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11.
Matthias Bollow Wolfgang Knauf Agnieszka Korfel Matthias Taupitz Andreas Schilling Karl-Jürgen Wolf Bernd Hamm 《Journal of magnetic resonance imaging : JMRI》1997,7(1):241-250
The purpose of this study was (a) evaluation of dynamic contrast-enhanced MR imaging of normal bone marrow versus malignant bone marrow infiltrations in patients with proven B-cell-type chronic lymphocytic leukemia (B-CLL) and (b) correlation with the clinical stage according to Binet (stages A, B, C) and response to therapy. Bone marrow imaging of the lumbar spine, pelvis, and proximal femurs was performed at 1.5 T in 45 patients without known malignancy and in 30 patients with B-CLL. The differences between opposed-phase and in-phase dynamic gradient-echo sequences before and up to 10 minutes after intravenous application of .1 mmol/kg body weight of gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA) were evaluated in normal bone marrow. The contrast-enhancement patterns of normal and malignant bone marrow were compared using the opposed-phase dynamic gradient-echo sequence. Ten of the patients with bone marrow infiltrations (Binet stage C) additionally underwent MR imaging follow-up during therapy. Opposed-phase gradient echo sequences demonstrated a signal decrease of normal bone marrow, and in-phase gradient echo sequences demonstrated a signal increase of normal bone marrow after administration of Gd-DTPA. The dynamic signal intensity time courses differed significantly (P < .05) between Binet stages B and C and controls as well as among the three Binet stages of B-CLL. In the 10 patients followed during therapy, MR imaging sensitively demonstrated response (n = 6), nonresponse (n = 2), or relapse after initial response (n = 2). In out-of-phase imaging, both normal bone marrow and initial bone marrow infiltration in CLL stage Binet A show signal decrease after administration of contrast agent, whereas there is increase in signal intensity in higher-grade bone marrow infiltration in Binet stage B or C disease. The signal loss of normal bone marrow in out-of-phase imaging is a phase effect rather than a T2* effect. The differentiation of initial from higher-grade bone marrow infiltration on out-of-phase images relies solely on a shift in the fat/water ratio. 相似文献
12.
Normal morphology of sacroiliac joints in children: magnetic resonance studies related to age and sex 总被引:2,自引:0,他引:2
M. Bollow J. Braun J. Kannenberg T. Biedermann C. Schauer-Petrowskaja S. Paris S. Mutze B. Hamm 《Skeletal radiology》1997,26(12):697-704
Objective. To determine in a prospective study the normal MRI morphology of the sacroiliac joints (SIJs) in relation to age and sex
during adolescence. Design and patients. A total of 98 children (63 boys, mean age 12.7±2.8 years; 35 girls, mean age 13.7±2.3 years), ranging in age from 8 to 17
years, with juvenile chronic arthritis (JCA) but without signs of sacroiliitis fulfilled the study prerequisites (no back
pain and no pathologic changes of the SIJs on physical examination before MRI in a 1.5-year follow-up). An additional eight
HLA-B27-negative boys and eight HLA-B27-negative girls without arthritis served as controls. The MRI protocol comprised a
T1-weighted SE sequence, an opposed-phase T2*-weighted GE sequence, and a dynamic contrast-enhanced study in single-section
technique. Results. Noncontrast MRI permitted differentiation of “open” from ossified segmental and lateral apophyses of the sacral wings, with
a significant difference in age (P <0.05) between children with open and ossified apophyses. Ossification of the apophyses of the sacral wings was seen significantly
earlier (P <0.05) in girls than in boys. Girls also had a significantly higher incidence of transitional lumbosacral vertebrae, pelvic
asymmetries, and accessory joints. In the contrast-enhanced opposed-phase MRI study, normal cartilage of the SIJs showed no
contrast enhancement whereas the joint capsule showed a moderate enhancement. Conclusion. There are significant age- and sex-related differences in the normal MRI morphology of juvenile SIJs. Our findings might
serve as a standard of comparison for the evaluation of pathologic changes – in particular for the early identification of
juvenile sacroiliitis. 相似文献
13.
Understanding the pathologic Haglund's deformity 总被引:1,自引:0,他引:1
Pathologic conditions behind the calcaneus are common, and may initiate during early childhood. The authors discuss osseous and soft tissue conditions involving the posterior-superior surface of the heel. Radiographic and clinical evaluation is considered. Treatment alternatives are also reviewed. 相似文献
14.
C W Hamm J H Robertson J T Robertson D K Hathaway E Tolley 《The Journal of neuroscience nursing》1988,20(5):303-308
Cardiovascular changes have been noted to occur during movement from the operating room or recovery room (RR) to the intensive care unit (ICU). This study examined blood pressure changes and related variables during transport from the RR to the ICU in 135 postoperative acoustic tumor patients. Although there was no significant change in blood pressure values from the RR to the ICU, patients with pre-existing hypertension and elevated RR blood pressures were noted to have an increased frequency of postoperative complications. In addition, a relationship was noted between administration of halothane and frequency of postoperative complications. Results highlight the need for nurses not only to monitor, but also closely control postoperative blood pressure in this population. 相似文献
15.
Lise Pedersen Susanne Holck Torben Schiødt Karin Zedeler Henning T. Mouridsen 《Breast cancer research and treatment》1989,14(1):91-99
Summary One hundred thirty-one breast carcinomas with medullary features, registered in the Danish Breast Cancer Cooperative Group from 1977–1982, have been histopathologically reviewed by two senior pathologists and classified as typical medullary carcinoma (TMC), atypical medullary carcinoma (AMC), and non-medullary carcinoma (NMC). Diagnostic criteria were based on those put forward by Ridolfiet al. and Fisheret al. The procedure was repeated with an interval of about one year by both pathologists. The diagnostic interobserver agreement was 72% with a Kappa of 0.55. The intraobserver agreement was 77% and 63% with Kappa values of 0.64 and 0.44, respectively. To see whether the observed inter- and intraobserver variability had any prognostic implications, diagnostic subgroups for both pathologists were analyzed with Kaplan Meier plots for recurrence-free survival (RFS) and with log rank tests. In the first evaluation pathologist 1 segregated a group of TMC with a significantly better RFS than for the NMC group, and pathologist 2 segregated a group of TMC with a corresponding strong trend. These findings could not, however, be reproduced in the second evaluation. The study indicates that the criteria of TMC and AMC as proposed by Ridolfiet al. need to be sharpened and simplified in order to reduce inter-and intraobserver variability. Larger studies with a control group of infiltrating ductal carcinomas are mandatory to elucidate the clinical importance of the diagnoses of Typical and Atypical Medullary Carcinoma of the breast. 相似文献
16.
Ralf-Peter Vonberg Sabine Stamm-Balderjahn Sonja Hansen Irina Zuschneid Henning Ruden Michael Behnke Petra Gastmeier 《Infection control and hospital epidemiology》2006,27(10):1123-1127
A systematic search was performed to identify outbreaks of methicillin-resistant Staphylococcus aureus infection and colonization caused by healthcare workers (HCWs). Of 191 outbreaks identified, 11 had strong epidemiological evidence that HCWs were the source. In 3 of these outbreaks, asymptomatic carriers were the cause. The frequent practice of screening asymptomatic HCWs should be reconsidered. 相似文献
17.
Intra-operative quick insulin assay to confirm complete resection of insulinomas guided by selective arterial calcium injection (SACI) 总被引:1,自引:0,他引:1
Oliver Gimm Evelyn König Phuong Nguyen Thanh Michael Brauckhoff Wolfram Karges Henning Dralle 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(6):679-684
Background and aims Insulinomas are rare endocrine disorders. Pre-operatively, conventional imaging techniques often fail to localise the tumor.
In addition, due to the lack of quick insulin assays, intra-operative confirmation of complete resection was impossible until
recently.
Materials and methods Six patients with biochemical evidence of an insulinoma underwent pre-operative localisation studies and selective arterial
calcium injection (SACI). In addition, insulin was measured before surgery and every 10–15 min after resection of the tumor
using a quick insulin assay.
Results Pre-operative localisation studies identified the tumor correctly as follows: endosonography: three of four, magnetic resonance
imaging: two of four and SACI: six of six. Tumors in the head and body were enucleated while those in the tail were resected
(n = 2, each). Those three patients, in whom magnetic resonance imaging and/or endosonography could localise the tumors pre-operatively,
underwent laparoscopic surgery while the remaining three patients underwent open surgery. Intra-operatively, insulin dropped
to normal levels within 20 min in all cases. After a follow-up of 0.8–3 years, all patients remained biochemically cured.
Conclusions Pre-operatively, SACI appears to be a very sensitive localisation technique and may be most helpful in guiding the surgeon
if conventional imaging techniques fail to localise the tumor. Complete removal of an insulinoma can be reliably predicted
using a quick insulin assay.
This paper was presented at the 2nd Biennial Meeting of the European Society of Endocrine Surgeons (ESES), May 18–20, 2006,
Krakow, Poland. 相似文献
18.
Barbara Schubert Cornelia S. Seitz Eva‐Bettina Brcker Henning Hamm 《Journal der Deutschen Dermatologischen Gesellschaft》2007,5(8):680-682
Childhood psoriasis is a disease with manifold clinical presentations which can make the correct diagnosis sometimes difficult. In a female infant, slightly itching, erythematous papules and plaques with discrete scaling spread over large parts of the integument starting from age three months. Histological examination supported the diagnosis of exanthematous infantile psoriasis. Topical treatment with dithranol in petrolatum led to slow clearance of the skin lesions. 相似文献
19.
A 72-year-old man with increasing shortness of breath and atypicalangina pectoris received a chest radiograph 相似文献
20.
OLG Hamm 《MedR Medizinrecht》2007,25(2):114-116
Abstrakt Besteht zwischen Sch?diger und Gesch?digtem Streit über eine genau beschriebene, auch in der Zukunft m?glicherweise wiederkehrende
einzelne Schadensposition, so besteht für die Feststellung der Einstandspflicht des Sch?digers hinsichtlich dieser konkret
bezeichneten Position auch dann ein Feststellungsinteresse, wenn seine Einstandspflicht für zukünftige (materielle) Sch?den
bereits zuvor allgemein rechtskr?ftig festgestellt wurde.
Wird wegen der Folgen eines Behandlungsfehlers ein Patient nicht in eine private Krankenversicherung aufgenommen, so umfasst
der vom Sch?diger zu leistende Schadensersatz auch die Verpflichtung, dem gesch?digten Patienten die Mehrkosten einer privat?rztlichen
Behandlung zu ersetzen. Dabei sind die ersparten Versicherungsbeitr?ge abzuziehen. (Leits?tze des Bearbeiters) 相似文献