Biomedical subjects

A Winkel

Publications and source records attributed to A Winkel.

3 recordsLinked to original sources

PubMed2002

[Use of a newly developed piezoelectrically driven drilling machine for MR-guided bone biopsies].

PURPOSE: Development and clinical testing of an MR-compatible bone biopsy system, to enable the sample collection from osteosclerotic or subcortical lesions for histological investigation under MR control. MATERIALS AND METHODS: A piezoelectrically driven drilling machine was constructed and tested in connection with an MR-compatible bone biopsy set in a vertical open MR scanner (0.5 T) on a phantom and 10 patients with ambiguous bone lesions. Images were obtained using T(1)-weighted spin-echo sequences and, in case of real-time imaging, a fast spoiled gradient-echo sequence. RESULTS: The influence of the enabled motor (RF-interference) leads to a reduction of the signal to noise ratio of the images, but can be minimised by appropriate measures. The observed slight field distorsions do not affect the image quality during real time acquisition in a substantial manner. No complications occurred. The extracted biopsy material was sufficient and of good quality. CONCLUSIONS: In spite of slightly restricted image quality, the described drilling machine combined with the bone biopsy set is well suited for MR-guided bone biopsies, which require the application of a motor driven drill. Its application within an interventional MR scanner is safe and its handling simple and manageable.

Biopsy, Needle↗

PubMed1999

[MR-track pointer. A reusable device for localization during interventions].

PURPOSE: Development of an helpful instrument for a better planning and orientation during MR guided interventions. MATERIAL AND METHODS: We developed a reusable, sterilizable instrument that can be filled both with a solution of Gd-DTPA (1%) and with a sodium chloride solution (0.9%). The pointer has a diameter of 3 and 5 mm resp. and its length is 100-150 mm. The instrument can be combined with an interactive stereotactic tracking device. RESULTS: The MR-Track-Pointer can be fixed to the two handpieces of the integrated interactive tracking system without problems. The pointer can be seen both on T1w and T2w sequences inside and outside of the tissue. This new instrument can be interactively used for reliable planning the biopsy trajectory, planning craniotomies and identifying structures which are only visible on MR images. CONCLUSIONS: The MR-Track-Pointer is an ideal supplement for the integrated virtual tracking system. It permits a minimal invasive orientation and facilitates the exact localisation of suspect lesions in sensible regions during MR guided interventions, e.g. diagnostic biopsies and tumour resections.

Biopsy↗

PubMed1998

Intensive training, physiotherapy, or manipulation for patients with chronic neck pain. A prospective, single-blinded, randomized clinical trial.

STUDY DESIGN: A randomized, prospective clinical study was conducted that included 119 patients with chronic neck pain of greater than 3 months' duration. OBJECTIVES: To compare the relative effectiveness of intensive training of the cervical musculature, a physiotherapy treatment regimen, and chiropractic treatment on this patient group. SUMMARY OF BACKGROUND DATA: There are only a few studies involving chronic neck pain patients representative of those seeking care in primary health care centers. Mobilization techniques and intensive training have been shown to be useful, but cervical manipulation has not been assessed. Clinical results involving these commonly used therapies have not been compared. METHODS: A total of 167 consecutive patients were screened. One hundred nineteen patients were admitted to the study and were randomized according to Taves' minimization principles. Primary outcome measures included self-reported pain, disability, medication use, patients' perceived effect, and physician's global assessment. Patients were assessed at enrollment and at completion of the study. Postal questionnaires were used to carry out 4- and 12-month follow-up assessments. Secondary outcome measures included active range of motion of the cervical spine as well as strength and endurance measurements of the cervical musculature. These measurements were carried out at enrollment and completion of the study. RESULTS: A total of 88% of the patients completed the study. Of these, 97% completed the 4-month questionnaire and 93% the 12-month questionnaire. Patients from all three groups demonstrated significant improvements regarding self-reported pain and disability on completion of the study. Improvements were maintained throughout the follow-up period. Medication use was also significantly reduced in all groups. There was, however, no significant difference between groups at any assessment period. Physician's and patients' assessments were also positive, and again group scores were essentially equal. Patients who underwent intensive training demonstrated significantly greater endurance levels at the completion of treatment. CONCLUSIONS: There was no clinical difference between the three treatments. All three treatment interventions demonstrated meaningful improvement in all primary effect parameters. Improvements were maintained at 4- and 12-month follow-up. However, whether this was a result of the treatments or simply a result of time is unknown. Future studies will be necessary to delineate ideal treatment strategies.

Adult↗