Biomedical subjects

A Dirisamer

Publications and source records attributed to A Dirisamer.

9 recordsLinked to original sources

PubMed2003

[CT and MRI characteristics of tumours of the temporal bone and the cerebello-pontine angle].

Tumours lesions of the temporal bone and of the cerebello-pontine angle are rare. This tumours can be separated into benign and malignant lesions. In this paper the CT and MRI characteristics of tumours of the temporal bone and the cerebello-pontane angle will be demonstrated. High resolution CT (HRCT) as usually performed in the axial plane are using a high resolution bone window level setting, coronal planes are the reconstructed from the axial data set or will be obtained directly. With the MRI FLAIR sequence in the axial plane the whole brain will be scanned either to depict or exclude a tumour invasion into the brain. After this,T2-weighted fast spin echo sequences or fat suppressed inversion recovery sequences in high resolution technique in the axial plane will be obtained from the temporal bone and axial T1-weighted spin echo sequences before and after the intravenous application of contrast material will be obtained of this region. Finally T1-weighted spin echo sequences in high resolution technique with fat suppression after the intravenous application of contrast material will be performed in the coronal plane. HRCT and MRI are both used to depict the most exact tumorous borders. HRCT excellently depicts the osseous changes for example exostosis of the external auditory canal, while also with HRCT osseous changes maybe characterized into more benign or malignant types. MRI has a very high soft tissue contrast and may therefore either characterize vascular space-occupying lesions for example glomus jugulare tumours or may differentiate between more benign or malignant lesions. In conclusion HRCT and MRI of the temporal bone are excellent methods to depict and mostly characterize tumour lesions and can help to differentiate between benign and malignant lesion. These imaging methods shall be used complementary and may have a great impact for the therapeutic planning.

Adenocarcinoma↗

PubMed2003

Head and neck imaging with MDCT.

Multi-slice CT (MDCT) is rapidly becoming the new standard in radiological imaging. Although its advantages in cardiovascular, thoracic and abdominal imaging are evident, the extent of its usefulness for imaging the head and neck has yet to be clarified. Because of the shorter examination time motion artifacts are reduced, phonation-studies are possible. Due to the thin-slicing and nearly isotropic multiplanar reconstruction (MPR) examination in only one plane is necessary, saving both time and radiation exposure. The shorter examination requires the use of higher concentrated contrast medium (400 mg of iodine/ml). The use of such a contrast medium produces a higher degree of contrast enhancement and provides a 5-10% higher contrast between the surrounding normal and pathological tissue, but is more time critical. MPRs are easily done in any plane within seconds and enables also three-dimensional visualization, what helps in the use of minimal invasive therapy, training and teaching and provides a way of handling the hundreds of images acquired during scanning.

Carcinoma, Squamous Cell↗

PubMed2003

Feasibility study of NeoMend, a percutaneous arterial closure device that uses a nonthrombogenic bioadhesive.

OBJECTIVE: The aim of this prospective single-center phase I feasibility study was to investigate the safety and efficacy of a novel vascular sealing device, the NeoMend Arterial Closure Device, that uses a bioadhesive after percutaneous endovascular procedures. SUBJECTS AND METHODS: In 26 consecutive patients, the sealing device was deployed at the femoral artery access site immediately after a catheterization procedure using a 6-French (1.91-mm) sheath. Patients were followed up at 24 hr with Doppler sonography of the treated femoral artery puncture site, and at 1 week and 1 month by a telephone interview. RESULTS: Successful hemostasis was achieved with the NeoMend Arterial Closure Device in 21 (88%) of 24 patients. One major complication required surgery: formation of puncture site hematoma and pseudoaneurysm 3 days after the intervention after successful primary hemostasis. Two device failures required crossover to manual compression, which was done without further complications. The mean time to hemostasis was 7.0 +/- 4.5 min. Mean time to ambulation was 6.0 hr. At follow-up, the patients did not report any puncture-site-related complaints. Doppler sonography of the puncture sites revealed three insignificant hematomas of less than 20 mL and patent common femoral vessels without stenoses. CONCLUSION: The NeoMend Arterial Closure Device appears to achieve rapid hemostasis with the potential of early ambulation after arterial punctures with a 6-French sheath. The device is an alternative in situations in which suture- or collagen-mediated devices show high complication rates.

Adult↗

PubMed2002

[Change in process management by implementing RIS, PACS and flat-panel detectors].

Implementation of radiological information systems (RIS) and picture archiving and communicating systems (PACS) results in significant changes of workflow in a radiological department. Additional connection with flat-panel detectors leads to a shortening of the work process. RIS and PACS implementation alone reduces the complete workflow by 21-80%. With flatpanel technology the image production process is further shortened by 25-30%. The workflow-steps are changed from original 17-12 with the implementation of RIS and PACS and to 5 with the integrated use of flatpanels. This clearly recognizable advantages in the workflow need an according financial investment. Several studies could show that the capitalisation-factor calculated over eight years is positive, with a gain range between 5-25%. Whether the additional implementation of flatpanel detectors results also in a positive capitalisation over the years, cannot be estimated exactly, at the moment, because the experiences are too short. Particularly critical are the interfaces, which needs a constant quality control. Our flatpanel detector-system is fixed, special images--as we have them in about 3-5% of all cases--need still conventional filmscreen or phosphorplate-systems. Full-spine and long-leg examinations cannot be performed with sufficient exactness. Without any questions implementation of integrated RIS, PACS and flatpanel detector-system needs excellent training of the employees, because of the changes in workflow etc. The main profits of such an integrated implementation are an increase in quality in image and report datas, easier handling--there are almost no more cassettes necessary--and excessive shortening of workflow.

Austria↗

PubMed2002

[Apophyseal damage in adolescent athlete].

The increasing demands on the adolescent athlete in high performance sports puts high biomechanical stress on the growing structures of the active and passive locomotor system. The "growing factor" itself increases stretching forces on tendon insertions, which are often overloaded when a physical demanding sport is performed additionally. The apophysis is an ossification nucleus near the tendon insertion, which appears before the growing age resumes and these apophysis finally fuses with the adjacent bone. The tensile forces from vigorous sports activity leads to a chronic or acute avulsion of the ossifying tendon insertion. The radiological appearance of this apophyseal damage with ossification and osteolytic processes is sometimes difficult with respect to differential diagnoses. Apophyseal impairment is associated with pain, tenderness to palpation and decreased muscle function. If it is not diagnosed and treated properly it can lead to end of career in many adolescent athletes.

Adolescent↗

PubMed2002

Prostanoids in the treatment of intermittent claudication--a meta-analysis.

BACKGROUND: Numerous studies have established the efficacy of prostanoids in PAD stages III and IV, but the role of prostanoids as an alternative or additive treatment in patients suffering from PAD II is less clear. To resolve this uncertainty we performed a meta-analysis of all randomised controlled studies analysing effects of prostanoids in patients suffering from intermittent claudication. METHODS: 96 studies have been screened by computerised searches of MEDLINE and EMBASE. Relevant studies were pooled in Cochrane's Review-manager 4.1. RESULTS: 19 studies were included for further analysis. Five studies could not be pooled for analysing walking distances, because standard deviations were not stated. Eight studies compared effects of any prostanoid i.v. vs. placebo. In total 557 patients (281/276) were included for analysis of painfree--walking distance (PFWD) and 519 patients (262/257) for analysis of maximum walking distance (MWD). Prostanoids compared to placebo significantly improved mean PFWD by 28% (7%-49%, P = 0.008) and mean MWD by 30% (11%-50%, P = 0.002). At least one adverse reaction was reported from 39.6% of the patients treated with prostacyclin and its analogues and from 13.7% of the patients treated with prostaglandin E1. CONCLUSION: Patients suffering from intermittent claudication benefit from administration of prostaglandin E1 by a significant improvement of their walking capacity.

Arterial Occlusive Diseases↗

PubMed2002

[The role of chest X-rays in the diagnosis of thoracic aortic aneurysms].

OBJECTIVE: To evaluate the role of routine chest radiographs in the diagnosis of thoracic aortic aneurysms (TAA). METHODS: An electronic full-text search was performed in our radiological information system for all patients who underwent chest radiograph under standard conditions between 1998 and 2000 and who had suspected widening or aneurysm of the thoracic aorta as a diagnosis. Computed tomography (CT) of the thorax was used as the gold standard and had to be performed within a period of 30 days. Two independent and blinded observers evaluated different morphologic and morphometric parameters in the diagnosis and correlated the results with those of CT. RESULTS: 28 patients were included in the present trial. With almost perfect interobserver correlation (r = 0.95) both investigated morphometric parameters correlated well (r = 0.85 and 0.83) with the diameter of the aorta as evaluated with CT. While a low subjective over-all probability for TAA had a negative predictive value of 100 %, we found that, despite an almost perfect interobserver variability (Kappa > 0.8), none of the investigated morphologic parameters (discrepancy between the ascending and descending aorta, displacement of the trachea to the right and caudal displacement of the left main bronchus) was significantly correlated with the final diagnosis. CONCLUSION: The investigated morphometric parameters help to estimate the diameter of the aorta in the arch and in the descending section, but none of the morphologic criteria can be used for the diagnosis of TAA.

Aortic Aneurysm, Thoracic↗

PubMed2002

Lipoprotein(a) as a potent risk indicator for early cardiovascular disease.

AIM: Elevated levels of lipoprotein (a) [Lp(a)] are associated with increased cardiovascular risk in adults. It is not known whether Lp(a) elevation can be regarded as an additional risk factor even in children and adolescents. Therefore the purpose of this study was to compare the serum concentrations, distribution and frequency of Lp(a) and lipids of children and adolescents with premature parental and/or grandparental cardiovascular disease (CVD) with controls. METHODS: 103 children and adolescents, aged 6-18 y, from families with premature CVD in a parent and/or grandparent, i.e. before the age of 55 y, and 103 controls were estimated for lipids and Lp(a). RESULTS: Mean levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and Lp(a) were significantly higher in the risk than in the control group. Median Lp(a) levels were 20 (10-61.5) mg dl(-1) in the risk subjects, and 15 (6-26.5) mg dl(-1) in the control subjects (p = 0.005). Mean TC and LDL-C concentrations of the risk group compared with the control group were 211 mg dl(-1) (5.5 mmoll(-1)) versus 165mg dl(-1) (4.3mmol l(-1)) (p < 0.0001), and 140 mg dl(-1) (3.6 mmol l(-1)) versus 101 mg dl(-1) (2.6 mmol l(-1)) (p < 0.0001), respectively. CONCLUSION: It may be important to estimate plasma Lp(a) levels in progeny with a familial history of premature CVD, because it seems possible to identify those subjects who are at greater risk for later CVD either with or without elevated LDL-C levels.

Adolescent↗

PubMed2002

[Temporary and permanent vena cava filter for prevention of pulmonary embolism].

Inferior vena cava filters have been used for prophylaxis of pulmonary embolism since the end of the sixties. Complication rates depend on the types of filters used and are reported to be 2% with the Guenther-Filter and 21% with the Titanium-Greenfield-Filter. Depending on the exact indication both filter types are useful instruments for the prevention of pulmonary embolism.

Equipment Design↗