PubMed Health⌕ Search

Biomedical subjects

Volkmar Jacobi

Publications and source records attributed to Volkmar Jacobi.

13 recordsLinked to original sources
PubMed2006

[Dystrophic calcinosis cutis after subcutaneous administration of para-aminosalicylic acid for treatment of pulmonary tuberculosis].

An 81-year-old women presented with monstrous subcutaneous mobile masses on the ventral and ventrolateral surfaces of her thighs. Radiography as well as computer tomography showed extensive soft tissue calcifications. We interpreted these alterations as dystrophic calcinosis cutis, most likely resulting from repeated subcutaneous PAS infusions for the treatment of pulmonary tuberculosis.

Aged, 80 and over↗
PubMed2005

Severe rhabdomyolysis, acute renal failure and posterior encephalopathy after 'magic mushroom' abuse.

We report the case of a 25-year-old, hepatitis C-infected man, who presented with severe rhabdomyolysis and acute renal failure, and later developed posterior encephalopathy with cortical blindness after the ingestion of magic mushrooms. Conventional respiratory and cardiovascular support including mechanical ventilation, continuous veno-venous hemodialysis and corticosteroids led to improvement and the patient recovered completely over the following months. Magic mushrooms are becoming increasingly fashionable among drug users, as they are believed to be more harmless than other hallucinogenic designer drugs. So far, little is known about their possible severe side effects.

Acute Kidney Injury↗
PubMed2005

Evaluation of the stereotactic 8G vacuum-assisted breast biopsy in the histologic evaluation of suspicious mammography findings (BI-RADS IV).

PURPOSE: The purpose of this study was to evaluate the potential of the new 8G stereotactic vacuum-assisted breast biopsy (ST-driver, Mammotome; Ethicon Endosurgery) in the histologic evaluation of BI-RADS IV microcalcifications. MATERIALS AND METHODS: Fifty-eight patients with 61 mammographic BI-RADS IV microcalcifications underwent stereotactic vacuum-assisted breast biopsy (SVAB). The new 8G system was mounted on the ST driver, which was formerly used only with the hand-held version under sonographic guidance. The evaluation criteria for each biopsy were minimally invasive and operative histologies, the time needed for biopsy, the amount of bleeding, number of rotations and specimen, the degree of resection, and the complications. RESULTS: Fifty-eight of 61 biopsies were technically successful because > or = 50% were resected (29 x 100%, 8 x 90%, 5 x 80%, 6 x 70%, 3 x 50%, 3 x 0%). In 7 cases with representative biopsies of segmental suspicious microcalcifications, the degree of resection could not be exactly measured. All but 2 biopsies were performed without clinically relevant complications and after gaining enough specimens (Ø 12.6 specimen, 1.85 rotations). Those 2 patients showed evidence of severe bleeding into the breast tissue and operative revision had to be performed (3.5%). The size of intramammary hematoma was measurable in 27 biopsies and showed a range from 0.5 to 5 cm (Ø 2.7 cm). The average external bleeding was still low with 16 mL (5-80 mL). In 3 of 61 lesions, it was not possible to gain representative tissue as a result of displacement of the lesion after introducing or shooting the needle. The average time needed for all biopsies was 28.2 minutes for all but 5 very complicated biopsies, which took 16.1 minutes. The histologic findings with further operative workup were: 10 ductal carcinomas in situ (DCIS), 4 atypical ductal hyperplasias, 1 atypical lobular hyperplasias (ALH), 3 lobular carcinomas in situ (LCIS), and 6 invasive ductal carcinomas. In 7 of 12 of the initial DCIS histologies, the operative histology was also DCIS, whereas in 4 of 12, no residual malignant tumor was found. In 1 of 12 patients with an initial DCIS histology, operative histology revealed invasive ductal cancer (8.3%). The cases with lobular lesions (ALH, LCIS) did not show any evidence for residual tissue in the operative workup. Most frequent benign histologies were mastopathy (13), ductal hyperplasia (9), fibroadenoma (8), and sclerosing adenosis (5). The control examinations (maximum 1 year) did not show any signs for a false-negative biopsy. CONCLUSION: The 11-G SVAB has proven to be a perfect adjunct to the existing breast biopsy methods. The new 8G SVAB speeds up the method when used for the same size of lesions and enables the user to representatively biopsy lesions up to 3 cm in diameter. The method is still minimally invasive; however, the amount of hematomas as well as clinically relevant complications is increased.

Biopsy, Needle↗
PubMed2005

Value of electrical impedance scanning (EIS) in the evaluation of BI-RADS III/IV/V-lesions.

Two hundred and fifty-six (256) patients (72% preoperative, 28% pre-Mammotome) were prospectively examined with EIS using the TS 2000 (TransScan Research and Development Center, Israel; temporarily distributed by Siemens, Erlangen) with the "LOS"-software (level of suspicion). All exams were performed with the targeted scan probe, the observer knowing all clinical and imaging facts. The area of the lesions was examined with EIS at least with 5 single scans. The evaluation included a scaling of lesions from 1 (surely benign) up to 5 (highly suggestive for malignancy) as well as the additional notification of spots. Results of EIS were based upon the automatic scaling which is provided by the software and were compared with mammography and histology. Furthermore the influence of the histology, size of lesions, and presence/absence of spots on the EIS results were analyzed. Histology revealed benign results in 138 lesions and malignant results in 118 lesions (DCIS=61, ID-Ca=51, IL-Ca=5, mucinous Ca=1). Mammography as expected yielded high values with 91% sensitivity and 62% specificity. Overall sensitivity of EIS was 75.4%, specificity 42.03%, negative predictive value 66.7% and positive predictive value 52.7% (89 TP, 58 TN, 80 FP, 29 FN). EIS was false negative in 20 ID-Ca, 3 IL-Ca, 1 IDL-Ca, 4 DCIS, and 1 mucinous carcinoma. Sensitivity and specificity of EIS did not differ for the different histological differentiations neither for the degree of invasion. Also the additional notification of "spots" didn't show a correlation to malignancy. There were significant differences of the sensitivity of EIS regarding the tumor size. While EIS correctly diagnosed 85% of lesions <10 mm in size, only 64% of lesions >10 mm were detected. Most frequent lesion types for false positives were mastopathy (55/80 FP) and fibroadenoma (21/80 FP). Patient acceptance of EIS was perfect and there were no drop outs because of movement artifacts. In conclusion the "LOS"-software clearly improved the clinical performance of the TS 2000 as compared to the initial software. The high sensitivity of EIS in small cancers which was found in our study may indicate an advantage of this method. However, the overall sensitivity and specificity with this setup of EIS is still far too low. Further improvements especially including the measurement of higher frequencies should be realized.

Breast Neoplasms↗
PubMed2004

Extracorporeal shock wave therapy in calcific tendinitis of the shoulder.

OBJECTIVE: To investigate clinical (pain, mobility) and radiological (resolution of calcium deposits) efficacy of different energy levels of extracorporeal shock wave therapy (ESWT) in calcific tendinitis of the shoulder. DESIGN AND PATIENTS: There were 90 study subjects with radiographically verified calcific tendinitis of one shoulder, mean age 52+/-6 years (range 29-65 years; females:males=55:35), all of whom had had symptoms for at least 6 months and substantial restriction of shoulder mobility and pain that required taking anti-inflammatory drugs. Calcium deposits were of type I or type II (clearly circumscribed and dense) and ranged from 1 cm to 3 cm in diameter. Subjects were divided into three groups to receive ESWT at one of two energy levels (E1=0.15 mJ/mm2, E2=0.44 mJ/mm2) or sham treatment. Treatment was given at 6 weekly intervals until symptoms resolved, five treatments had been given or the subject dropped out of the programme. RESULTS: All subjects in groups E1 and E2 completed the programme. Those in group E1 had significantly less pain during treatment but more treatments than those in group E2, and at 6 month follow-up had residual calcification and recurrence of pain (87%). Subjects in group E2 had no residual calcification or recurrence of pain. Sham treatment had no effect. There were no side effects except a small number of haematomas (2 in E1, 6 in E2; maximum size 2 cm). CONCLUSION: ESWT in calcific tendinitis of the shoulder is very effective. It does not have significant side effects at an energy level of E=0.44 mJ/mm2, which can therefore be recommended.

Adult↗
PubMed2004

Virtual endoscopy of the tracheo-bronchial system: sub-millimeter collimation with the 16-row multidetector scanner.

The purpose of this study was to evaluate the scope of sub-millimeter collimation reconstruction parameters using 16-row computer tomography and ECG triggering on image quality in virtual bronchoscopy. Thirty-two patients (5 women, 27 men, mean age 66.6+/-1.4) who had been admitted for coronary artery bypass graft surgery underwent CT examination of the thorax (Sensation 16, Siemens, Inc., Forchheim, Germany). All patients were examined with 16x0.75-mm collimation. Image reconstruction was performed for two groups. In group A ( n=32), slice thickness of 1.5 mm and an overlap of 0.75 mm were used. In group B ( n=32), slice thickness of 0.75 mm and an overlap of 0.4 mm were applied. Retrospective ECG triggering was performed in all patients. The maximum order of recognizable bronchi was determined in each data set. In addition to assessing the maximum order of bronchial bifurcation, bronchial diameter was determined in truly perpendicular sections in each patient. For every segment proximal to a bifurcation, image quality was subjectively graded as poor (grade 1), moderate (grade 2) or good (grade 3). The observers were asked to identify the minimum cardiac movement ECG-triggered image sets assuming that they would be of better quality than the maximum cardiac movement ECG-triggered image sets. The Mann-Whitney U-test and the Fisher's Exact Test were used for statistical evaluation. In group A, a mean of 4.8+/-0.2 bifurcations was ascertained vs. 6.5+/-0.3 bifurcations in group B [ P<0.0003]. For bronchial diameters in group A, a mean of 7.5+/-0.4 mm was determined vs. 4.6+/-0.4 mm in group B [ P<0.0001]. In group B, two independent radiologists observed a significant shift to better image quality in all segments evaluated [ P<0.006 to P<0.000001]. Motion artifacts were judged as being significantly reduced by minimum cardiac movement ECG-triggering in group B [observer 1: P=0.0007 (20/32); observer 2: P=0.008 (18/32)], but not in group A [observer 1: P=0.286 (13/32); observer 2: P=0.123 (16/32)]. Sub-millimeter collimation and minimum cardiac movement ECG-triggered data acquisition allow deeper penetration into the tracheo-bronchial system allowing visualization of the bronchial surface down to diameters below 5 mm in certain cases up to the eighth bifurcation. Along with an enhanced visualization as such, better image quality is acquired in all segments evaluated. Trade off between better image quality, of doubtful diagnostic consequence, and much higher irradiation dose must be made.

Aged↗
PubMed2004

MR imaging of lung parenchyma at 0.2 T: evaluation of imaging techniques, comparative study with chest radiography and interobserver analysis.

The purpose of this study was to evaluate low-field MR imaging of the lung parenchyma in comparison with postero-anterior (PA) and lateral chest radiographs (CR). One hundred one prospectively randomized patients who had received routine CR were additionally examined with magnetic resonance imaging (MRI) at 0.2 T. Utilized sequences were: constructive interference in steady state (CISS), true fast imaging in steady state precession (True-FISP) and T1-weighted spin-echo (T1SE). Consensus reading of two observers was performed for CR. Three other observers analyzed hardcopies of the MRI examinations for each sequence independently. The individual results for the comparisons between the sequences and CR were calculated using kappa coefficients with their corresponding confidence intervals. Additionally, an interobserver analysis was performed. The proportions of agreement for the three sequences compared with CR were high, with 0.93 for CISS, 0.89 for True-FISP and 0.91 for T1SE. The kappa coefficients and the corresponding confidence intervals were 0.81 [0.68; 0.95] for CISS, 0.72 [0.57; 0.88] for True-FISP and 0.78 [0.65; 0.92] for T1SE. Concerning CISS, differences between MRI and CR were mainly related to advantages resulting from cross-sectional imaging. The smallest 95% lower confidence bound of the three kappa measures for comparing the MR readers with each other was 0.97, indicating a high interobserver agreement. Low-field MRI of the lung parenchyma using the CISS sequence is well comparable with chest radiography and demonstrates slight advantages resulting from the cross-sectional imaging technique.

Adult↗
PubMed2002

Galactography: an important and highly effective procedure.

Galactography should only be performed if there is spontaneous bloody or serous discharge from a single lactiferous duct of one breast. If this is observed, only pathologic processes instead of normal breast tissue are removed upon surgery and there is a close correlation between radiologic results and pathologic findings. Galactography localizes intraductal pathologic processes precisely and thus contributes to minimal volume surgery.

Female↗
PubMed2002

MR-guided laser-induced thermotherapy with a cooled power laser system: a case report of a patient with a recurrent carcinoid metastasis in the breast.

We report a case of a 52-year-old woman with a palpable recurrent metastasis of a neuroendocrine carcinoma to the upper outer quadrant of the right breast. For the treatment of this lesion, MR-guided laser-induced thermotherapy was performed with a cooled power laser system (Nd:YAG-Laser). An open 0.2-T MR unit was used for the monitoring of the laser energy delivery to the breast; thus, a thermosensitive fast low-angle shot 2D sequence for MR thermometry was used, so the ablation of the tumor and the increase of laser-induced necrosis could be interactively visualized with the repetitive use of this sequence. The postinterventional MR control exams 1 day and 4 months after laser-induced thermotherapy at the 1.5-T MR unit (Magnetom Symphony Quantum, Siemens, Erlangen, Germany) verified the complete ablation of the tumor without any signs of residual or relapsing tumor.

Breast Neoplasms↗
PubMed2002

[Computer tomography findings in lung tuberculosis].

PURPOSE: Tuberculosis remains the most important infectious disease all over the world. We report on the CT findings of lung tuberculosis. MATERIAL AND METHODS: Standardised retrospective analysis of the computed tomographic examinations in a total of 100 patients suffering from cultural or histological proven pulmonary tuberculosis. RESULTS: The most common finding in our study group were micronodules and lobular opacities accompanied by enlarged lymph nodes. Cavitation and alteration of the bronchial system (esp. bronchial wall thickening) were found less common. The so-called tree-in bud-appearance which had been estimated by other authors to be rather characteristic for active pulmonary tuberculosis was seen in only 12/100 examinations. It is often found in cases showing severe bronchogenic spreading of the disease. CONCLUSION: The active pulmonary tuberculosis does not show any pathognomonic sign but the combination of findings as opacities and cavitation and segmental spreaded micronodules make the diagnosis probable. This holds also for the so-called tree-in-bud appearances which may be rather suggestive but is seen only in cases suffering from severe bronchiogenic propagation.

Adult↗