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Biomedical subjects

E Salomonowitz

Publications and source records attributed to E Salomonowitz.

At least 19 recordsLinked to original sources
PubMed2001

MR imaging-guided biopsy and therapeutic intervention in a closed-configuration magnet: single-center series of 361 punctures.

OBJECTIVE: The purpose of the study was to evaluate practical experience with interventional MR imaging in a closed-bore 1.5-T imaging system. A total of 361 MR-guided biopsies were performed in 250 patients and analyzed retrospectively. The technique comprised four steps: localization; planning; action (cutting or aspiration biopsy, or instillation of a therapeutic agent), with verification in two perpendicular planes; and obtaining control scans. CONCLUSION: The mean duration of a biopsy was 21 min; there were no major complications. Image contrast, signal, matrix options, and visibility of needle track and tip position permitted uncomplicated orientation. The interventional MR technique could be applied in any puncture setting.

Adult↗
PubMed1998

High-resolution MR imaging anatomy of the orbit. Correlation with comparative cryosectional anatomy.

High resolution MR imaging of the orbit enables visualization of anatomic details in the orbit, including important blood vessels, muscles, nerves and connective tissue structures. The best resolution of anatomic details currently is obtained by using surface coils and T1-weighted spin echo sequences. Some examples of clinical applications demonstrate that a detailed knowledge of orbital imaging anatomy is a prerequisite for successful interpretation of clinical MR images. Additionally, this noninvasive diagnostic technique may be used for anatomical in vivo studies.

Anatomy, Cross-Sectional↗
PubMed1998

[Simple and effective rt-PA thrombolysis design].

PURPOSE: Assessment of a novel, simple and practical thrombolysis scheme for the purposes of a central hospital. MATERIALS AND METHODS: 314 thromboembolic lower extremity occlusions in 260 consecutive patients were treated by thrombolysis as follows: 6 ml rt-PA/h for 30 min; 3 ml rt-PA/h for another 30 min; 1 ml rt-PA/h for 7 hours, and 0.4 ml rt-PA until vessel patency. Antegrade introduction of a 5 F straight end-hole catheter through a 6 F, constantly heparin-flushed sheath, to the level of occlusion was followed by subsequent advancement of the catheter tip according to progress of lysis at time intervals of 2, 4, and 8 hours. The regimen was continued overnight. RESULTS: 82% of arterial occlusions were completely recanalized at the end of thrombolysis. Then, angioplasty was performed if appropriate. Best results (100% recanalization rate) were achieved by treating occlusions of the superficial femoral artery, even in cases of involvement of the entire length of the vessel, and isolated popliteal occlusions. A recanalization rate of 70% was achieved by treating distal crural vessel occlusion. Bypass grafts were recanalized in 50%. COMPLICATIONS: 3 x major hematoma, 2 x transluminal perforation; 16 x minor hematoma from the puncture site at the sheath, 4 x erythema, obviously reaction to rt-PA (together n = 25; 8%). CONCLUSIONS: We empirically found and solidly evaluated an effective thrombolysis scheme. Our results demonstrate that major advances are possible even in this well-grounded field.

Adult↗
PubMed1992

Placement of venous stents: clinical experience with a self-expanding prosthesis.

A self-expanding vascular prosthesis was used to treat 20 venous stenoses or occlusions in 13 patients. The lesions were caused by tumor (n = 5), postoperative fibrous scars (n = 2), and chronic hemodialysis fistulas (n = 13). Follow-up ranged between 6 weeks and 53 months (mean follow-up, 14.9 months). Acute occlusion occurred in two stents, one within a tumor stenosis and one in a dialysis shunt after 3 days and 2 days, respectively. Balloon angioplasty, thrombolysis, and aspiration in the first case and balloon angioplasty and thrombolysis in the second case successfully restored patency. Definite occlusion occurred in these two patients after 8 weeks and 5 months, respectively. Ten secondary interventions were performed in three patients with 10 restenoses who had stenotic arm veins in chronic hemodialysis at presentation. Five of seven patients who received treatment for stenoses associated with hemodialysis underwent successful kidney transplantation 5-27 months after placement of vascular stents. Both patients who received treatment for benign strictures had patent stents at follow-up examinations performed at 45 and 53 months, respectively. Four of five stents placed for malignant stenoses were patent at venography (n = 3) or autopsy (n = 1).

Adult↗
PubMed1992

CT-guided percutaneous drainage and fluid aspiration in intensive care patients.

Fifty-two intensive care unit (ICU) patients with clinical signs of sepsis who were considered to be at extremely high risk for operation were subjected to CT-guided interventions. Bedside ultrasound (US) had been performed prior to CT in all patients but diagnoses were equivocal or US-guided interventions had failed. Nineteen patients solely underwent CT-guided diagnostic aspiration of fluid collections to rule out infection. Eighteen patients (72%) with abscess formations after surgery or trauma were cured by catheter drainage alone; 4 patients required additional surgery. Out of 8 patients suffering from acute pancreatitis (after several necrosectomies), abscesses could be cured in 5 (62.5%). Three patients with acute necrotizing pancreatitis (no surgery) were not cured by the interventional procedure and all required surgical debridement. Even patients who required additional surgery after drainage improved clinically after the interventional radiologic procedure. Our overall success rate was 64%, emphasizing the need for CT in the case of equivocal US results or if US-guided procedures have failed in ICU patients with signs of sepsis.

Abscess↗
PubMed1991

[The value of mammography in patients up to the age of 35].

The use of mammography in young women is under debate. In this prospective study of 220 women aged up to 35 years, the indications for mammography were compared with the final diagnosis. In this way, an attempt was made to define the signs and symptoms that justify mammography in this age group. The results show that mammography is indicated only in the presence of palpable lumps. All other signs or symptoms should not be investigated by means of ionising radiation in this particular age bracket.

Adolescent↗
PubMed1991

Arterial stent placement with use of the Wallstent: midterm results of clinical experience.

Self-expandable stents of the Wallstent type were used in 26 iliac and 15 femoropopliteal artery lesions of 31 patients to treat stenoses or occlusions. The indications were confined to complex lesions, including residual stenoses and dissections after percutaneous procedures or previous surgery in the iliac artery lesions, and long-segment (mean, 13.5 cm) occlusions with inadequate response to percutaneous recanalization in the femoropopliteal artery lesions. In the iliac artery group, after stent placement, 96% of the lesions were patent at a mean follow-up of 16 months (range, 6-30 months). In the femoropopliteal artery group, of 11 patients available for follow-up, only six had patent stents at 7-26 months (mean, 20 months). Four of these six patients required one to three secondary interventions. Self-expanding endoprostheses are of great value in complex iliac artery lesions where simple balloon dilation is insufficient. Stent placement for long femoral artery lesions should be performed with utmost reserve, and the extent of stent placement should be as short as possible.

Aged↗
PubMed1990

[Better evaluability of post-therapeutic mammograms using a double-exposure technic. A prospective perception study].

The authors have found the results of a dual-exposure technique for the breast which proved very useful for evaluations following surgery and irradiation. The technique consists of double exposure of the treated breast on two films, one with the exposure data of the normal breast and one with two additional mAs steps. The two films demonstrate anatomical details better than conventional techniques. The over-exposed film shows 18% more reticular patterns than the standard exposure. The authors believe that the dual-exposure technique is a valuable adjunct in the management of the postoperative breast-cancer patient.

Austria↗
PubMed1990

Injury of the Achilles tendon: diagnosis with sonography.

We determined the diagnostic accuracy of sonography for the assessment of injury to the Achilles tendon. After anatomic investigations in three human cadavers, we performed a clinical study in 24 healthy volunteers and 73 symptomatic patients referred for achillodynia or signs of heel thickening or both in whom a clinical diagnosis of acute total rupture was excluded. High-resolution real-time sonography was performed and the results were compared with final clinical diagnoses (55 patients) and surgical findings (18 patients). Fifty-two of the patients had been involved in various sporting activities (long-distance runners, jumpers, and basketball players), three patients had familial hypercholesterolemia, five patients had systemic inflammatory disease, and 13 patients had no known underlying cause. Anatomic investigation demonstrated accurate assessment of tendon structure and thickness. Sonograms were abnormal in 53 patients (sensitivity, 0.72; specificity, 0.83), and the extent of structural disorders of the tendon could be assessed properly. Abnormalities occurred in the form of tendon swelling (45%), abnormal tendon structure (42%), rupture (15%), and peritendinous lesions (47%). No changes were detected in low-grade disease of short duration, which suggests symptoms caused by functional disorders. Sonography is valuable in the diagnosis of various lesions of the Achilles tendon and its surrounding tissue. Furthermore, it can be used to estimate the degree of tendon abnormality and to differentiate between functional and morphologic conditions.

Achilles Tendon↗
PubMed1987

Breast calcifications in renal hyperparathyroidism.

A prospective mammographic study was performed on 151 women to determine the prevalence of breast calcifications in patients with chronic renal failure. Frequency, size, structure, and location of calcific lesions were assessed in 15 patients with compensated renal insufficiency, 22 on hemodialysis, 14 who had renal transplants, and 100 who had normal kidney function. Serum levels of calcium, phosphorus, alkaline phosphatase, and parathyroid hormone were determined for all 151 women. The calcific lesions occurred preponderantly in dialysis patients (arteries, 55%; parenchyma, 68%; and ducts, 36%). Next in order were those with renal transplants (43%, 64%, and 29%, respectively) and those with renal insufficiency (33%, 53%, and 20%, respectively). Patients with renal disease had significantly more calcifications (p less than .001) than the patients with normal kidney function: arteries, 45% vs 8%; parenchyma, 61% vs 27%; and ducts, 29% vs 9%. Frequencies of calcifications correlated with serum levels of parathyroid hormone. None of the calcifications induced by renal disease simulated those seen in carcinoma of the breast.

Adult↗
PubMed1987

Tongue cancer. Sonographic assessment of tumor stage.

In an effort to improve preoperative evaluation of tumors of the tongue, a prospective study on the value of ultrasound (US) for the staging of 50 surgically proven cancers of the tongue and floor of mouth was performed. Sonography was correlated with clinical staging and surgical outcome. Real-time high-frequency transducers and an echo-free silicone interface were used. The dorsal and middle thirds of the tongue were scanned from a submental access and the tip of the tongue directly. US accurately defined tumor sizes and locations in all cases. US staged cancers correctly in all cases but one. In contrast, clinical staging was correct in only 66% of cases. Surgically relevant details, such as crossing of the midline of the tongue or infiltration of the lateral pharyngeal wall, were detected with US. The major limitations of US include the nonvisualization of the epiglottis and retropharyngeal space as well as bone infiltration.

Female↗
PubMed1986

Dynamic 123I-HDA myocardial scintigraphy after aortocoronary bypass grafting.

In an attempt to evaluate the dynamics of fatty acid metabolism after aortocoronary bypass grafting (ACBG), ten patients were investigated after ACBG by 123I-HDA myocardial scintigraphy. Tracer kinetics were followed for 90 min and compared to those of 36 nongrafted patients with different underlying heart diseases, including healthy volunteers. Regional analysis and monoexponential curve fitting were used to evaluate t1/2 (half-life of the early period of tracer elimination); biexponential curve analysis was used to calculate Ca/Cb, the ratio of a fast and a slow component of tracer elimination. Rest and stress MUGA-RNV served as discriminating parameters to discern between patient groups with normal and abnormal ventricular function. Group I (normal controls) encompassed ten patients with normal ventricular function, including three after ACBG, and group II seven patients after ACBG and with abnormal ventricular function. Group III had coronary artery disease (CAD) documented by angiography, and group IV by prior myocardial infarction (MI). Group V included patients with cardiomyopathy (CMP). Regional analysis of group II revealed no significant differences to control regions (Gr I) for t1/2 or Ca/Cb, but showed for Ca/Cb a nonsignificant shift toward group III values. However, group II differed significantly from group III and V. Three patients with normal ventricular function after ACBG showed elimination values that were all well within the range of completely normal individuals. Thus our data support the assumption that a normal function is indicative of a normal metabolism. Following myocardial fatty acid metabolism during rest might be a helpful noninvasive tool for etiologic differentiation of disturbed ventricular function.

Coronary Artery Bypass↗
PubMed1986

The intravertebral vacuum phenomenon.

An intravertebral vacuum phenomenon was observed within 19 vertebrae of 17 patients. It represents a non-healing vertebral fracture. Three possible pathologic mechanisms are discussed: ischemic bone necrosis, trauma with ensuing ischemic necrosis, and intraosseous disc prolapse. The intravertebral vacuum phenomenon was found in two patients with multiple myeloma and thus does not exclude the presence of malignancy in the affected bone. Radiographs obtained during traction or extension may be of diagnostic value.

Aged↗
PubMed1986

Hydrophilic-lipophilic balance as predictor of mucus coating with barium sulfate.

In order to improve barium coating of the mucus layer covering the alimentary tract, various surface active substances are added to commercially available contrast media. The action of additives can be expressed in part by their hydrophilic-lipophilic balance (HLB). In an experimental study using human colonic mucus and barium sulfate USP, surfactants of varying HLB (range, 3-11) were used to study the range of HLB resulting in optimal coating. The best coating occurred with an HLB of 7. Quality of coating may be predicted based on knowledge of the HLB of various surface active additives.

Barium Sulfate↗
PubMed1986

[Expansion, deformation and bursting characteristics of commonly used balloon dilatation catheters. In vitro studies (1)].

We evaluated the characteristics of dilatation and deformation, as well as pressure requirements, bursting point, and type of bursting of the five most common balloon dilatation catheters. Polyvinyl chloride, polyethylene, and polyurethane-nylon balloons from 4 different manufacturers were examined in water-baths and an arrangement of tightly fitting teflon tubes. Defined balloon inflations were monitored and documented until balloon rupture occurred. Significant differences were found according to the different constructions and materials of the balloon catheters. Modern PVC showed a quality equal to PE material. Marked and clinically relevant differences of balloon compliance and behaviour in the water baths and within teflon tubes were demonstrated.

Angioplasty, Balloon↗
PubMed1986

[Expansion, deformation and bursting characteristics of frequently used balloon dilatation catheters. In vivo studies on canine vessels (2)].

In an experimental angioplasty study in dogs, we evaluated the characteristics of dilatation and deformation, as well as the pressure requirements, bursting points, and types of bursting of four different balloon dilatation catheters. The balloons, which were selected 0%, 30%, and 80-100% larger than the arterial lumen, measured 4, 6, and 8 mm in diameter and were inflated with an automated pump which simultaneously recorded balloon pressure and volume. Changes to the vessel wall were assessed radiographically and by histology. In vivo, balloon dilatation catheters demonstrated a markedly different behaviour than in vitro. Significantly higher pressures were tolerated due to the support of the arterial sleeve. Non-compliant oversized balloons caused more damage to the arterial wall than compliant ones. Oversized balloons attained their required diameters only with high inflation pressures of 10 to 12 atm or after rupture of the artery.

Angioplasty, Balloon↗