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Biomedical subjects

K F Kreitner

Publications and source records attributed to K F Kreitner.

120 records · Page 7Linked to original sources
PubMed1988

[Adenoid cystic carcinomas of the head and neck. Results of treatment with high-dosage radiotherapy].

Different opinions exist about the role of radiotherapy in the treatment of adenoid cystic carcinoma of the head and neck. In this paper the results of 14 patients with high-dosage irradiation are reported. Radiotherapy with local curative intent was performed in all patients. 10/14 patients were irradiated post-operatively. 4/14 patients received radiation therapy alone. By percutaneous irradiation (n = 13) focal doses of 80 Gy were applied, by interstitial irradiation (n = 1) 70 Gy. Despite the less favourable patient group - 8/14 patients had either a T3- or T4-tumour; 5/14 patients were referred because of recurrent disease - local tumour control could be achieved in all cases after a mean observation time of 3.5 years. Together with newer reports of literature we consider adenoid cystic carcinomas of salivary gland origin as locally curable by postoperative high-dosage radiotherapy.

Adult↗
PubMed1987

[Duplex sonography of the normal portal vein].

In 50 normal subjects flow velocity and direction on the portal vein was measured by ultrasonic duplex system. The measurements revealed at a mean diameter of 9.7 mm, a mean flow velocity of 15.2 +/- 2.6 cm/s, corresponding to a volume flow of 693 +/- 235 ml/min. Postprandially this increased to 880 +/- 269 ml/min. Inter-observer and day to day measurements demonstrated good reproducibility. Thus, this simple non-invasive method is well suited for quantitative assessment of the portal vein system in portal hypertension, thrombosis or after shunt operations.

Adult↗
PubMed1987

[Shoulder luxation. A late clinico-radiologic study].

There are various opinions regarding the aetiology and pathogenesis of dislocation of the shoulder. Various aspects of these theories and their clinical significance have been examined in the course of a clinical and radiological follow-up. Crucial to the development of subluxation is the occurrence of trauma. The age of the patient is important in the prognosis: more than 60% of patients under the age of 30 develop recurrent or persistent dislocation. Apart from a congenital disposition and inadequate treatment, accompanying injuries are primarily responsible for the development of persistent dislocation. Late follow-up has shown that radiologically recognisable post-traumatic changes are apparent in at least one-third of the patients. Persistent symptoms are much more common and consist of pain, limitation of movement, weakness and paraesthesia. In evaluating the late results, one should distinguish between objective functional limitation of movement and subjectively felt reduction in function.

Female↗
PubMed1987

[Duplex sonography of abdominal vessels].

Duplex sonography is a non-invasive procedure which permits the determination of flow velocity and direction in visceral vessels. Results in 50 normals have shown that small arteries can be evaluated in about 50% of cases. The portal venous system can be demonstrated in all cases; average flow velocity and volume is 15.2 +/- 2.8 cm/s and 694 +/- 230 ml/min, corresponding with the values obtained by invasive methods. Clinical application for duplex examinations can be found in portal hypertension, varices, thromboses, aneurysms and transplant kidneys.

Abdomen↗
PubMed1987

[Focal nodular hyperplasia of the liver in 930 patients].

Analysis of 930 patients with focal nodular hyperplasia of the liver (FNH), including 23 seen by the authors, showed the following results: 82.2% of patients were female, 37.8% of these had taken female steroidal hormones. There was no preference for a particular lobe of the liver. 57.7% of FNH were subcapsular, 33.7% were intrahepatic and 8.8% were pedunculated. Average size was 5.9 cm, 80.8% of the patients were asymptomatic. In 93.5% (115 out of 123) a space-occupying lesion in the liver could be demonstrated by sonography. In 13%, second or multiple tumours were missed by sonography. CT without enhancement demonstrated FNH in 90.4% (94 out of 104 patients). A rapid, marked increase in density after contrast was seen in 64 out of 68 lesions (94.1%). Colloid scintigraphy showed normal uptake in 34.9% of patients. Hepato-biliary functional scintigraphy demonstrated 32 out of 35 lesions (91.4%). In 97.3% (183 out of 188) FNH was demonstrated by angiography, in 95.4% as a highly vascular tumour.

Adolescent↗
PubMedDate not supplied

Imaging of the lungs using 3He MRI: preliminary clinical experience in 18 patients with and without lung disease.

The purpose of this study was to describe the 3He MRI findings of normal pulmonary ventilation in healthy volunteers and to evaluate abnormalities in patients with different lung diseases. Hyperpolarized 3He gas (300 ml, 3 x 10(5) Pa, polarized to 35-45% by optical pumping, provided in special glass cells) was inhaled by 8 healthy volunteers and 10 patients with different lung diseases. Imaging was performed with a three-dimensional fast low-angle shot (FLASH) sequence (TR = 11.8 msec; TE = 5 msec; transmitter amplitude, 5-8 V; corresponding flip angle, < 5 degrees) in a single breath-hold (22-42 seconds). Clinical and radiological examinations were available for correlation. The studies were performed successfully in eight of eight volunteers and in 8 of 10 patients. The lung parenchyma of volunteers with normal ventilatory function exhibited rather homogeneous intermediate to high signal, whereas patients with chronic obstructive lung disease or bronchiectasis presented with severe signal inhomogeneities with patchy or wedge-shaped defects. The mass effect of bronchogenic carcinoma, chronic empyema, lymphadenopathy, or pleural effusion caused large signal defects, representing the lesion and adjacent hypoventilation, the extent of which had not been presumed from chest x-ray or CT. 3He MRI is a promising new modality for the assessment of pulmonary ventilation and its abnormalities. Additional studies are needed to determine its potential clinical role.

Adult↗
PubMedDate not supplied

Hypothenar hammer syndrome caused by recreational sports activities and muscle anomaly in the wrist.

A 34-year-old man with digital ischemia is reported. Angiography revealed thromboembolic occlusions of the proper digital arteries of the index, middle, and ring fingers and a tortuous ulnar artery in Guyon's canal. Though hypothenar hammer syndrome was suspected, there was no relevant occupational history. Magnetic resonance imaging and magnetic resonance angiography demonstrated an anomalous muscular sling around the ulnar artery immediately adjacent to the hook of the hamate. The ulnar artery showed mural thrombi in its tortuous segment. These findings were confirmed during operative exploration. After thrombectomy and embolectomy the involved segment of the ulnar artery was replaced by an autologous vein graft. Postoperatively there was complete resolution of the symptoms. Only during convalescence did it become clear that the patient was a passionate golfer.

Adult↗
PubMedDate not supplied

[Pelvic type of chronic recurrent multifocal osteomyelitis].

We report about the juvenile and adolescent pelvic type of CRMO in 7 girls and 4 boys. The results show from solitary up to 7 pelvic lesions (average 3 lesions) predominantly in the acetabular and paraacetabular region (sometimes with hip joint effusion as a sign for concomitant coxitis).Tc99m-bone-scan is helpful to evaluate exactly the pattern of bone affection. We find 3 stages of an primarily chronic, non-purulent osteomyelitis going along with a "plasma-cell-sclerotic process", leading to a Garrè-type sclerosing end-stage, which probably heals after some years spontaneously, projecting on clinical symptoms and radiological appearance. The concomitant coxitis ("sympathetic coxitis") is clinically often in the foreground, but reversible. Pain in case of CRMO responds surprisingly well on medication with acithromycine. Knowing about CRMO in its different clinical appearances - especially concerning what we call "sympathetic coxitis" - can be a useful for pediatric rheumatologists and orthopedic surgeons, as well as MRI-focused radiologists and pathologists. Therapy might find a useful drug in acithromycine. In conclusion we d like to point out, that CRMO is one entity under the "roof" of the so called SAPHO-syndrome, which again shows us, that SAPHO-syndrome ist not a diagnosis itself but more a sign-post on the way to a correct diagnosis.

Acquired Hyperostosis Syndrome↗
PubMedDate not supplied

[Primary hypertrophic osteoarthropathy].

A case of the very rare primary-hypertrophic-osteoarthropathy (Touraine-Solente-Golé-Syndrome) is reported. A middle-aged women was suffering from chronic joint- and limb-pain for more than twenty years. All diagnostical experiences only showed a cortical thickening mainly of the tubular bones and a craniosclerosis but no link for the possible origin. As typical for the disease, periosteal reactions could be discovered in X-ray examinations too. Thickening of the facial skin as well as drumstick-configurations of the fingers could be seen. A pulmonary affection leading to a secondary pulmonary osteoarthropathy (Pierre-Marie-Bamberger's Syndrome) could be excluded. The syndrome presented here is only to be found in 3 to 5% of all cases with hypertrophic osteoarthropathy. It is a rare differential-diagnosis of chronic bone and joint pain.

Diagnosis, Differential↗
PubMedDate not supplied

The benefit of multislice CT in the emergency room management of polytraumatized patients.

The early treatment of polytraumatized patients needs an effective and standardized approach. Reducing time requirements for the primary diagnostic evaluation is a major concern in the early phase of polytrauma management. Multislice-CT (MSCT) is a quick and reliable method for the initial diagnostic evaluation. Computed tomography provides more detailed and more consistent information than conventional radiography. It has the great advantage of allowing rapid examination of the head, vertebral column, chest, abdomen and pelvis during one single examination. The CT-suite needs to be adequately equipped for resuscitation and reanimation, which is done parallel to the radiological investigations. Since polytrauma management is based on a multidisciplinary approach characterized by a coordinated interaction between trauma surgeons, anaesthesiologists and radiologists, members of all involved disciplines need adequate teaching. Guidelines and algorithms contribute to optimize the early management.

Humans↗