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Biomedical subjects

W D Reinbold

Publications and source records attributed to W D Reinbold.

At least 19 recordsLinked to original sources
PubMed1991

Accuracy of vertebral mineral determination by dual-energy quantitative computed tomography.

Quantitative computed tomography is an established method for the non-invasive assessment of bone mineral content. Scanning with two different X-ray energies allows material-selective image reconstruction and separation on the basis of differing atomic numbers. As proven by chemophysical analysis of 45 bone samples, dual-energy quantitative computed tomography with basis material decomposition allows highly accurate measurement of bone mineral density with an error of 1.4%, independent of fat and soft tissue content.

Bone Density↗
PubMed1990

Surgical treatment of bilateral chylothorax due to benign lymphangioma of the thoracic duct.

We present a female patient in whom after an 8-year history of recurrent bilateral pleural effusions, a benign lymphangioma of the thoracic duct was diagnosed and successfully treated by ligation of the duct, resection of the tumour and simultaneous decortication of the right pleural space and lung. This observation supports surgical intervention in this condition even in patients of advanced age.

Aged↗
PubMed1990

[Structural changes in the lung in the late stage of fatal paraquat poisoning].

Poisoning with Paraquat, an efficient weedkiller, causes a progressive interstitial fibrosis of the lung starting after about one week's latency. The X-ray findings of a 30-year-old female patient who died 12 days after oral ingestion of Paraquat could be documented. We found a correlation between X-ray examination and microscopic post mortem findings of necrotizing alveolitis of the lung changing from exsudative to sclerosing alterations. This diffuse interstitial fibrosis was accompanied by an increase of contractile filament laden cells, characterized by an expression of alpha-smooth muscle actin, which could be identified by immunohistochemical methods. The substantial increase in alpha-actin containing cells has recently been observed in cases of Bleomycin-injured lungs.

Adult↗
PubMed1989

[Hypophosphatemic osteomalacia in adults].

Hypophosphataemic osteomalacia occurred in a 38-year-old woman. The leading clinical symptom was severe bone pain. X-ray studies demonstrated fractures of the iliac crest and pubic and ischiadic bone, as well as Looser's zones and demineralization of the skeleton. Computerized densitometry of the bone revealed a 31% reduction of hydroxyapatite. Histological evaluation showed nearly absence of osteoclasts and extensive demineralisation of the bone. Hypophosphataemia (0.48 mmol/l), increased urinary phosphate clearance (36 ml/min), reduced renal-tubular reabsorption for phosphate (73%) and increased alkaline phosphatase (355 U/l) were present. Parathyroid hormone and 1,25-dihydroxyvitamin D were normal. No inborn errors, disturbances of the calcium metabolism or paraneoplastic signs could be detected. Defective renal tubular reabsorption of phosphate is likely to be the underlying cause of the disease. Phosphate supplementation and intermittent vitamin D administration remains the therapy of choice.

Adult↗
PubMed1989

Osteodensitometry of vertebral metastases after radiotherapy using quantitative computed tomography.

Bone density has been assessed during and after radiotherapy of metastases of the spine using quantitative computed tomography (QCT) in 19 patients with osteolytic vertebral lesions. All patients underwent external photon radiation with a total dose of 40 Gy over a period of 4 weeks. Measurements of vertebral mineral density were performed at the beginning, at the end, and 3 months after radiotherapy. In 13 patients with osteolytic metastases, radiotherapy achieved complete release of pain; it was unsuccessful in the remaining 6 patients. Immediately after successful radiotherapy, osteolytic metastases showed a decrease of bone density of 24.7% followed by an increase of 60.6% 3 months later. Normal bone surrounding the osteolysis showed an increase of density at the end and 3 months after radiotherapy. QCT has proved to be a helpful tool in assessing successful radiotherapy of metastases of the spine.

Absorptiometry, Photon↗
PubMed1989

[Pulmonary artery hypertension in chronic obstructive lung disease. The place of morphometric studies in thoracic radiography].

Standard biplane chest X-rays were tested for the validity of morphometric criteria in the diagnosis of pulmonary artery hypertension. Twenty-seven patients suffering from chronic obstructive lung disease were examined and compared with a control group without cardiopulmonary disease. The diameter of the right and left pulmonary artery, pulmonary conus and the hilar-to-thoracic ratio were significantly increased in patients with chronic obstructive lung disease (p less than 0,0001). Measurement of the right pulmonary artery was 19.7 +/- 3.9 mm compared to 13.6 +/- 1.2 mm of the control group; mean hilar thoracic index was 0.35 compared to 0.31. Thus if the width of the descending branch of the right pulmonary artery was above 16 mm, pulmonary arterial hypertension was suggested, with a specificity of almost 100%, although the sensitivity of the diagnosis was only 59%. The mean pulmonary arterial pressure obtained by right heart catheterization correlated poorly with the morphometric criteria obtained.

Adult↗
PubMed1988

Clinical application of percutaneous transluminal angioscopy. Comparison of findings in percutaneous transluminal angioplasty, thrombolysis, thrombus-extraction and stent-application.

Since the introduction of ultrathin angioendoscopes into clinical application, it has been possible to subject the findings of conventional or digital angiography to objective verification. In dogs and in patients, this new angioscopic method for visualization of arteries without surgical intervention has been carried out. The approach is transfemoral. Endoscopy is combined with angiography and, when indicated, percutaneous transluminal angioplasty (PTA), thrombolysis, thrombus extraction and insertion of a new type of stent. An ultrathin endoscope with an outer diameter of 1.6 mm and a working channel of 0.35 mm is used. Guidewires, contrast media and drugs for local thrombolysis can be employed through this channel. The endoscope is placed in the region of interest under fluoroscopy and direct visualization is obtained by using 0.9% NaCl for decreasing blood flow. Image recording is achieved by video or high-speed camera. With this method, the intraluminal events of dilatation, recanalization, local lysis, stent application and thrombus extraction can be visualized.

Angioplasty, Balloon↗
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↗
PubMed1988

[Comparative bone density measurements in healthy women and women with osteoporosis].

To compare methods of noninvasive measurement of bone mineral content, 40 healthy early postmenopausal women and 68 postmenopausal women with osteoporosis were studied. The methods included mono- and dual-energy quantitative computed tomography (QCT) and dual-photon absorptiometry (DPA) of the lumbar spine, single-photon absorptiometry (SPA) of the distal third of the radius, and combined cortical thickness (CCT) of the second metacarpal shaft. Lateral thoracolumbar radiographic studies were performed and the spinal fracture index calculated. There was good correlation between QCT and DPA methods in early postmenopausal women and moderate correlation in postmenopausal osteoporotic women. Correlations between spinal measurements (QCT or DPA) and appendicular cortical measurements (SPA or CCT) were moderate in healthy women and poor in osteoporotic women. Measurements resulting from one method were not predictive of measurements obtained by another method for individual patients. The strongest correlation with severity of vertebral fracture was provided by QCT and the weakest by SPA. There was good correlation between single- and dual-energy QCT results. Osteoporotic women and younger healthy women can be distinguished by the measurement of spinal trabecular bone density using QCT, and this method is more sensitive than the measurement of spinal integral bone by DPA or of appendicular cortical bone by SPA or CCT.

Adult↗
PubMed1987

[Computerized tomography in thoracic trauma].

Chest CT scans were obtained in 86 patients suffering from serious blunt or penetrating chest trauma. The finding of mediastinal widening was by far the most common CT indication. CT proved to be a more sensitive method for detection of parenchymal lung lesions and occult pneumothorax than bedside radiographs. CT contributed substantially in differentiation of lung abscess and empyema, exclusion of mediastinal pathology and spinal injuries. Aortography is still indicated, even when CT findings are normal if aortic laceration is clinically suspected. Despite all of the technical problems combined with CT examinations in the critically ill patient, we consider CT a valuable diagnostic tool for certain problems in the traumatized patient.

Aortic Dissection↗
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↗
PubMed1987

Radiologic findings in peripheral neurilemoma.

Neurilemoma is a primary nerve sheath tumour that usually arises from a peripheral nerve. In a series of eight solitary neurilemomas four benign and four malignant tumours are observed. Three neoplasms are of intrathoracic origin, four tumours arise in the retroperitoneal space and one tumour develops in the duodenal wall. Radiographic findings using computed tomography, ultrasonography and arteriography are presented. All neurilemomas show relatively low density in CT compared with other parenchymal tumours. All benign and three of the malignant neurilemomas reveal good contrast enhancement. Arteriography has an important role in defining the tumour's blood supply and establishing the origin of the tumour. Five of six neurilemomas show hypervascularity in arteriography. Ultrasonography shows cystic degeneration in three malignant and in one benign neurilemoma. Pathologic correlation of peripheral neurilemoma is discussed by using a special immunoperoxidase technique.

Adolescent↗
PubMed1986

[Diagnosis and therapy of pseudo-obstruction of the colon].

Pseudo-obstruction of the colon (Ogilvie's syndrome) occurred in 18 patients as an acute abdominal emergency. It was characterized by massive distension of the caecum or the entire colon in the absence of any organic cause. Usually there was an underlying extraintestinal disease. Diagnosis of this entity depends on careful radiological investigation of the abdomen, whereby barium enema reveals the absence of organic obstruction. Increasing distension in untreated patients may lead to spontaneous perforation of the caecum.

Cecal Diseases↗
PubMed1986

Bone mineral content in early-postmenopausal and postmenopausal osteoporotic women: comparison of measurement methods.

To investigate associations among methods for noninvasive measurement of skeletal bone mass, we studied 40 healthy early postmenopausal women and 68 older postmenopausal women with osteoporosis. Methods included single- and dual-energy quantitative computed tomography (QCT) and dual-photon absorptiometry (DPA) of the lumbar spine, single-photon absorptiometry (SPA) of the distal third of the radius, and combined cortical thickness (CCT) of the second metacarpal shaft. Lateral thoracolumbar radiography was performed, and a spinal fracture index was calculated. There was good correlation between QCT and DPA methods in early postmenopausal women and modest correlation in postmenopausal osteoporotic women. Correlations between spinal measurements (QCT or DPA) and appendicular cortical measurements (SPA or CCT) were modest in healthy women and poor in osteoporotic women. Measurements resulting from one method are not predictive of those by another method for the individual patient. The strongest correlation with severity of vertebral fracture is provided by QCT; the weakest, by SPA. There was a high correlation between single- and dual-energy QCT results, indicating that errors due to vertebral fat are not substantial in these postmenopausal women. Single-energy QCT may be adequate and perhaps preferable for assessing postmenopausal women. The measurement of spinal trabecular bone density by QCT discriminates between osteoporotic women and younger healthy women with more sensitivity than measurements of spinal integral bone by DPA or of appendicular cortical bone by SPA or CCT.

Adult↗
PubMed1986

[Diaphragmatic defect in trisomy 13].

Congenital diaphragmatic defect is often combined with other malformations that are severe or fatal. The rare finding of a congenital diaphragmatic defect in a newborn with trisomy 13 is reported. The newborn died within 2 days. Postmortem examination showed typical malformations due to trisomy 13 besides a diaphragmatic defect of left retrosternal position. Karyotype revealed a 13/14 translocation of trisomy 13.

Chromosomes, Human, 13-15↗