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Biomedical subjects

A L Wagner

Publications and source records attributed to A L Wagner.

At least 19 recordsLinked to original sources
PubMed2006

Refracture with cement extrusion following percutaneous vertebroplasty of a large interbody cleft.

We present a case report of a patient on long-term dialysis who underwent percutaneous vertebroplasty to treat a painful intrabody vertebral cleft and who subsequently experienced a refracture of the posterior portion of the same vertebral body, resulting in anterior displacement of the cement through the anterior cortex. The case raises the question whether, in some patients, the marrow space should be filled with cement in addition to the cleft.

Aged↗
PubMed2001

Outcome comparison of patients receiving oral or depot neuroleptic medication.

Three outcome measures of psychiatric treatment were retrospectively compared between two groups of acutely hospitalized psychotic patients who had been prescribed either oral haloperidol (n = 58) or depot haloperidol (n = 95) as the only medication at the time of discharge. There were no significant differences between the groups on demographic variables, including sex, age, and ethnicity. There were no significant differences between the groups on keeping the initial outpatient appointment, in readmission history over a 4-yr. follow-up, or in length of time to subsequent readmission, if any. It appears that there is no benefit in choosing one form of medication over the other from a clinical perspective, as neither appears more clinically efficacious when examined on these outcome variables. However, there is a significant difference in cost of the two forms of the medication in favor of the oral form, making the oral form more favorable if cost is to be minimized.

Administration, Oral↗
PubMed2001

Isolated stenosis of a persistent hypoglossal artery visualized at 3D CT angiography.

The persistent hypoglossal artery is a rare perseverance of an embryonic vessel connecting the anterior and posterior circulations and is generally considered to be an incidental finding. This is a case of a patient with an atherosclerotic narrowing at the origin of the persistent hypoglossal artery seen at 3D CT angiography. The pertinent findings and clinical implications of this anomalous vessel are discussed.

Aged↗
PubMed2000

Relationship of Schmorl's nodes to vertebral body endplate fractures and acute endplate disk extrusions.

BACKGROUND AND PURPOSE: Literature regarding clinical pain syndromes associated with acute, traumatic Schmorl's nodes (SNs) is limited. Our purpose was to determine whether an SN could be related to a previous traumatic event producing either acute SN or a vertebral endplate fracture. METHODS: Two neuroradiologists independently reviewed initial and follow-up MR examinations of 14 patients with a clinical diagnosis of acute, symptomatic thoracolumbar SNs or vertebral body endplate fractures that evolved into SNs to evaluate marrow edema, signal intensity, margin definition, presence of intravertebral extruded disk material, and pattern of contrast enhancement. RESULTS: Edema of the affected vertebral body, adjacent to an endplate without wedging or collapse, was observed on the initial MR images in all cases. The initial MR images of six (43%) of 14 patients exhibited only edema of the marrow immediately adjacent to the endplate without wedging or collapse. The MR images obtained at the time of follow-up showed subsequent formation of a chronic and eventually asymptomatic SN for all six patients. The initial MR images of eight (57%) of the 14 patients showed the typical appearance of acute SNs with marrow edema of the affected vertebra. The contrast-enhanced images of three patients manifested enhancement of the invaginated disk material in three (100%) of three cases and enhancement of the surrounding vertebral body in one case (33%). Six (43%) of 14 patients had acute typical compression fracture of a vertebral body of at least one additional level. CONCLUSION: Most (57%) of the SNs in this series could be traced to episodes of significant, sudden-onset, localized, nonradiating back pain and tenderness for which the MR images showed SNs surrounded by vertebral body marrow edema. The remaining SNs (43%) were not immediately apparent as SNs and manifested only as vertebral body edema representing endplate fracture but did evolve into classical chronic SNs that follow-up imaging revealed.

Acute Disease↗
PubMed1998

Radiologic manifestations of round pneumonia in adults.

Round pneumonia, a benign cause of coin lesions seen on chest radiography, can often be difficult to distinguish from bronchogenic carcinoma. Although relatively uncommon in adults, this entity will probably be seen in most radiology practices and may lead to CT and biopsy. Because round pneumonia is easily treated with antibiotics, this diagnosis should be considered in all patients with a coin lesion, keeping in mind that bronchogenic carcinoma is much more frequent. A recent chest radiograph with normal findings or a history of cough and fever can aid in the diagnosis. A trial of antibiotics followed by a second chest radiograph in 2-3 weeks may be indicated in symptomatic or younger patients but should be considered in all patients with a solitary pulmonary nodule, because round pneumonia can occur in patients of any age and may be clinically silent. Any patient with a pulmonary nodule that does not decrease in size or resolution after antibiotic treatment should be further assessed with bronchoscopy, transthoracic needle biopsy, or other diagnostic procedures.

Adult↗
PubMed1997

Indocyanine green videoangiography of hemorrhagic retinal arterial macroaneurysms.

We examined 3 patients with isolated retinal macroaneurysms and secondary hemorrhage by standard fluorescein angiography (FA) and indocyanine green (ICG) angiography. In contrast to standard FA, ICG videoangiography clearly demonstrated the lesion to be pulsatile, contiguous with the arterial wall and pathognomonic of an isolated retinal artery macroaneurysm. ICG with its absorption and emission peak in the near-infrared range penetrates hemorrhage to a greater degree than does blue or green light of conventional FA. ICG can be essential in delineating the specific cause of the bleeding and allow the physician to choose the correct specific form of treatment needed.

Aged↗
PubMed1997

Measurement of the normal optic chiasm on coronal MR images.

PURPOSE: To develop an objective method for measuring the optic chiasm and to document its normal range in size. METHODS: Measurements of the height and area of the optic chiasm, made on coronal T1-weighted MR images with the use of commercially available region-of-interest software, were obtained in 114 healthy subjects who had a total of 123 MR studies. A normal range and standard deviation were calculated, and the information was broken down by age and sex. RESULTS: The mean area of the optic chiasm was 43.7 mm2, with a standard deviation of 5.21. The mean width was 14.0 mm, with a standard deviation of 1.68. CONCLUSION: The area and width of the optic chiasm can be measured with the use of commercially available software, which allows an objective estimate of the chiasm's size. Knowledge of the normal size range of the optic chiasm can be helpful in the early detection of some disorders.

Adolescent↗
PubMed1993

Can the Yale-Brown Obsessive Compulsive Scale be used to assess trichotillomania? A preliminary report.

Given recent conceptualizations of trichotillomania (TM) as a variant of obsessive compulsive disorder (OCD), clinician-rated measures of obsessive compulsive symptoms have been adapted for use in the assessment of TM. Although the reliability and validity of these instruments have been well-documented in patients with OCD, psychometric properties have not been examined systematically in patients with TM. Here, we evaluate the reliability and validity of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) in a sample of 11 patients with a primary diagnosis of TM. Data addressed the utility of the Y-BOCS for evaluating symptoms of TM, and provided information regarding the proposed overlap between OCD and TM. Initial analyses suggested that interrater reliability, internal consistency, and test-retest reliability for the total score were adequate. However, the range of scores was somewhat restricted, and suggested in particular that interference in daily functioning from TM symptoms is quite low. Both internal consistency and test-retest reliability for the Target Behaviors subscale were inadequate, suggesting that this combined score is inappropriate for use with TM patients. Concurrent validity data using the total score were mixed, although the Y-BOCS did appear to be sensitive to change in TM symptoms over treatment. Implications for the use of the Y-BOCS with TM patients and hypothesized phenomenological differences between TM and OCD are discussed.

Adult↗
PubMed1990

Laser excisional conization in an office environment.

Use of the laser as an excisional tool in the treatment of cervical disease is an established technique. A study was constructed to determine whether laser excisional conization could be done safely and effectively in an office environment. The subjects of the study were 104 sequential patients who underwent laser excisional cone in an office environment. The average cone size was 16.5 mm by 12.5 mm. The average operating time was 15 minutes. Margins of the cone specimen were adequate for interpretation in 100 patients (96%). Of patients available for complete posttherapy follow-up, 96/98 (98%) achieved initial cure of their lesion. Complications included bleeding requiring revisit in 7.7%, relocation of the SCJ out of colposcopic view in 7%, and cervical stenosis/occlusion in 2 patients. Four pregnancies have occurred and have either been delivered or are progressing satisfactorily. We believe that laser excisional conization may safely and effectively be moved out of the operating room environment.

Adult↗
PubMed1984

Kinetics of [99mTc]heparin, venous scintigraphy with [99mTc]fibrinogen and beta-thromboglobulin assay in the diagnosis of deep-vein thrombosis.

The information provided by three examinations: [99mTc]heparin kinetics (KH), venous scintigraphy with [99mTc]fibrinogen (VSF) and plasmatic assay of beta-thromboglobulin (beta TG), are studied on 23 patients separated into two groups on the basis of phlebographic results. VSF which could provide to a certain extent the same kind of information as phlebography, proves to have insufficient sensitivity. KH has high specificity but low sensitivity, while beta TG performance is the opposite. The authors discuss the mechanisms responsible for these discordant results. They observe that in cases where the KH and beta TG correspond, the diagnostic value is very satisfactory, so that a double positive can replace phlebography in cases where the latter is contra-indicated or difficult to perform.

Beta-Globulins↗
PubMed1983

A clinical and epidemiological study of adult patients with epilepsy.

The clinical and epidemiological data of 1054 patients with epilepsy between the ages of 16 and 66 years are described. 70% of the patients were treated in neurological departments, 20% by their general practitioners, while 8% received no treatment. The age-specific prevalence was 430 per 100 000 inhabitants, the same for men and women. Hereditary epilepsies (pyknoleptic absences, juvenile myoclonic epilepsy, epilepsy with awakening grand mal) comprised 16% of all the epilepsies; epilepsies with clinical primary generalized grand mal seizures as the only seizure type 32%, epilepsies with complex partial seizures 25% and epilepsies with simple partial seizures 18%. 8% could not be classified.

Adolescent↗