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T Kröpelin

Publications and source records attributed to T Kröpelin.

At least 19 recordsLinked to original sources
PubMed1990

[Renal microaneurysms in necrotizing vasculitis--incidence in autopsy and clinical value].

Histological renal sections of 24 autopsied patients were evaluated for ectasias with greater than or equal to 2 mm diameter that corresponded to "microaneurysms" of radiologic nomenclature. Such renal "microaneurysms" of smaller and medium sized arteries were seen in 7/9 patients with periarteritis nodosa, 6/10 patients with secondary vasculitides and 1/5 patients with Wegener's Granulomatosis. Lumen ectasias in acute or subacute lesions of smaller and medium sized arteries were caused by fibrinoid necrosis of the arterial walls. Destruction of intimal elastic fibres and scar tissue within the arterial wall resulted in real aneurysmatic ectasias. Generalised, aggressive, necrotizing vasculitides show the highest frequency of microaneurysms. In that cases angiography can frequently establish the definite diagnosis by demonstration of microaneurysms.

Adult↗
PubMed1989

[Pulmonary changes in AIDS].

We reviewed retrospectively the clinical records of 28 patients with AIDS staged group IV according to CDC-criteria. Among these, 19 had pulmonary disease: most of them (n = 17) had pneumocystis carinii pneumonia (Pcp). 12/17 patients with proven Pcp displayed typical x-ray findings with diffuse perihilar interstitial infiltration sparing lung periphery. 3/17 had atypical features and 2 normal chest x-ray findings. These data are important to identify patients with pulmonary complications of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Renal artery aneurysm in Wegener's granulomatosis].

Microaneurysms of renal and visceral arteries are characteristic signs of periarteritis nodosa. Normally they are not found in Wegener's disease, where glomerulonephritis is commonly observed. We report on a patient with vasculitis of the upper and lower respiratory tract, focal glomerulonephritis, prostatic and pulmonary granulomas and anti-cytoplasm antibodies corresponding to Wegener's disease. The most striking findings in angiography were multiple small aneurysms of the peripheral branches of the renal artery. At necroscopy these angiographic findings were histologically proven as necrosis of the arterial wall with destruction of the elastic lamina, causing local vascular ectasia. These renal vascular changes are a characteristic sign of periarteritis nodosa. The combination of clinical, laboratory, radiologic and histologic findings in our patient can be explained as an overlap-syndrome of Wegener's disease and periarteritis nodosa. We assume that the combination of pathologic findings in our patient correspond to a rare atypical renal manifestation of Wegener's disease.

Aneurysm↗
PubMed1989

[Primary manifestation of Wegener's granulomatosis of the prostate].

In approximately 2-7% of patients with Wegener's granulomatosis involvement of the prostate has been demonstrated histologically. This usually comes about quite late in the course of disease, after generalization of the granulomatous vasculitis from respiratory tract to kidneys and other organs. The patient we present had a highly atypical first manifestation of Wegener's granulomatosis in the prostate, generalized vasculitis not developing until later. When a biopsy shows unclear granulomatous changes in the prostate, a test for anticytoplasmatic antibodies should be performed in addition to the conventional serologic and cultural examinations. Anticytoplasmatic antibodies are highly specific for the diagnosis of active Wegener's granulomatosis. Early diagnosis and immediate initiation of immunosuppressive therapy with cyclophosphamide and corticosteroids can prevent or limit organ damage and improve the prognosis in Wegener's granulomatosis.

Autoantibodies↗
PubMed1989

[Thoracic calcification in the elderly--frequency and clinical value].

Chest X-ray films of 200 patients, aged between 90 and 102 years, were analysed for frequency of distribution and varying degrees of thoracic calcification. Calcification was found within the aortic wall in 89%, costal cartilage 79%, lung parenchyma 65%, lung hilum and/or mediastinum 64%, and tracheobronchial cartilages 55%. The degree of calcification was dependent on the tissue and sex involved (significant p less than 0.001). Calcification is of clinical value more often in younger patients than in the elderly. The classification, pathogenesis and differential diagnosis of thoracic calcifications are discussed.

Aged↗
PubMed1988

[X-ray changes in the thoracic organs in acute heart infarct].

Chest X-rays were used to evaluate the hemodynamic status of 86 patients with acute myocardial infarction. The chest films, divided into three groups depending on the degree of pulmonary venous hypertension revealed: grade 1, pulmonary-venous congestion; grade 2, interstitial pulmonary edema; grade 3, diffuse alveolar edema. On clinical examination, four grades of congestive heart failure were distinguished in acute myocardial infarction. In 69% of our patients radiological and clinical grading of left ventricular failure led to precisely the same conclusions. Pulmonary capillary wedge pressure was measured in 31 patients with acute infarction. Radiological criteria of the degree of pulmonary vascular congestion, when related to pulmonary capillary wedge measurements, provide a basis for consistent therapy of left ventricular failure secondary to acute myocardial infarction.

Adult↗
PubMed1987

[Roentgen diagnosis in diaphragmatic trauma].

The diagnostic value of roentgenology in 85 patients who had to undergo surgery because of diaphragmatic rupture at the university of Freiburg from 1973 to 1985 is reviewed. The ratio of left- to right-sided diaphragmatic rupture is 62 to 23. Preoperatively the following diagnostic procedures were used: chest film examination in 82, plain film of the abdomen in 64, contrast radiographs of the gastrointestinal tract in 21, ultrasonography in 37, computed tomography in 8 and angiography in 9 patients. Sensitivity and specificity of these diagnostic methods depend on an intrathoracic prolapse of abdominal structures and on the existence of concomitant injuries. The combination of all these procedures improved the diagnostic accuracy. In 11 patients a diaphragmatic rupture was only detected by surgery.

Adolescent↗
PubMed1983

Chronic renal failure due to unilateral renal agenesis and total renal dysplasia (= aplasia). Report of three cases.

Three adult patients with unilateral renal agenesis/total dysplasia (= aplasia) and with an early chronic renal failure are presented. One patient had renal agenesis without ureter bud and ureteric ostium on one side, and reflux pyelonephritis on the other; one had small compact total renal dysplasia (= aplasia) on one side, while chronic uric acid nephropathy (chronic renal disease as a cause of gout) was diagnosed on the other; the third patient had a total large multicystic dysplasia on one side, and on the other a segmental large multicystic dysplasia. Radiological steps and radiodiagnostic criteria are discussed and the combination of urogenital and extraurogenital anomalies is referred to.

Adult↗
PubMed1980

[Renal embolisation, renal cystography and percutaneous nephrostomy (author's transl)].

In renal disease, therapeutic procedures performed by radiologists include embolisation, cystography with obliteration and percutaneous nephrostomy. More than 72 therapeutic occlusions of the renal artery by balloon, coil, and gelfoam are presented. Basic differences in technique of application and in the mechanism of Ethibloc in comparison to other kinds of embolisation material are pointed out. In 61 diagnostic punctures of renal cysts, guided by sonograpny, 31 were treated by injection of Lipiodol. As in cystography, the combination of sonography and radiology proved to be highly valuable in 37 percutaneous nephrostomies. Technique, indication, contraindication, and complication of renal embolisation, renal cystography and percutaneous nephrostomy are briefly discussed.

Adenocarcinoma↗
PubMed1980

[Diagnostic radiology in nephrolithiasis and nephrocalcinosis (author's transl)].

In summary it can be stated that clinically and radiologically, nephrolithiasis und nephrocalcinosis are not uncommonly encountered together. It is the aim of x-ray diagnostic to detect stones and parenchymal calcification, to assess localisation, size and numer or extent, to recognise secondary changes in the renal parenchyma and urinary-tract resulting from stones and to aid the search for the primary disease. In addition there are readiographic methods valuable for the initiation of treatment, e. g. percutaneous antegrade pyelography and nephrostomy.

Adolescent↗
PubMed1980

[Treatment of renovascular hypertension by catheter dilatation (author's transl)].

Percutaneous transluminal angioplasty in renal artery obstructions was performed in 10 cases. In 7 patients the hypertension was successfully treated and in one patient renal function could be restored. The procedure can be applied in atherosclerotic and fibromuscular stenoses as well as in stenosis of kidney grafts. In our opinion catheter dilatation should be prefered to vascular surgery, because it is efficient and inexpensive and has a low risk. Operation should be reserved to cases untreatable with angioplasty.

Adult↗
PubMed1978

[Radiology of bacterial and abacterial interstitial nephritis (author's transl)].

The x-ray findings of 727 patients with chronic interstitial nephritis are evaluated; these patients have been controlled over a period of several years: 594 suffer from chronic bacterial interstitial nephritis (pyelonephritis) and 133 patients from chronic abacterial interstitial nephritis of different etiology. The causes for the abacterial type of nephritis are phenacetin and primary gout. The radiological signs of the two forms of chronic interstitial nephritis in different degrees of involvement are pointed out. Whereas with the chronic abacterial interstitial nephritis symmetrical affection is typical, the chronic bacterial interstitial nephritis shows asymmetrical findings, especially in ascending pyelonephritis. Differentiation between the chronic bacterial nephritis and the chronic abacterial nephritis can be achieved in most cases by radiological signs, (morphological findings). The microscopic evaluation does not always allow a differentiation; because there are mixed forms and secondary bacterial infections are associated with primary chronic abacterial interstitial nephritis in the late stages. The multiple causes for chronic abacterial interstitial nephritis is radiologically reflected mostly by uniform signs during the different degrees of involvement.

Chronic Disease↗