vs CAPD) result in similar changes of body composition. Despite continuous glucose loading in CAPD-patients, neither central nor peripheral fat stores are increased in these subjects compared with HD treated patients.

Adipose Tissue↗
PubMed1990

Enlargement of regional lymph nodes in renal cell carcinoma is often not due to metastases.

Preoperative axial computerized tomography scans in 163 patients with renal cell carcinoma were reviewed to assess the predictive value for the diagnosis of regional lymph node metastases. Computerized tomography was falsely negative in 5 patients: 2 had metastatic lymph nodes in the renal hilus adjacent to the primary tumor measuring 2 and 2.5 cm., and 3 had micrometastases in nodes of less than 1 cm. In 43 patients enlarged lymph nodes with a diameter of 1 to 2.2 cm. (median 1.4 cm.) were diagnosed on the preoperative scan and this was confirmed at nephrectomy and pathologically. In 18 of these 43 patients (42%) histological study showed metastases of the renal cell carcinoma in the enlarged lymph nodes. In the other 25 patients (58%) the enlarged nodes showed only inflammatory changes and/or follicular hyperplasia. This finding was significantly more frequent in patients with tumor involvement of the renal vein and tumor necrosis (p = 0.0044). We conclude that the sensitivity of preoperative computerized tomography is good for the detection of enlarged lymph nodes in patients with renal cell cancer (95%). However, significant lymph node enlargement frequently may be caused by inflammatory changes, especially in the presence of tumor necrosis. This radiological finding should not be misinterpreted as metastatic disease, unless it has been proved cytologically by fine needle aspiration.

Carcinoma, Renal Cell↗
PubMed1990

Ultrasonography of testicular tumors.

From 1984 to 1989, 62 patients with palpable testicular tumor were examined with ultrasound before surgical exploration. The ultrasonographic morphology was compared with the histological diagnosis of the tumor. The radiologist's interpretation regarding the type of tumor (seminoma versus nonseminomatous tumor) was correct in 70%. The typical sonography of the seminoma comprises homogeneous, hypoechogenic and sharply delineated masses, but nonseminomatous tumors are inhomogeneous, hypoechogenic, normoechogenic and hyperechogenic masses with cysts and calcifications. The tumor stage could be predicted in precisely 44% of the seminomas and in only 8% of the nonseminomatous tumors. Nevertheless, the ultrasonogram of the testis may provide a false-positive tumor diagnosis. We conclude that ultrasonography may help us in the differential diagnosis of malignant tumors of the testis, but cannot replace surgical and histological exploration of the testis.

Dysgerminoma↗
PubMed1989

[Diagnostic and therapeutic problems in angiomyolipoma of the kidney].

The diagnostic problems are being discussed specifically in 9 patients with angiomyolipoma. Ultrasound and computerised tomography show clear results in tumours with a fatty structure, where angiography is a better method to show vascular elements. Where an inhomogeneous tissue structure is given, an exact diagnosis is only possible by using a combination of different examination methods. It is important to define a renal cell carcinoma preoperatively, as during the operation a differentiation from an angiomyolipoma is in most cases not possible. With a correct diagnosis an organ saving operation can be performed on symptomatic patients, respectively a conventional management can be discussed for the treatment of asymptomatic patients.

Aged↗
PubMed1986

Hepatic vein occlusion: morphologic features on computed tomography and ultrasonography.

Hepatic vein occlusion causes morphologic changes that can be demonstrated by computed tomography (CT) and ultrasound. In this study the imaging findings of acute, subacute, and chronic occlusion of the hepatic veins were analyzed retrospectively in 9 patients and correlated with the histopathologic changes. The CT findings were focal or scattered hypodense parenchymal lesions of the liver before and a patchy enhancement after intravenous bolus injection of contrast material. In none of the cases could the hepatic veins be identified. Hepatomegaly with relative enlargement of the caudate lobe was almost always observed. Ultrasonography demonstrated solid material within the major hepatic veins, intrahepatic venous collaterals, and focal parenchymal lesions, which varied with the stage of the disease: a hypoechogenic area was observed in acute hepatic vein thrombosis with subsequent hemorrhagic infarction; hyperechogenic lesions corresponded with fibrotic zones in chronic disease. Ascites was shown by both methods in all patients.

Adult↗
PubMed1985

Overestimation of renal function in glucocorticosteroid treated patients.

Creatinine clearance is commonly used as a parameter for individualization of dosages of drugs primarily excreted by the kidney. Nomograms and equations have been developed for estimating creatinine clearance from serum creatinine concentration, body weight, age and sex. Glucocorticosteroids are said to cause proximal muscle wasting and therefore may be expected to cause a decrease in the creatinine production rate. The purposes of the present investigation were first to evaluate by a computed tomography the effect of long term treatment with prednisone on the mid-thigh muscle area, and second, to establish whether the presumed supposed decrease in muscle mass was associated with a decrease in the urinary creatinine excretion rate, and hence in a systematic error whenever a nomogram is used to predict creatinine clearance in such subjects. Patients taking prednisone had smaller mid-thigh muscle areas than controls. A linear relationship between the mid-thigh muscle area and the observed urinary excretion of creatinine was found, suggesting that the muscle loss could account for the decrease in the urinary excretion rate of creatinine. The ratio of observed to predicted (by nomogram) urinary creatinine excretion was lower in patients than controls, resulting in a corresponding underprediction of creatinine clearance by nomograms in the patients taking prednisone.

Adult↗
PubMed1983

[Computer tomography in acute pyelonephritis].

Computer tomography of the kidneys was performed on 30 patients with acute renal infections (acute suppurative pyelonephritis, acute renal abscess, infected cyst, pyelonephrosis, calculus perforation, retroperitoneal abscess). Computer tomography provided more accurate information concerning the extent of the renal and extra-renal inflammatory process than did the urogram or sonogram. This may significantly affect the choice of treatment, particularly concerning the use of drugs or of surgery. Angiography and retrograde pyelography may be used in selected cases, especially where there is a suspicion of acute bacterial nephritis, renal vein thrombosis or ureteric obstruction.

Acute Disease↗