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Biomedical subjects

L Hering

Publications and source records attributed to L Hering.

At least 19 recordsLinked to original sources

Dense bone around the sacroiliac joint: a radiological review of the differential diagnosis.

Solitary osteosclerotic bone lesions around the sacroiliac (SI) joints are described as seen on plain radiographs or conventional tomography, with the descriptive attributes ranging from round to ovoid over square and triangular to multiform. The etiology of the solitary osteosclerotic lesions around the SI joint can often be concluded from the radiographic appearance, sometimes complemented by the presentation on CT and/or scintigraphy.

Diagnosis, Differential↗

Acquired hyperostosis syndrome--AHYS--(sternocostoclavicular hyperostosis, pustulotic arthro-osteitis, SAPHO-syndrome): bone scintigraphy of the anterior chest wall.

The objective of this report is to provide a description of diagnostically significant scintigraphically recognizable sites and patterns of acquired hyperostosis syndrome (AHYS) on the anterior chest wall (ACW), which is involved in 82% of AHYS patients. In 49/90 of our own AHYS patients, planar bone scans of the ACW were performed with the gamma camera, applying an average of 650 MBq of 99mTc-phosphate complexes. In addition, 53 atraumatic patients with extrathoracic cancer were available for routine whole-body scintigraphy. None of these patients had increased uptake identifiable as metastasis clinically or by imaging modalities in either the ACW or the rest of the skeleton. The scintigraphic involvement of the various morphological ACW structures is described in AHYS. Moreover, attention is called to the diagnostic significance of focal hyperactivities at the anterior end of the 2nd-8th rib of adults, which are in the 5th place with respect to their frequency in AHYS. The diagnostic significance of sternocostal-joint involvement in AHYS can likewise be recognized by bone-scan scintigraphy and will be discussed. Bone scintigraphy is more sensitive than radiomorphological imaging in AHYS. This, however, only applies under three conditions. 1. The increased radiotracer uptake in the upper sternocostoclavicular region must be assessed on both the anterior and the posterior view of the ACW scan. 2. In addition to the anterior view of the routine scintiscan, further anterior scans with reduced scan time of the gamma camera are usually necessary. This ensures better visibility of the involvement of certain morphological structures that are important for AHYS diagnosis. Moreover, a statement can be made about the inflammatory ossifying activity/inactivity of the AHYS on ACW.3. Increased radionuclide uptake in the manubrium sterni and corpus sterni on the anterior scan should be verified by additional lateral or oblique scans of the thorax (sternum).

Acne Vulgaris↗

Tempe fermentation: some aspects of formation of gamma-linolenic acid, proteases and vitamins.

During a tempe fermentation the concentrations of linoleic, and alpha-linolenic acids (ALA) decreased while the concentration of oleic acid increased. During fatty acid synthesis Rhizopus sp. produced only gamma-linolenic acid (GLA) instead of ALA. The amount of GLA in tempe were influenced by varying external parameters. The proteolytic capacity of 36 strains of the genus Rhizopus isolated from Indonesian tempe or tempe inocula was examined. There was a distinct increase in the amount of free amino acids during tempe fermentation. Fermentations with mixed populations of bacteria and Rhizopus yielded a lower level of free amino acids, but an increase in total amount of amino acids. In comparison to intracellular, and extracellular proteases the proteases of the cell wall fraction are most responsible for proteolytic capacity of the different Rhizopus strains. Two isolated strains of Citrobacter freundii were found to be the best vitamin B(12) producers during the soaking of soybeans. In the solid substrate fermentation the Rhizopus molds formed vitamin B(6), riboflavin, and nicotinic acid. The addition of bacteria to the solid substrate fermentation resulted in a strong increase of active vitamin B(12) in tempe. In the presence of the Rhizopus mold, the vitamin B(12) formation by C. freundii was three times higher than that of a fermentation without the mold.

Journal Article↗

[Alloarthroplasty of the hip joint. Radiologic diagnosis of loosening and infection in cemented total endoprostheses].

Patients with problems following implantation of cemented total hip prostheses must be clinically examined. This examination is followed by a series of diagnostic imaging procedures. These include X-ray diagnosis, 3-phase 99mTc-MDP bone scans, scintigraphy for inflammation, and arthrography, performed singly or as sequential studies. X-ray findings and scintigraphic patterns arousing or confirming a suspicion of aseptic (mechanical) or septic (infectious) loosening of the prosthesis are evaluated and discussed.

Hip Prosthesis↗

[The acquired hyperostosis syndrome. Synthesis of 13 personal observations of sternocostoclavicular hyperostosis and 300 cases from the literature. 1].

Sterno-costo-clavicular hyperostosis (SCCH) is the most common manifestation of a syndrome, consisting of increased bone metabolism, mostly new bone formation and heterotopic ossification of fibrous tissue, which we have characterised as the acquired hyperostosis syndrome. In part I we discuss the terminology, radiological appearances, scintigraphy, clinical and laboratory findings, bacteriology, histology, nosology, complications, treatment and differential diagnosis of SCCH. Chronic recurrent multifocal osteomyelitis (CRMO) is regarded as a phenotype of SCCH, depending on the age. CRMO occurs in children, adolescents and young adults, SCCH predominantly in middle-aged and elderly adults.

Adult↗

[The acquired hyperostosis syndrome. 2].

In the second part of this publication, we describe some additional findings in cases of sternocostoclavicular hyperostosis. These include focal hyperostosis of the spine, in the pelvis and in the extremities and psoriatic skin lesions and severe forms of acne (acne conglobata, acne fulminans). Other features, which are not diagnostic, include erosive or non-erosive peripheral arthritis and unilateral or bilateral sacro-iliitis. An analysis of our 13 patients and of the relevant literature indicates that the hyperostosis is due to increased bone metabolism and heterotopic ossification of fibrous tissue and that these are the pathogenic bases of the changes in the axial skeleton, the pelvis and the bones of the extremities. We have suggested a scheme which would categorize the syndrome into complete, incomplete and possibly acquired forms.

Adult↗

[Computed tomography and the pathogenic potential of the medial parapatellar fold].

The anatomy of the synovial folds of the knee joint is described. Autopsy material and the authors' clinical experience are discussed and compared with the literature. CT is superior to conventional arthrography for demonstrating the synovial folds, even when Knutson's technique is used. The morphology of the plica and its relationship to chondropathia of the patella is discussed.

Cadaver↗

[Value of angiography, sonography and computer tomography in the differential diagnosis of renal space-occupying lesions].

157 space-occupying lesions of the kidneys (89 cysts, 57 malignant tumours, 8 benign tumours, 1 abscess, 1 non-traumatic bleeding and a special form of inflammation, namely, xanthogranulomatous pyelonephritis) which were observed in 2 years, were evaluated, using angiography, ultrasound and computed tomography. If a space-occupying lesion is found--mostly by I.V. urography--ultrasound should be applied next for differentiating the cyst from the solid tumour. If this is not possible, or if a solid tumour is found, the next step should be computed tomography. (Staging of carcinoma, diagnosis of angiomyolipoma or another benign tumour, eg.. a lipoma). Angiography as an invasive procedure is indicated only in cases in which ultrasound and computed tomography don't yield a diagnosis. (Possibility of pharmacoangiography and magnification angiography).

Adenocarcinoma↗

[Value of computed tomography in congenital hip dysplasia and hip luxation].

A lot of methods of measurement have been developed to record precisely the degrees of luxation and the deviations from the normal form in the hip joints of the child and adult. The orthopaedic surgeon needs those data for a preoperative "coxometric program" before performing acetabuloplastic operations with osteotomy, osteotomy of the pelvis and combined operations. Computed tomography yields a series of informations and of possibilities of measurements which can determine the operative procedure in particular. These informations concern among other things the dimensions of the dysplasia of the acetabulum in the horizontal plane with the extension of the posterior lip and the angle of the acetabular opening, furthermore the physiological or pathological congruence between the head of the femur and the acetabulum, the angle of antetorsion of the neck of the femur and, in the small infant, the direct noninvasive imaging of the tube of the capsule with imaging of possible obstacles to reposition.

Acetabulum↗

[Adult degenerative and senile degenerative hyperostosis triangularis ilii (author's transl)].

A randomized study of 2000 patients (1000 males, 1000 females) revealed two forms of the triangular hyperostosis of the ilium in female patients. The hyperostosis triangularis ilii, HTI, is also known as osteitis condensans. One form of HTI concerning women under the age of 50 is called the adult generative HTI, the other beyond the age of 50 senile degenerative HTI. These two forms are not evident in male patients. The 3.05% incidence of HTI in adults appeared to be higher than presumed till now. The sex incidence male/female of 1:1.6 diverges considerably from preceding investigations. Histomorphological studies of two autopsies of cases of senile degenerative HTI revealed no signs of inflammation. Statistical correlations of HTI with other chronic diseases of the pelvis and hip could doubtlessly and generally be established only for osteoarthrosis of the sacro-iliac joints in females beyond the age of 50 and in males as a matter of principle.

Adult↗

[Ileitis caused by Yersinia enterocolitica--X-ray differential diagnosis of Crohn's disease (author's transl)].

The article gives a brief description of the characteristic features of the clinical and roentgenological course and the various stages of enteritis caused by Yersinia. Basing on three cases of ileitis caused by Yersinia, the far-reaching similarity with the early changes and even the advanced stages of Crohn's disease are demonstrated. Attention is drawn to the possibilities of differentiating between the two disease patterns.

Adult↗