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Biomedical subjects

E Heiberg

Publications and source records attributed to E Heiberg.

At least 19 recordsLinked to original sources
PubMed2004

Contribution of mitral annular excursion and shape dynamics to total left ventricular volume change.

The mitral annulus (MA) has a complex shape and motion, and its excursion has been correlated to left ventricular (LV) function. During the cardiac cycle the annulus' excursion encompasses a volume that is part of the total LV volume change during both filling and emptying. Our objective was to evaluate the contribution of MA excursion and shape variation to total LV volume change. Nine healthy subjects aged 56 +/- 11 (means +/- SD) years underwent transesophageal echocardiography (TEE). The MA was outlined in all time frames, and a four-dimensional (4-D) Fourier series was fitted to the MA coordinates (3-D+time) and divided into segments. The annular excursion volume (AEV) was calculated based on the temporally integrated product of the segments' area and their incremental excursion. The 3-D LV volumes were calculated by tracing the endocardial border in six coaxial planes. The AEV (10 +/- 2 ml) represented 19 +/- 3% of the total LV stroke volume (52 +/- 12 ml). The AEV correlated strongly with LV stroke volume (r = 0.73; P < 0.05). Peak MA area occurred during middiastole, and 91 +/- 7% of reduction in area from peak to minimum occurred before the onset of LV systole. The excursion of the MA accounts for an important portion of the total LV filling and emptying in humans. These data suggest an atriogenic influence on MA physiology and also a sphincter-like action of the MA that may facilitate ventricular filling and aid competent valve closure. This 4-D TEE method is the first to allow noninvasive measurement of AEV and may be used to investigate the impact of physiological and pathological conditions on this important aspect of LV performance.

Adult↗
PubMed1996

The unreliability of CT scans and initial chest radiographs in evaluating blunt trauma induced diaphragmatic rupture.

OBJECTIVE: There is no gold standard for early and reliable diagnosis of traumatic diaphragmatic rupture (TDR). The purpose of this study is to correlate CT scans, chest radiographs, and intubation on the ability to diagnosis traumatic diaphragmatic rupture. MATERIALS AND METHODS: Twenty patients with blunt trauma induced diaphragmatic rupture were identified from a five year review of a Level 1 Trauma Registry. RESULTS: Ten of the 20 (50%) patients had TDR on initial chest X-ray, all on the left side. Twelve patients had both chest X-rays and a chest and abdominal CT scan; however, only five (42%) of the CT scans were diagnostic. Of the 12 patients initially intubated, TDR was diagnosed in only four (33%) patients on initial chest X-ray and in one (14%) of seven patients having chest and abdominal CT scans and being intubated. CONCLUSION: The early diagnosis of blunt traumatic diaphragmatic rupture, especially in intubated patients, continues to be a diagnostic dilemma. There is a significantly better possibility of identifying left over right-sided TDR (P < or = 0.05). Diagnosing TDR is also facilitated by extubation. If the suspicion exists, a post extubation chest radiograph should be performed to evaluate for TDR.

Adolescent↗
PubMed1994

Computed tomography as a screening exam in patients with suspected blunt aortic injury.

BACKGROUND: Chest computed tomography (CT) screening of patients with blunt trauma for thoracic aortic injury is controversial. This study was undertaken to determine whether CT could exclude aortic injury and be used to select patients for aortography. METHODS: Computed tomography and aortography were used to evaluate 155 patients with blunt trauma. Computed tomography scans were reviewed separately by four attending radiologists who were unaware of the patients' clinical course and angiographic findings. RESULTS: Eight of 155 patients had aortic injuries requiring operation. Computed tomography scans in five patients were read as positive by all reviewers. One scan was read as positive by three reviewers and as negative by one. Two scans were read as positive by two radiologists and as negative by two. After poor scans were excluded, the combined sensitivity of CT for detecting aortic injury was 88%, specificity was 54%, positive predictive value was 9%, and negative predictive value 99%. CONCLUSIONS: The sensitivity of CT scan for indicating the need for aortography is observer dependent. As CT manifestations of aortic injury are often subtle, CT does not reliably exclude aortic injury.

Adolescent↗
PubMed1991

Effects of varying potential and electrolytic dosage in direct current treatment of tumors.

The effects of different voltages and dosages during direct current treatment were studied to determine the most effective tumor treatment. Groups of nude mice with subcutaneous human colon cancer nodules were treated with a single electrolytic dose (charge) of direct current using two percutaneously placed needle electrodes. All the treated groups responded and the residual tumor volumes were significantly lower (p less than 0.001) than the control group. 7.5 V gave the greatest tumor reduction, significantly more than for 12.5, 10.0, and 2.5 V. 35 C/ml of tumor was more effective than 30 C/ml (p less than 0.05) and no difference in response was obtained between 35 and 50 C/ml. Hyperthermia did not appear to play a significant part in direct current treatment in the examined voltage range as no intra-tumoral temperature elevation was observed. Direct current may allow effective percutaneous treatment of metastases which are unresponsive or unsuitable for conventional treatment.

Animals↗
PubMed1990

Observer reliability in CT and MRI of the abdomen/pelvis.

The purpose of this research was to evaluate two sources of error in the performance of computerized tomography (CT) and magnetic resonance imaging (MRI) of the abdomen/pelvis. The sources of error assessed were inter- and intra-observer reliability. Thirty abdomen/pelvis CT scans were randomly selected from each of three hospitals (university, VA, military) with different CT scanners. Two radiologists were recruited from each site to be CT observers. Forty-five abdomen/pelvis MRI scans were randomly selected from two institutions with different MRI scanners. Four observers were recruited to read the MRI scans. All scans were read blind without clinical information or patient identification. Overall inter-observer and intra-observer diagnostic agreement was significantly higher for MRI compared to CT. Inter-observer diagnostic agreement rates were also significantly higher for MRI when the etiologies of neoplastic vascular and metabolic/toxic were assigned. Observer experience in CT (range: 5-9 yr) or MRI (range: 2-4 yr) was not statistically associated with improved diagnostic agreement. This research addresses many of the criticisms of the MRI literature and compares MRI favorably to CT.

Abdomen↗
PubMed1988

Body computed tomography findings in systemic lupus erythematosus.

Fifty-five computed tomography scans in 27 patients with systemic lupus erythematosus were reviewed. The most frequent indication for scanning was suspected intraabdominal sepsis, and the most frequent finding was mild lymphadenopathy. Renal abnormalities were: subcapsular hematoma, focal defects, overall enlargement, and diminution of size. Other findings included serositis, bowel wall thickening with pneumatosis intestinalis, pancreatic pseudocyst, and hepatic and splenic enlargement. Five abscesses were found that were indistinguishable from other fluid collections. Computed tomography was helpful in clinical evaluation and in some cases changed management.

Abscess↗
PubMed1987

Effects of facial paralysis after acoustic neuroma surgery in Norway.

This survey investigated how individuals with facial paralysis resulting from acoustic neuroma surgery manage self-care needs of daily living. Facial paralysis was defined to include damage from surgery to other cranial nerves located in the same area as the facial nerve. The 40 patients surveyed had surgery performed at the Neurosurgical Department, National Hospital of Norway, Oslo, during a four-year period. The instrument used was a questionnaire based on Orem's universal self-care requisites. Results showed that problems related to eating and drinking and certain physiological problems were accepted over time, while pain, eye problems, and hearing loss remained difficult for patients to cope with. Social and psychological problems related to the facial paralysis were ongoing for many patients and seemed to be mitigated by self-acceptance and acceptance by others.

Activities of Daily Living↗
PubMed1986

Magnetic resonance imaging of lesions of synovial origin.

Three patients with histologically differing lesions of synovial origin and two with synovial cysts, one of which was a dissecting popliteal cyst, were examined by magnetic resonance imaging (MR) and computerized tomography (CT). The three histologically proven synovial lesions were synovial sarcoma, diffuse giant cell tumor of tendon sheath, and synovial chondromatosis. In two of the five patients MR provided better anatomic and morphologic appreciation than CT, while in the others they were of equal value. CT demonstrated calcification in two of the lesions while on MR calcification could be identified in only one patient where it outlined the mass. MR did not demonstrate calcification in the substance of the diffuse giant cell tumor of tendon sheath. Coronal, transverse, and sagittal images of magnetic resonance graphically demonstrated the extent of the soft tissue masses and their relationship to bone, vessels, and soft tissue structures. Synovial sarcoma had a shorter T1 than diffuse giant cell tumor of tendon sheath (these two lesions being of comparable size) and also had a uniformly longer T2. The dissecting popliteal cyst showed the most intense signals on the T1 weighted images, while the uncomplicated synovial cyst showed a long T1. On the T2 weighted images, each type of cyst showed a long T2. The variance and overlap of intensity of MR signals suggest limited specificity in predicting the histologic nature of the synovial lesion.

Adult↗
PubMed1986

Magnetic resonance imaging in planning limb-salvage surgery for primary malignant tumors of bone.

In defining the linear extent of a malignant tumor in a long bone, radiographs, computerized tomography, and scintigraphy are routinely employed, especially when non-ablative surgery is being considered. The drawbacks of these modalities in defining the true intracompartmental extent of disease within a bone can largely be overcome with the use of magnetic resonance imaging. We did a prospective analysis of magnetic resonance imaging in sixteen consecutive patients with a primary malignant tumor of a long bone, and it showed that this modality has clinical promise of being more precise than the other modalities in defining the true proximal and distal extent of a tumor in a long bone. Coronal images permit easier planning of surgical techniques for salvage of a limb using an allograft than do a multiplicity of transverse images.

Bone Neoplasms↗
PubMed1984

CT findings in leukemia.

Review of 84 computed tomographic (CT) scans in leukemic patients demonstrated a wide spectrum of abnormalities. Findings caused by leukemia were lymphadenopathy, visceral enlargement, focal defects, and tissue infiltration. Hemorrhage was by far the most common complication and could usually be characterized on the noncontrast CT scan. The distinction between old hematomas, foci of infection, and leukemic infiltration could not be made with certainty without CT-guided aspiration. Unusual instances of sepsis, such as microabscesses of the liver and typhlitis, were seen.

Adult↗
PubMed1983

Comparison of computed tomography with high-resolution real-time ultrasound in the localization of the impalpable undescended testis.

Localization of an undescended testis was attempted in 23 instances in 20 patients using both computed tomography (CT) and high-resolution real-time ultrasonography. The testis was identified and correctly localized 16 times by CT and 15 times by ultrasound. There was one false-negative diagnosis by CT and two by ultrasound. False-positive diagnoses were not made with either modality in the six cases in which the testis was not found during exploratory surgery. CT showed 94% sensitivity, 100% specificity, and 96% accuracy; ultrasound resulted in 88% sensitivity, 100% specificity, and 91% accuracy. The authors recommend high-resolution real-time ultrasound as the modality of choice for this procedure because it is simple, accurate, and avoids the use of ionizing radiation. CT may be used when ultrasound findings are negative or equivocal. Angiography should rarely be required.

Adolescent↗
PubMed1983

Hyperdensity of recent hemorrhage at body computed tomography: incidence and morphologic variation.

Body computed tomographic (CT) scans were reviewed in 73 patients with hematomas of recent onset. The incidence, extent, and morphologic variation of regions of hyperdensity on precontrast scans were assessed. Hyperdensity was also sought in the scans of 80 control subjects with a mass due to neoplasm or abscess demonstrated at CT. Of the 73 hematomas 55 (75%) exhibited regions of localized or diffuse hyperdensity. Only one of the 80 (1.25%) control lesions showed relative hyperdensity that could not be explained by obvious calcification, bone fragments, or diminished density of the organ of origin. Predominant hyperdensity throughout the lesion was present in 35 (48%) of the hematomas and in 16 (22%) of these was homogenous in texture. Other patterns of hyperdensity included linear shadows, hyperdense filling defects surrounded by fluid, dependent position of hyperdense fragments, and fluid fluid levels with dependent hyperdensity. Hyperdensity at CT was due to the high hemoglobin content of retracted clot or sedimented blood. The various patterns seen can be related to sequential changes occurring in blood following hemorrhage. Relative hyperdensity and its variations seen on precontrast scans are useful diagnostic signs of recent hemorrhage.

Hematoma↗
PubMed1983

Carotid atherosclerosis: high-resolution real-time sonography correlated with angiography.

The merits of high-resolution real-time sonography in detection of plaque and estimation of stenoses were compared with angiography in 97 carotid bifurcations from 50 consecutive patients. For flow-reducing lesions, that is, stenosis greater than or equal to 50% or complete occlusion, sonographic accuracy was 86% and the mean difference in percentage narrowing was 17% (SD, 21.6%). For detection of normal or non-flow-reducing lesions, that is, less than 50% stenosis, sonographic accuracy was 89% and the mean difference in percentage narrowing was 8% (SD, 10.2%). Errors occurred mainly in severely diseased vessels and were often related to calcification in lesions and/or plaque of low echogenicity. Accuracy was lowest in predicting complete vessel occlusion (36%). Greatest accuracy was found in assessment of minimal disease. The technique is a useful supplement to the battery of noninvasive tests used to screen patients at risk for stroke and in defining those requiring angiography before surgery.

Arteriosclerosis↗
PubMed1983

CT in aortic trauma.

A diagnosis of aortic transection was made at computed tomography (CT) in four of 10 patients with acute multiple trauma suspected of having thoracic aortic injuries. There were no false-negative or false-positive examinations. The CT findings of an injured aorta were (1) false aneurysm, (2) linear lucency within the opacified aortic lumen caused by the torn edge of the aortic wall, (3) marginal irregularity of the opacified aortic lumen, (4) periaortic or intramural aortic hematoma, and (5) dissection. The extent of associated mediastinal hemorrhage and the amount of blood in the pleural space were not useful as indicators of aortic injury. Similarly, shift of the trachea and esophagus or absence thereof was found in patients with or without aortic tear.

Accidents, Traffic↗