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2024 03 02

Hemodynamic Consequences of Pre-and Retroaortic Left Renal Vein Compression(„Nutcracker Syndrome“)  Causing a Surprising Variety of Symptoms and  Complaints, Especially in Patients Affected by Hypermobility Spectrum Disorders

Our talk at the American Venous Forum,  Tampa USA, March 2024

2024 01 20

A rare variant of Wilkie syndrome

(published on 20.01.2024 on the 41st birthday of Prof. Dr. rer. nat. Jakob Scholbach, who developed the first version of the PixelFlux software as a pupil at the Ostwald-Gymnasium in Leipzig)

2024 01 19

The problem of angle measurement in Wilkie syndrome

2024 01 17

PixelFlux is the most sensitive parameter to detect COVID related damage of the microvessels:

Effect of Respiratory Failure on Peripheral and Organ Perfusion Markers in Severe COVID-19: A Prospective Cohort Study

Our results show a significant association between the severity of respiratory failure and the impairment of peripheral and organ perfusion, which seems to be consistent with the pathophysiology of the development of ARDS. The usefulness of DTPM developed by Scholbach was investigated in many clinical applications [39,40,41,43,44]. Lubas et al. proved its usefulness in the assessment of renal perfusion among patients with hypertension and glomerulonephritis. However, DTPM was never investigated in ARDS or septic patients.

“revealed that the RCP [ PixelFlux measurements of renal cortical perfusion (inserted by Th. Scholbach) was the best independent parameter associated with the Oxygenation Ratio (R2 = 0.120; p < 0.001) (Table 7).”

“In the presented study, impaired kidney perfusion (RCP) correlates with the deterioration of gas exchange (Oxygenation Ratio; p < 0.000035 and CT score; p = 0.01).

Moreover, statistically significant associations concerning the relationship between the severity of ARDS and renal cortex perfusion, RCP, (p < 0.0001) were revealed. Nevertheless, according to the stepwise retrograde multivariable regression analysis, RCP was the best independent parameter linked to the Oxygenation Ratio.
Our results also show a correlation between the RCP and urea concentration (p = 0.031), which is consistent with the view of reduced renal flow and impaired renal function in sepsis [41,58]. Existing studies show a decrease in the blood flow through the cortex and medulla of the kidneys in patients with severe COVID-19, visible on magnetic resonance imaging [61].”
“It turns out that the peripheral perfusion parameters FIT (p = 0.038), CRT (p < 0.0006), RCP (p < 0.0002)[the best correlation of all parameters! – inserted by Th.Scholbach], and saturation (p = 0.0021) are better related to the severity of gas exchange than the pressure assessment, MAP, SBP, and DBP (p = 0.683, p = 0.718, and p = 0.474, respectively) (Table 5).”

“only renal cortex perfusion (RCP) was substantially correlated with the CT score (p < 0.010) …(CT score—based on Computer Tomography lung involvement severity score).”

“Dear Professor Scholbach,

…Your brilliant software still works! 😊

Kind regards,

Arkadiusz Lubas”

2024 01 17

Restless legs-a little known symptom of abdominal vascular compression syndromes

2024 01 13

POTS – different from what you might think: an example

2024 01 05

Functional criteria for evaluation and treatment of POTS, neurological and pelvic symptoms in venous compression syndromes

2023 12 23

Why the diagnosis of a psychosomatic illness is often a misdiagnosis

2023 12 15

Our chapter

appeared in

2023 11 30

Diaphragmatic compression of the liver veins with hepatic and intestinalis congestion

2023 11 30

I proudly annonce the first method ever for a  4D – blood flow volume measurement

2023 11 11

This paper: Non-Contrast Ultrasound Image Analysis for Spatial and Temporal Distribution of Blood Flow After Spinal Cord Injury (issued 09 Oct, 2023) confirms that the PixelFlux algorithm measuring area related blood flow intenity  is the most sensitive ultrasound parameter to describe spinal cord perfusion.

2023 10 27

Postural tachycardia syndrome (POTS) – the hemodynamic consequence of vascular compression syndromes and loose connective tissue

2023 10 26

Migraines may develop in the wake of vascular compression syndromes

2023 10 26

Researchers from the prestigious Harvard University publish the first paper on the application of our PixelFlux-software in stomatology!

Doppler ultrasonographic evaluation of tissue revascularization following connective tissue graft at implant sites

PixelFlux has proven its usefulness in diagnosing stomatological issues after teeth implantation.

After my congratulation the author wrote:

“Your software is truly amazing. Thank you for this amazing contribution you gave to science

Lorenzo”

 

2023 09  26

Posture dependent unbearable breathlessness and fullness in the right upper abdomen due to a variable diaphragmatic compression of the hepatic veins and the vena cava inferior

2023 09 23

Our contribution to the  American Venous Forum in Tampa, USA 3.-6. March 2024

Hemodynamic Consequences of pre-and retroaortic left renal vein Compression - Venous Forum Tampa USA March 3-6 2024

 

My talks at the Annual German Angiological Conference in Leipzig 21.- 23.10.2023

52. Jahrestagung der Deutschen Gesellschaft für Angiologie – Gesellschaft für Gefäßmedizin e. V.

here search for “Scholbach”

Venous stenting of abdominal compression syndromes (ACS)- basically not a good idea  –  slightly extended talk at the DGA Conference 2023 in Leipzig

The lordogenetic midline syndrome – pathophysiology, diagnosis and treatment – talk at the DGA Conference 2023 in Leipzig

 

2023 08 08

Posture dependent left flank / thoracic / lumbar pain – a new compression syndrome I recently detected

 

2023 07 07

Genital and sexual symptoms of vascular compression syndromes – patient with ulcer of labia minora

 

2023 07 05

Abdominal pain due to liver compression in slipping rib syndrome in an EDS patient

 

2023 06 05

Commissioning of the new ultrasound system Philips Epiq Elite with 4D color cardiac and abdominal Doppler

2023 06 15

Gradually increasing, unbearable pain in the left flank only when standing or sitting – first description of a new compression syndrome

 

2023 06 08

Unbearable abdominal pain only while standing – easily diagnosed with PixelFlux

 

 

2023 05 07

Downloadable excerpt of my diagnostic spectrum

Excerpt from my diagnostic spectrum

2023 03 30

Our paper

Surgical treatment of abdominal compression syndromes: The significance of hypermobility-related disorders

was among the most downloaded ones in the American Journal of Medical Genetics

I’m deeply thankful to my senior coauthor Professor Wilhelm Sandmann and coauthor Konstantinos Verginis and daily many hundreds of readers of my website

2023 03 22

The first paper comparing PixelFlux and conventional Doppler flow volume measurements of the portal vein show promising results with

apparently higher sensitivity of PixelFlux (left) for postprandial volume flow changes

Quantification of Portal Vein Vascularization Using an Automated PostProcessing Video Analysis Tool

 

 

2023 03 11

Debilitating neurologic disease successfully treated by decompression of the left renal and left common iliac vein in a young woman with massive ataxia due to venous congestion of the spinal cord via a tronc réno-rachidièn rendering her wheel-chair bound

Neurological consequences of the spinal congestion in midline congestion syndrome 

Overview of the tronc réno-rachidièn – a widely unknown connection of the left renal vein with the spinal canal of utmost importance

 

2023 02 16

Our contribution to the American Venous Forum 22-25.02.2023 San Antonio, Texas /USA : “Nutcracker and May-Thurner syndrome: Decompression by extra venous tube grafting and significance of hypermobility related disorders” Sandmann /Scholbach/Jacobi

 

 

2022 09 23

Postprandiale Schmerzen im rechten Oberbauch aufgrund eines von mir  neu entdeckten Kompressionssyndroms der rechten Nierenvene

die rechtsseitige Rückenschmerzen und Schmerzen im rechten Ober- oder Mittelbauch verursachen

Zwerchfellkompression der Lebervenen – ein neues Kompressionssyndrom

verursacht intermittierende Schwellungen der Leber, Völlegefühl und Schmerzen im rechten Oberbauch

 

2022 09 11

Entdeckung eines neuen Kompressionssyndroms: Bilaterale Kompression der Vena iliaca interna zwischen dem Psoas-Muskel und der Arteria iliaca interna bei einem Patienten mit chronischen  Penisschmerzen

Liste der Genitalsymptome bei Kompressionssyndromen in “Checkliste” eingefügt

 

2022 05 09

PixelFlux is recommended in diagnosis of Carpal Tunnel syndrome

chart from the above mentioned paper; inset by Thomas Scholbach

The authors refer to a very positive review of PixelFlux in the World Journal of Radiology 2020

” Interestingly, in the haemodialysis cohort, blood flow measurements were significantly improved after dialysis, suggesting that this measure may have future utility as a biomarker of both disease severity and treatment response[50]. Carroll AS, Simon NG. Current and future applications of ultrasound imaging in peripheral nerve disorders. World J Radiol 2020; 12(6): 101-129 [PMID: 32742576 DOI: 10.4329/wjr.v12.i6.101]”

2022 05 05

Project “International scholarship for quantitative functional color Doppler ultrasound training”

 

2022 04 10

Example of failed renal autotransplantation in left renal vein compression – the reasons why

 

2022 04 02

Addition to Wilkie syndrome page with example videos of patients with apparent duodenal compression that can be confidently classified as normal findings by functional sonography

 

2022 02 19

I now offer my papers for download for personal non-commercial use

Papers authored by others: by clicking this button I declare the only non-commercial use of this download

 

2022 02 15 (On occasion of the 88th birthday  – 15.02.1934 – of my mother

Dr. med. Lilli Scholbach – ophthalmologist til her 75th birthday)

 

PixelFlux discriminates diabetic neuropathy in patients with chronic renal failure

Peripheral nerve morphology and intraneural blood flow in chronic kidney disease with and without diabetes

T Issar, S Walker, R Arnold, AM Poynten, ZH Endre… – Muscle & Nerve

 

2022 01 20 ( On occasion of the 39th birthday of my son Prof. Dr. rer. nat. Jakob Scholbach, developer of PixelFlux-software)

Under false flag – the so-called nutcracker syndrome Journal: Vascular Surgery

 

2022 01 04

Massive hematuria never in the morning but always in the evening – only PixelFlux knows the answer

 

2022 01 01 ( for the birthday of my great-grandfather Traugott Scholbach 01.01.1866 – 31.05.1942)

I added a search line on the top of all webpages – hoping to provide you more focused information from the dispersed and steadily growing content 🙂

 

2021 12 29

PixelFlux demonstrates rapid post-dialysis improvement of peripheral nerve perfusion ( BORIRE et al. Prince of Wales Clinical School, University of New South Wales, Sydney, Australia)  :

“… we have shown that peripheral nerve hypervascularity is demonstrable in ESKD patients and rapidly improves following a single session of dialysis. Increased INBF is more likely to be seen in nerves of patients with evidence of axonal loss and moderate to severe neuropathy, suggesting that it may be a potential marker of neuropathy severity.

PixelFlux has significantly higher intra- and interobserver reliability than traditional methods to evaluate intraneural blood flow in carpal tunnel syndrome ( BORIRE et al. Prince of Wales Clinical School, University of New South Wales, Sydney, Australia)

PixelFlux perfusion measurements in peripheral diabetic nerves correlate significantly with the severity of diabetic neuropathy ( BORIRE et al. Prince of Wales Clinical School, University of New South Wales, Sydney, Australia)

 

2021 12 28

Our contributions at the EDS ECHO SUMMIT – Scientific Meeting on EDS, HSD, & Comorbidities October 2020

THE SURPRISING FREQUENCY OF HYPERMOBILE EHLERS-DANLOS (hEDS) AMONG PATIENTS WITH ABDOMINAL AND PELVIC COMPRESSION SYNDROMES (APCS) by W. Sandmann , K. Verginis, S. Jacobi, and T. Scholbach

Hyper-elastic fibrous tissue disorder is a risk factor for development of multiple retroperitoneal and pelvic compression syndromes and for recurrences after surgery by W. Sandmann , K. Verginis, S. Jacobi, and T. Scholbach

EDS COMPLICATED BY SEVERE SCOLIOSIS AND THREE RETROPERITONEAL AND PELVIC
COMPRESSION SYNDROMES (RPCS) by W. Sandmann , K. Verginis, S. Jacobi, and T. Scholbach

PixelFlux makes the antihypertensive treatment effect on renal perfusion measurable

PixelFlux directly demonstrating influence of thyroid hormone level on renal blood flow

 

2021 12 14

New paper published underscoring the usefulness of PixelFlux measurements in malignant diseases of the pancreas

Dynamic Doppler Ultrasound Assessment of Tissue Perfusion Is a Better Tool than a Single Vessel Doppler Examination in Differentiating Malignant and Inflammatory Pancreatic Lesions

 

2021 11 26

Multiple severe compression syndromes and post-operative vomiting and pain – the necessity of a postop PixelFlux exam of all relevant organs

 

2021 11 07

We published (on the 124. birthday of my grandfather Max Scholbach :-)):

REVIEW ARTICLE

Surgical treatment of abdominal compression syndromes: The significance of hypermobility-related disorders

Papers authored by others: by clicking this button I declare the only non-commercial use of this download

 

2021 10 22

A left renal vein stent – reducing one compression – creating three new ones

 

2021 09 11

Bending of a straight vein compels its narrowing

English version : Lordosis /hollow back – cause of numerous abdominal compression syndromes.

Muscle cramps caused by a posture dependent pubic compression of the femoral artery

Update: Ehlers Danlos-syndrome the flashing redlight of vascular compressions

 

2021 08 20

I linked the audio version of my talk ” The Nutcracker syndrome is a misnomer ” to the following page

The Nutcracker Syndrome is a misnomer Euroson September 2018

An audio version of this talk can be found her

 

2021 08 18

Outline of my special examination technique for patients with connective tissue disorders  -see last part of the English version of

Ehlers Danlos-syndrome the flashing redlight of vascular compressions

 

2021 07 16

Swollen bluish feet nausea unbearable epigastric and breast pain breathlessness

Unbearable breast pain while sitting

 

2021 06 14

Genitalschmerzen beim Sitzen  – manchmal Pudendusneuralgie – hier lange unentdeckte subakute Bartholinitis bei hypermobiles Ehlers-Danlos-Syndrom und multiplen Kompressionssyndromen – Diagnose durch PixelFlux

 

2021 02 05

Why I prefer not to publish in journals but in the Internet

Vessel stretching in nephroptosis – an important driver of complaints2023 01 09

An important paper on headaches as a patient’s only symptom that could be traced back to left renal vein compression was published recently. To my great joy this work was stimulated by my paper “From the nutcracker-phenomenon of the left renal vein to the midline congestion syndrome as a cause of migraine, headache, back and abdominal pain and functional disorders of pelvic organs” :

Nutcracker phenomenon with a daily persistent headache as the primary symptom: Case series and a proposed pathogenesis model based on a novel MRI technique to evaluate for spinal epidural venous congestion

2022 11 03

A new color Doppler sonographic sign of venous pooling in patients with severe orthostatic intolerance

2022 09 23

Post-prandial pain in the right upper abdomen due to a newly detected compression syndrome of the right renal vein

causing right sided back pain and pain in the right upper or mid-abdomen

Diaphragmatic compression of the hepatic veins – a novel compression syndrome

causing intermittent swelling of the liver, fullness and pain in the right upper abdomen

2022 09 11

Detection of a new compression syndrome : Bilateral compression of the internal iliac vein between the psoas muscle and the internal iliac artery in a patient with penile pain

List of genital symptoms in compression syndromes inserted in “Checklist”

 

2022 05 09

PixelFlux is recommended in diagnosis of Carpal Tunnel syndrome

chart from the above mentioned paper; inset by Thomas Scholbach

The authors refer to a very positive review of PixelFlux in the World Journal of Radiology 2020

” Interestingly, in the haemodialysis cohort, blood flow measurements were significantly improved after dialysis, suggesting that this measure may have future utility as a biomarker of both disease severity and treatment response[50]. Carroll AS, Simon NG. Current and future applications of ultrasound imaging in peripheral nerve disorders. World J Radiol 2020; 12(6): 101-129 [PMID: 32742576 DOI: 10.4329/wjr.v12.i6.101]”

2022 05 05

Project “International scholarship for quantitative functional color Doppler ultrasound training”

 

2022 04 10

Example of failed renal autotransplantation in left renal vein compression – the reasons why

 

2022 04 02

Addition to Wilkie syndrome page with example videos of patients with apparent duodenal compression that can be confidently classified as normal findings by functional sonography

 

2022 02 19

I now offer my papers for download for personal non-commercial use

Papers authored by others: by clicking this button I declare the only non-commercial use of this download

 

2022 02 15 (On occasion of the 88th birthday  – 15.02.1934 – of my mother

Dr. med. Lilli Scholbach – ophthalmologist til her 75th birthday)

 

PixelFlux discriminates diabetic neuropathy in patients with chronic renal failure

Peripheral nerve morphology and intraneural blood flow in chronic kidney disease with and without diabetes

T Issar, S Walker, R Arnold, AM Poynten, ZH Endre… – Muscle & Nerve

 

2022 01 20 ( On occasion of the 39th birthday of my son Prof. Dr. rer. nat. Jakob Scholbach, developer of PixelFlux-software)

Under false flag – the so-called nutcracker syndrome Journal: Vascular Surgery

 

2022 01 04

Massive hematuria never in the morning but always in the evening – only PixelFlux knows the answer

 

2022 01 01 ( for the birthday of my great-grandfather Traugott Scholbach 01.01.1866 – 31.05.1942)

I added a search line on the top of all webpages – hoping to provide you more focused information from the dispersed and steadily growing content 🙂

 

2021 12 29

PixelFlux demonstrates rapid post-dialysis improvement of peripheral nerve perfusion ( BORIRE et al. Prince of Wales Clinical School, University of New South Wales, Sydney, Australia)  :

“… we have shown that peripheral nerve hypervascularity is demonstrable in ESKD patients and rapidly improves following a single session of dialysis. Increased INBF is more likely to be seen in nerves of patients with evidence of axonal loss and moderate to severe neuropathy, suggesting that it may be a potential marker of neuropathy severity.

PixelFlux has significantly higher intra- and interobserver reliability than traditional methods to evaluate intraneural blood flow in carpal tunnel syndrome ( BORIRE et al. Prince of Wales Clinical School, University of New South Wales, Sydney, Australia)

PixelFlux perfusion measurements in peripheral diabetic nerves correlate significantly with the severity of diabetic neuropathy ( BORIRE et al. Prince of Wales Clinical School, University of New South Wales, Sydney, Australia)

 

2021 12 28

Our contributions at the EDS ECHO SUMMIT – Scientific Meeting on EDS, HSD, & Comorbidities October 2020

THE SURPRISING FREQUENCY OF HYPERMOBILE EHLERS-DANLOS (hEDS) AMONG PATIENTS WITH ABDOMINAL AND PELVIC COMPRESSION SYNDROMES (APCS) by W. Sandmann , K. Verginis, S. Jacobi, and T. Scholbach

Hyper-elastic fibrous tissue disorder is a risk factor for development of multiple retroperitoneal and pelvic compression syndromes and for recurrences after surgery by W. Sandmann , K. Verginis, S. Jacobi, and T. Scholbach

EDS COMPLICATED BY SEVERE SCOLIOSIS AND THREE RETROPERITONEAL AND PELVIC
COMPRESSION SYNDROMES (RPCS) by W. Sandmann , K. Verginis, S. Jacobi, and T. Scholbach

PixelFlux makes the antihypertensive treatment effect on renal perfusion measurable

PixelFlux directly demonstrating influence of thyroid hormone level on renal blood flow

 

2021 12 14

New paper published underscoring the usefulness of PixelFlux measurements in malignant diseases of the pancreas

Dynamic Doppler Ultrasound Assessment of Tissue Perfusion Is a Better Tool than a Single Vessel Doppler Examination in Differentiating Malignant and Inflammatory Pancreatic Lesions

 

2021 11 26

Multiple severe compression syndromes and post-operative vomiting and pain – the necessity of a postop PixelFlux exam of all relevant organs

 

2021 11 07

We published (on the 124. birthday of my grandfather Max Scholbach :-)):

REVIEW ARTICLE

Surgical treatment of abdominal compression syndromes: The significance of hypermobility-related disorders

Papers authored by others: by clicking this button I declare the only non-commercial use of this download

 

2021 10 22

A left renal vein stent – reducing one compression – creating three new ones

 

2021 09 11

Bending of a straight vein compels its narrowing

English version : Lordosis /hollow back – cause of numerous abdominal compression syndromes.

Muscle cramps caused by a posture dependent pubic compression of the femoral artery

Update: Ehlers Danlos-syndrome the flashing redlight of vascular compressions

 

2021 08 20

I linked the audio version of my talk ” The Nutcracker syndrome is a misnomer ” to the following page

The Nutcracker Syndrome is a misnomer Euroson September 2018

An audio version of this talk can be found her

 

2021 08 18

Outline of my special examination technique for patients with connective tissue disorders  -see last part of the English version of

Ehlers Danlos-syndrome the flashing redlight of vascular compressions

 

2021 07 16

Swollen bluish feet nausea unbearable epigastric and breast pain breathlessness

Unbearable breast pain while sitting

 

2021 06 14

Genitalschmerzen beim Sitzen  – manchmal Pudendusneuralgie – hier lange unentdeckte subakute Bartholinitis bei hypermobiles Ehlers-Danlos-Syndrom und multiplen Kompressionssyndromen – Diagnose durch PixelFlux

 

2021 02 05

Why I prefer not to publish in journals but in the Internet

Vessel stretching in nephroptosis – an important driver of complaints

 

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