[Confusion, tachypnea, and tachycardia in a 71-year-old man with type 2 diabetes mellitus].

Patients with type 2 diabetes who present with confusion and/or abdominal pains should be screened for sodium-glucose cotransporter 2 (SGLT-2)-induced diabetic ketoacidosis. Severe acidosis was diagnosed despite only moderately increased blood sugar levels. If so, immediate ICU treatment is essential.

Living-donor parathyroid allotransplantation for therapy-refractory postsurgical persistent hypoparathyroidism in a nontransplant recipient - three year results: a case report.

Background: Therapy-refractory persistent hypoparathyroidism after extensive neck surgery is a rare but severe complication. Parathyroid allotransplantation may represent a definitive treatment option.

Case Presentation: A 32-year old female was referred to our hospital with intractable persistent hypocalcemia after neck surgery for papillary thyroid cancer.

Tumor-Induced Osteomalacia: Increased Level of FGF-23 in a Patient with a Phosphaturic Mesenchymal Tumor at the Tibia Expressing Periostin.

In our case, a 45-year-old male patient had multiple fractures accompanied by hypophosphatemia. FGF-23 levels were significantly increased, and total body magnetic resonance imaging (MRI) revealed a tumor mass located at the distal tibia leading to the diagnosis of tumor-induced osteomalacia (TIO). After resection of the tumor, hypophosphatemia and the increased levels of FGF-23 normalized within a few days.

[Treatment of type 2 diabetes in elderly patients].

Background: Type 2 diabetes is a disease which occurs more frequently with increasing age and is particularly influenced by the lifestyle of those affected in addition to a genetic disposition and age-related alterations.

Aim: The purpose of this article is to discuss the evidence for special characteristics of the therapy of type 2 diabetes in elderly patients.

Material And Methods: The study is based on a literature survey and the guidelines of the"Deutsche Diabetes-Gesellschaft" (DDG, German Diabetes Society).

[A 43-year-old patient with character changes, recurrent impaired consciousness and retrograde amnesia].

A 43-year-old male patient with recurring impaired consciousness and retrograde amnesia was admitted to the department of neurology. During the neurological evaluation no pathological findings could initially be revealed but one day the patient was confused again and presented with inadequate behavior: at this time a blood glucose value of 40 mg/dl was measured. For further evaluation the patient was transferred to our department.

Topical delivery of steroids in inflammatory bowel disease.

Crohn's disease (CD) and ulcerative colitis (UC) represent two similar but probably not uniform entities of inflammatory bowel disease (IBD). Since up to now no curative treatment is available the therapeutic goal in active IBD is elimination or at least alleviation of symptoms and maintenance of remission. Glucocorticoids have been successfully used in the treatment of symptoms and inflammation.

[Contrast-enhanced sonographic drainage control: a feasibility study].

Liver abscesses still represent a life-threatening disease. Interventional abscess puncture and/or drainage are often the most adequate treatment. The aim of our study was the evaluation of drainage control with contrast-enhanced sonography.

Comparison between quantitative assessment of bowel wall vascularization by contrast-enhanced ultrasound and results of histopathological scoring in ulcerative colitis.

Purpose: In ulcerative colitis (UC), endoscopic methods are preferred for assessment of extent and activity of disease. Due to the invasive nature of endoscopical examinations, replacement by other, reliable imaging procedures would be helpful. Contrast-enhanced ultrasound (CEUS) in combination with perfusion assessment using a specific quantification software might be such a new diagnostic tool.

Low risk of Clostridium difficile infections in hospitalized patients with inflammatory bowel disease in a German tertiary referral center.

Introduction: Many reports, mainly from the US and Canada but also a recent report from a center in Europe, have documented the increasing impact of Clostridium difficile infections in patients with inflammatory bowel disease (IBD) during the last years. To determine the prevalence of C. difficile infections in hospitalized IBD patients in a tertiary referral center in Germany, we conducted this retrospective analysis.

Comparison of high-resolution ultrasound and MR-enterography in patients with inflammatory bowel disease.

Aim: To compare the results of high-resolution ultrasound (HR-US) and magnetic resonance enterography (MRE) examinations in patients with inflammatory bowel disease (IBD).

Methods: The reports of 250 consecutive cases with known IBD, who had an MRE and HR-US examination, were retrospectively analyzed. Using a patient-based approach we evaluated morphological disease features such as affected bowel wall, stenosis, abscess and fistula.

Comparison between a clinical activity index (Harvey-Bradshaw-Index), laboratory inflammation markers and quantitative assessment of bowel wall vascularization by contrast-enhanced ultrasound in Crohn's disease.

Purpose: Due to its character as a remitting inflammatory disease, patients suffering from Crohn's disease (CD) often undergo several imaging studies subjecting the mostly young patients to ionizing. Contrast enhanced ultrasound for capillary microvascular assessment might be a new diagnostic tool for identifying the activity of inflammation by ultrasound techniques.

Materials And Methods: We prospectively evaluated 45 patients with proven Crohn's disease performing contrast enhanced ultrasound (CEUS) and laboratory assessment including C-reactive protein (CRP), leucocytes and hematocrit as well as calculating the Harvey-Bradshaw Index (HBI).

Image fusion with volume navigation of contrast enhanced ultrasound (CEUS) with computed tomography (CT) or magnetic resonance imaging (MRI) for post-interventional follow-up after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinomas (HCC): Preliminary results.

Aim: The assessment of the immediate post-interventional microcirculation and perfusion following transcatheter arterial chemoembolization (TACE) with new real time imaging fusion technique (VNav) of computed tomography (CT) or magnetic resonance imaging (MRI) with contrast enhanced ultrasound (CEUS) compared to follow-up.

Material: Following TACE an image fusion of CEUS with CT or MRI of the liver was performed in 20 patients (18 men, 2 women; age 29-75 years) with confirmed hepatocelluar carcinoma (HCC) to evaluate the post-interventional tumor vascularization and perfusion of HCC tumor lesions. Image fusion with CEUS performed immediately was compared with the result at the end of TACE (DSA), with post TACE CT (non-enhanced CT within 24 hours) and with follow up CT (enhanced CT after 6 weeks) after embolization.

Clinical feature and bowel ultrasound in Crohn's disease - does additional information from magnetic resonance imaging affect therapeutic approach and when does extended diagnostic investigation make sense?

Background/aims: Some suggest MRI to be superior to ultrasound in Crohn's disease. We analyzed how often MR enterography (MRE) following a routine ultrasound leads to a change in therapeutic decision.

Material And Methods: We retrospectively evaluated 47 patients with Crohn's disease undergoing routine ultrasound examination.

Innovations in contrast enhanced high resolution ultrasound improve sonographic imaging of the intestine.

The aim was to describe the perfusion pattern of the inflamed bowel wall and the surrounding tissue in inflammatory bowel disease and diverticulitis of the sigmoid colon applying a high resolution matrix transducer and the new hybrid technique. We performed contrast enhanced ultrasound (CEUS) using an updated version of the 1-5 MHz (C1-5-D convex probe) and the 6-9 MHz probe (9L-D linear probe) as well as a matrix 6-15 MHz transducer (ML 6-15-D Matrix Array Linear Probe) and updated post-processing procedures to examine microvascularization of inflamed bowel wall in Crohn's disease (11 patients), ulcerative colitis (1 patient) and diverticulitis of the sigmoid colon (2 patients). Assessment of mural microvascularization was successful as well as identification of fistulas (2 patients) and covered perforation (1 patient).

Comparison between preoperative quantitative assessment of bowel wall vascularization by contrast-enhanced ultrasound and operative macroscopic findings and results of histopathological scoring in Crohn's disease.

Purpose: Patients with Crohn's disease (CD) often undergo several radiological imaging studies, which - with the exception of MRI and US - subject patients to ionizing radiation. Thus, efforts have been made to identify the inflammation activity using ultrasound techniques. The aim of our study was to describe the perfusion pattern of the inflamed bowel wall in CD using contrast-enhanced ultrasound (CEUS) and specific quantification software for perfusion assessment.

Sono-hepatic-arteriography (Sono-HA) in the assessment of hepatocellular carcinoma in patients undergoing transcatheter arterial chemoembolization (TACE).

Purpose: The aim of our study was to evaluate sono-hepatic-arteriography in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization.

Materials And Methods: We evaluated 15 patients with hepatocellular carcinoma undergoing TACE who presented in our institution from February 2006 to May 2008. All patients underwent a conventional B-mode ultrasound examination using a high-end machine and a multi-frequency transducer (2.

Semiquantitative characterization of hepatocellular carcinoma (HCC)--perfusion with contrast-enhanced ultrasound and perfusion analysis.

Background: At the moment, there is only poor specificity of HCC-detection in tumors smaller than 2 cm in a cirrhotic liver. Thus, efforts have to be made to optimize the distinction between regenerative nodules and HCC.

Aims: The aim of our study was to describe the particular perfusion pattern of hepatocellular carcinoma using a specific quantification software.

Quantitative assessment of bowel wall vascularisation in Crohn's disease with contrast-enhanced ultrasound and perfusion analysis.

Patients with inflammatory bowel disease (IBD) often undergo several radiologic imaging studies, which - with the exception of magnetic resonance imaging (MRI) and B-scan ultrasound (US) - subject patients to ionizing radiation. With contrast enhanced ultrasound microvascular imaging of the bowel is possible. Hence, the aim of our study was to assess the perfusion pattern of inflamed bowel walls in Crohn's disease compared with healthy volunteers quantitatively using a specific quantification software.

Transabdominal ultrasound with echoenhancement by contrast media in the diagnosis of hepatocellular carcinoma.

According to the European Association for the Study of the Liver (EASL) and the American Association for the Study of Liver Diseases (AASLD), ultrasound (US) is the recommended tool for surveillance of patients at risk of developing hepatocellular carcinoma (HCC). Larger HCCs can be diagnosed with a high accuracy by conventional US. However, the differentiation of smaller malignant lesions in cirrhotic livers can be improved by contrast-enhanced ultrasound (CEUS).

[Diagnostic and therapeutic consequences of abnormal ultrasound findings].

Background And Objective: The aim of this study was to evaluate the diagnostic and therapeutic consequences arising from abnormal ultrasound findings in a multidisciplinary setting in the University of Regensburg Clinical Centre.

Patients And Methods: The results of 1162 randomly selected ultrasound examinations (on 671 males and 491 females) from a total of 14,301 at an interdisciplinary ultrasound unit were analysed. The investigators recorded the findings in a routinely used standardized manner.

[Therapy and prevention of hyperthyroidism].

A decreased serum TSH level can be observed in more than 10% of the German population. Although treatment is not mandatory in each of these cases patients with an unrecognized autonomous thyroid dysfunction have a substantial risk of developing thyrotoxicosis when exposed to large amounts of iodine. Thionamid drugs in combination with potassium perchlorate are given for preventive and therapeutic reasons until definitive thyroidectomy or radioiodine therapy is performed.

Orofacial granulomatosis as initial manifestation of Crohn's disease: a report of two cases.

Patients with Crohn's disease generally present with chronic diarrhoea and/or abdominal pain. However, it may be the extraintestinal manifestations as orofacial granulomatosis (OFG)--a rare syndrome with chronic swelling of the lips and the lower half of the face combined with oral ulcerations and hyperplastic gingivitis--that urge patients to seek medical advice. We report two rare cases in which swelling of the lips and cheeks were the initial symptoms that finally led to the diagnosis of Crohn's disease.