PubMed Health⌕ Search

Biomedical subjects

E Hering

Publications and source records attributed to E Hering.

At least 19 recordsLinked to original sources

Report on a new type of trauma full-body digital X-ray machine.

The purpose of this study was to evaluate the diagnostic equivalence, radiation dose, clinical usefulness and radiographic aspects of a low-dose, full-body digital X-ray machine in a busy trauma unit. A digital trauma X-ray machine known as "LODOX" was compared with conventional radiography between June 1999 and November 2001 in the Groote Schuur Hospital Trauma Unit, Cape Town. Digital images of a variety of body regions commonly imaged in trauma were compared for diagnostic image quality in a number of categories with equivalent conventional radiographs. A seven-point equivalence scoring system ranging from much inferior (-3) through equivalent (0) to much superior (+3) was used in each category. Radiation dose was recorded and compared with that in conventional measurements. Turnaround times of patients undergoing digital and conventional X-rays were evaluated. Clinical and radiographic issues were assessed by staff feedback. The digital images when compared with conventional film had an overall mean equivalence score of -0.429, with a standard deviation (SD) of 0.77. The best digital performance was in the mediastinum (mean 0.346, SD 0.49) and the weakest was for bony detail (mean -0.654, SD 0.81). Relative digital radiation dose compared to conventional varied from 72% (chest) to 2% (pelvis), with a simple average of 6%. Radiographic points included full-body imaging capability and differing positioning, penetration, workflow and practicality considerations. The digital images required overall patient times of 5-6 min, compared with 8-48 min for conventional X-rays. New installations are under way, and computed tomography and angiography applications are being explored. FDA approval is awaited. Projected cost is similar to that of flat-panel digital units. This digital unit was felt to be diagnostically substantially equivalent to conventional radiographs, with low-dose full-body imaging, improved workflow, digital technology and long-term cost benefits as potentially favourable contributions to trauma imaging.

Journal Article↗

Localized whole eye radiotherapy for retinoblastoma using a (125)I applicator, "claws".

PURPOSE: To treat children with retinoblastoma, who require whole eye radiotherapy, with a specially designed (125)I applicator that irradiates the eye while sparing the surrounding tissues. METHODS AND MATERIALS: Under general anesthesia, a pericorneal ring is attached to the 4 extraocular muscles, and 4 appendages, each loaded with (125)I seeds, are inserted beneath the conjunctiva in-between each pair of muscles and attached anteriorly to the ring. Twenty-nine eyes were treated. Eighteen received a median dose of 28 Gy during 91 hours and 11 received 40 Gy during 122 hours, when the relative biologic effectiveness was taken as 1 instead of 1.5. Six had received prior chemotherapy. RESULTS: Twenty-four eyes were followed up for 2-157 months (median 29). Although 22 eyes responded, local control was achieved in 13 patients, 3 of whom required additional treatment for new tumors; a further 3 required additional treatment for tumor recurrence as well as new tumors. One of these eyes was enucleated for neovascular glaucoma. All 6 Group I-III eyes and 6 of 18 Group V eyes were retained for 2-157 months (median 39), with good vision in 10 eyes. Three developed cataracts 7, 8, and 12 years later, 1 of which has been removed. CONCLUSIONS: This is a new way of irradiating the whole eye with a minimal dose to the surrounding tissues. The treatment time is only 5 days. It is effective in Groups I-III, but only 33% of Group V eyes retained vision. No late cosmetic defects occurred.

Antineoplastic Combined Chemotherapy Protocols↗

Sleep patterns in autistic children.

Sleep disturbances are regarded as a common clinical feature in autistic children. This concept is based primarily on informal observations or studies conducted with questionnaires. In this study we compared data obtained by questionnaires to that obtained with actigraphy. Among 22 autistic children, 12 were reported as having sleep problems and 8 patients completed 72 hours actigraphy. While the employment of questionnaires disclosed that autistic children had an earlier morning awakening time and multiple and early night arousals, actigraphic monitoring showed that with the exception of an earlier morning arousal time (p = .045), sleep patterns of autistic children were similar to that of normal children. Parental oversensitivity to sleep disturbances of the autistic children may explain this phenomenon.

Autistic Disorder↗

Evaluation of a new type of direct digital radiography machine.

OBJECTIVE: To evaluate a recently developed low-dose, large-field, direct digital X-ray scanning system for medical use. METHOD: Radiation dose, image quality, diagnostic capability and clinical utility of the unit were compared with those of conventional radiography. RESULTS: Radiation doses ranged from 3% to 5% of conventional radiographic values, and a mean of 1 line-pair per millimetre could be detected. Ease of use, anatomical coverage and tolerance to patient motion were advantages. However, image quality was inferior to that of conventional radiographs, with limited fine detail visibility and penetration. Only 67 of 156 (42.9%) pathological features seen on conventional radiographs were detected, including 13 of 41 fractures (31.7%) and 11 of 18 pneumothoraces (61.1%). CONCLUSION: Although image quality and diagnostic performance were not ideal, potential roles in triage, foreign body detection and possibly screening were promising. Radiographic factors may have affected sensitivity. This machine demonstrated useful attributes that may, with improvement, be beneficial in the imaging of trauma and other patients.

Adolescent↗

Improved iodine-125 plaque design in the treatment of choroidal malignant melanoma.

The use and development of iodine-125 plaque therapy for choroidal malignant melanoma are described. Since 1975 experience has led to changes in plaque design and insertion techniques. Twenty-one patients were irradiated with local episcleral iodine-125 plaques. Three patients required a second plaque for tumour recurrence. Four eyes were enucleated because of continued tumour growth and a further eye was removed because of glaucoma secondary to radiation retinopathy. Two patients (9.5%) died of metastases. The remaining 19 patients are alive and clinically clear of metastases, with a mean follow up time of 73.1 months (range 43-142 months).

Adult↗

Progress in the use of iodine therapy for tumours of the eye.

Developments in a new system of brachytherapy for tumours of the eye are reported. This involves the use of 125I sources with special screens and filters to avoid irradiation of vital structures and to produce a homogeneous radiation field. Methods for the treatment of tumours of the lids, conjunctiva, retina, choroid and lachrymal gland have been developed. Sixteen out of 20 treatments appear to have been successful. This system would seem to be a material advance on those previously reported.

Brachytherapy↗