First sequence-confirmed case of infection with the new influenza A(H1N1) strain in Germany.

Here, we report on the first sequence-confirmed case of infection with the new influenza A(H1N1) virus in Germany. Two direct contacts of the patient were laboratory-confirmed as cases and demonstrate a chain of direct human-to-human transmission.

Portal hypertension due to traumatic hepatic arterioportal fistula: report of successful embolization.

We report a case of severe portal hypertension due to a post-traumatic hepatic arterioportal fistula. A 77-year-old male patient was admitted for abdominal pain, inappetence and weight loss. Further clinical signs were ascites and splenomegaly. Sonography showed a marked enlargement of an arterioportal fistula, which was diagnosed some years before as a consequence of abdominal trauma during the Second World War. Angiography demonstrated an imposing dilatation of the right hepatic artery filling an intrahepatic pseudoaneurysmatic cavity with fistula formation to the portal vein. By means of selective hepatic artery embolization, complete occlusion of the right hepatic artery and the arterioportal fistula was achieved. Within 4 weeks the patient recovered and sonography showed disappearance of ascites and splenomegaly.

Information processing in nuclear magnetic resonance imaging.

An extended image analysis and classification system is presented to discuss the principal composition of the components as well as the methods of its realization in the field of reference based NMR diagnostics and tissue characterization.

[Absolute measurement of laminar flow with the aid of an orthogonal excitation technic in NMR tomography]. / Absolute Messung laminarer Flüsse mit Hilfe orthogonaler Anregungstechniken in der NMR-Tomographie.

A method for absolute measurement of flow quantities by excitation of a slice orthogonal to the measuring plane is presented. The developing flow profile can be imaged directly and its dynamic behaviour can be sampled and measured using the multiecho technique. Simple formulas can be derived by means of Hagen-Poiseuille's law for quantification.

[Sirolimus-eluting stents for the treatment of symptomatic extracranial vertebral artery stenoses: early experience and 6-month follow-up]. / Die Behandlung symptomatischer extrakranieller Stenosen der Arteria vertebralis mit sirolimusbeschichteten Stents: erste Erfahrungen und Ergebnisse nach 6 Monaten.

PURPOSE: To evaluate the clinical and morphological effectiveness of sirolimus-eluting stents in patients with stenoses in the extracranial vertebral artery and to assess the 6-month results. MATERIALS AND METHODS: Sirolimus-eluting stents were implanted in 8 stenoses of the extracranial vertebral artery in 7 patients with symptoms of vertebrobasilar insufficiency. Seven stenoses were located at the ostium, and one further cranially in segment V 1. The mean grade diameter of the stenoses was 85.1 % (60.9 % - 98.3 %). Clinical and angiographic follow-up was performed over a period of 6 months in all patients. RESULTS: All lesions were successfully stented with a residual stenosis of 20.2 % (0.0 - 38.5 %). Clinically, all patients showed resolution or improvement of the symptoms after stenting. After 6 months, 5 of the 8 stenoses developed intimal hyperplasia with a stenosis grade > 50 %. The mean measured grade of stenosis after 6 months was 56.2 % (0.0 - 94.1 %). Five patients had no clinical symptoms of a vertebrobasilar insufficiency while two had recurrent symptoms. CONCLUSION: Sirolimus-eluting stents in the extracranial vertebral artery have a high and unsatisfactory re-stenosis rate after 6 months.

[Gadolinium dimeglumine gadopentetate compared to CPMG sequencing and image synthesis]. / Gadolinium-Dimeglumin-Gadopentetat im Vergleich mit der CPMG-Sequenz und der Bildsynthese.

The skulls of 46 patients were examined by means of ordinary scans and after contrast. 24 of these patients with cerebral abnormalities had scans, using identical planes, with and without contrast and with CPMG sequences. Contrast in intracranial, but extracerebral (extra-axial), tumours (meningiomas, neurinomas) was much better after using contrast, but intracerebral (intra-axial) tumours were mostly shown as well on T2-rated CPMG sequences. Image synthesis has shown that contrast uptake occurred only in solid tumour regions.

[Initial clinical results of tissue characterization by T1, T2 and proton density in nuclear magnetic resonance tomography]. / Erste klinische Ergebnisse der Gewebecharakterisierung durch T1, T2 und Protonendichte bei der Kernspintomographie.

The NMR parameters (proton density, relaxation times T1 and T2) have been assessed by Carr-Purcell-Meiboom-Gill (CPMG) spin echo sequences. A computer assisted analysis of the data of 21 patients with cerebral tumours allowed a classification of tumour tissue in different tumours. The use of quantitative procedures for tissue characterisation allows the differentiation of benign and malignant brain tissue by characteristic colour coding demonstrating morphological details like tumour, edema and necrosis as well as indicating the histological types of the tumours of the central nervous system.

Three-dimensional ultrasonography in maxillofacial surgery. A new diagnostic tool.

Three-dimensional (3-D) ultrasonography is introduced as a new diagnostic method for soft-tissue lesions. This method is based on the production of absolutely parallel brightness (B)-scan tomographies with constant intervals. After adequate preparation, the sonographic primaries are processed into 3-D graphs by a specialized program called EUCLID-IS. This method promises to be useful in the evaluation of tumor patients as well as in the follow-up examination of these patients. The main advantages of the presented method are the capacity to measure accurately the volume of regions of interest and the excellent visualization of the structures examined.

Vitamin D receptor ablation alters skin architecture and homeostasis of dendritic epidermal T cells.

BACKGROUND: 1alpha,25-dihydroxyvitamin D(3)[1,25(OH)(2)D(3)], the active metabolite of vitamin D, exerts its activities by binding to the vitamin D receptor (VDR) with subsequent function as a transcription factor. Targeted ablation of the VDR in mice results in rickets and alopecia. OBJECTIVES: To study the consequences of VDR deficiency for skin physiology, and to investigate the mechanisms of the immunosuppressive effect of 1,25(OH)(2)D(3) on LC. METHODS: We studied the structural, phenotypic and functional properties of skin and individual skin leucocyte populations in VDR(-/-) mice. RESULTS: The lack of VDR induced a wide spectrum of pathologies including dermal deposition of collagen, enlargement of sebaceous glands, dilation of the hair follicles, development of epidermal cysts, increased numbers of dendritic epidermal T cells (DETC) and hyperkeratosis. Ageing aggravated these changes. Intriguingly, Langerhans cells (LC) were indistinguishable in distribution, morphology and number compared with controls. In vitro, LC underwent a maturation/migration process similar to LC from control mice. Pretreatment of epidermal cells or LC-enriched epidermal cell suspensions with 1,25(OH)(2)D(3) impaired LC maturation and T-cell stimulatory capacity from VDR(+/+) but not VDR(-/-) mice, demonstrating that LC are targets of vitamin D(3) and that interaction between vitamin D(3) and LC results in a suppression of LC activity. CONCLUSIONS: Our data imply that VDR expression controls dermal collagen production, hair development and growth, proliferation of sebaceous glands and the homeostasis of DETC. Surprisingly, VDR deficiency does not influence LC phenotype and function.

[Stereotactically guided histologic punch biopsy of the breast in comparison with stereotactically guided cytologic puncture]. / Die stereotaktisch gezielte histologische Stanzbiopsie der Mamma im Vergleich zur stereotaktisch gezielten zytologischen Punktion.

Stereotactic large-core biopsy provides better results in comparison to stereotactic cytologic fine-needle aspiration. Good results arise in 92.52% of the cases; that is 13.17% better than fine-needle aspiration. Technique and indication of the cases are described.

[The radiologic manifestations of a MALT-lymphoma of the colon]. / Radiologisch ausgeprägtes Bild eines Malt-Lymphoms im Dickdarm.

Malt-Lymphoma is a malignant polyposis with its origin in the lymphatic cells of the digestive tract. We report on a 69-year-old female suffering from severe lymphoid polyposis in the colon. There was no evidence of malignant lymphoma in other organs such as liver, spleen retroperitoneum, and lymph nodes.

[Radiologic image of massive diverticulosis of the small intestine]. / Radiologisches Bild einer massiven Dünndarmdivertikulose.

Diverticulosis of the small bowel is rare compared with diverticular disease of the colon. Diverticulosis of the duodenum is more common than the involvement of the whole small bowel including the ileum which is a very rare condition. In a patient presenting with gastrointestinal bleeding extensive diverticulosis of the whole small bowel was identified; the etiology is discussed.

Brain tumors: detection and typing by use of CPMG sequences and in vivo T2 measurements.

A spin-echo sequence with 24 echoes (Carr-Purcell-Meiboom-Gill sequence) was evaluated to determine the usefulness of magnetic resonance (MR) in detecting and typing brain tumors. The TEs in these examinations were between 28 and 346 msec, and the TR was 860, 1260, or 1660 msec. The results of the MR examination of 32 histopathologically proved tumors are presented. All but one tumor could be detected by MR. Tumors generally were obvious on MR due to the higher contrast enhancement of these lesions, especially with a TE longer than 100 msec. T2 values calculated from an eight-point fit, however, did not allow discrimination of different tumors, nor did they allow differentiation between tumor, inflammatory tissue, and demyelination.

[Intracranial hemorrhage in MRT]. / Die kranielle Blutung in der MRT.

About 10% of all intracranial findings in cranial MRI were hemorrhages, or findings associated with bleeding. There was great variation in the hemorrhages as a result of their location and their age, and this could disguise the underlying lesions. Therefore a knowledge of the typical appearance of spontaneous bleeding and tumor bleeding is necessary for interpretation of the MRI findings. During its course, cerebral bleeding shows all of the known interactions between biochemical and histological factors and MRI signal. Thus, an understanding of the variations during the clinical course of bleeding is helpful for a better understanding of contrast mechanisms in MRI.

[The pattern of regional disorders of wall motion in primary dilated cardiomyopathy]. / Muster der regionalen Wandbewegungsstörung bei primärer dilatativer Kardiomyopathie.

Regional left ventricular wall motion was measured in 41 patients with dilated cardiomyopathy (DCM) and 30 healthy normal controls. Global and regional left ventricular function was noninvasively determined by radionuclide angiography (RNA). The amplitudes and phases of the first Fourier coefficient of the regional time-activity curves were used to measure regional wall motion. The normal left ventricle has its strongest contractions in the apical and distal antero-septal regions. In contrast, the left ventricle of patients with DCM contracts the least in these segments. These regional wall motion impairments are parallel to the reduced global left ventricular function. Since such a typical pattern of reduced wall motion can already be demonstrated in patients with mild DCM, determination of regional left ventricular wall motion can help to improve the early detection of DCM.

[Angiographic image of intestinal angiodysplasia of the duodenum in comparison with endoscopy--case report]. / Angiographisches Bild einer intestinalen Angiodysplasie des Duodenums im Vergleich mit der Endoskopie--Fallbericht.

Angiodysplasia of the bowel wall is a malformation of intestinal giodysplasia of the bowel wall is a malformation of intestinal blood vessels. There seem to be different aetiologies of this disease entity. It is reported to be a common cause of occult intestinal bleeding in patients with negative findings on primary endoscopy of the upper and lower gastrointestinal tract. They occur most frequently in the right colon. The case reported demonstrates endoscopy and arteriography of extensive angiodysplasia in duodenum and proximal jejunum causing severe bleeding.

[T2-analysis of normal and pathological structures of the head]. / T2-Analyse normaler und pathologischer Strukturen des Kopfes.

Analyses of T2 values (spin-spin relaxation time constant) in magnetic resonance tomography were carried out in 29 patients with brain tumours. 21 of these had tumours of the glioma group (17 astrocytomas WHO I-III and oligoastrocytomas, 4 glioblastomas). Measurements were effected both pixel by pixel and according to relevant ROI (regions of interest). Although the measurements yielded a T2 value which was typical of the disease, it was individually difficult to effect proper grading on account of the scatter occurring from case to case. Markedly more relevant information was obtained by the introduction of profile measurements in T2 images. The relation between T2 profile and histology of the gliomas permits rough grading between more or less differentiated gliomas.

[Possibilities in using a specific pulse sequence (interlocking sequence) to improve the specificity in NMR tomography]. / Anwendungsmöglichkeiten einer speziellen Pulssequenz ("Schachtelsequenz") zur Verbesserung der Spezifität bei der NMR-Tomographie.

Methods and possibilities of application of a doubled and interlaced pulse sequence ("interlaced sequence") are discussed. This makes it possible to perform contrast variations and pulse sequence variations subsequently, as well as to determine the parameters proton density, T1 and T2. The selectivity of the combination of all three parameters for tissue classification is demonstrated by means of an individual case and seems to promise a higher specificity of MR tomography.