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Biomedical subjects

F Lomoschitz

Publications and source records attributed to F Lomoschitz.

At least 19 recordsLinked to original sources

Changes in bone mineral density in the proximal femur after cementless total hip arthroplasty. A five-year longitudinal study.

We investigated prospectively the bone mineral density (BMD) of the proximal femur after implantation of a tapered rectangular cementless stem in 100 patients with a mean age of 60 years (16 to 87). It was determined using dual energy x-ray absorptiometry, performed one week after surgery and then every six months until the end-point of five years. The BMD increased significantly in Gruen zones 2, 4 and 5 by 11%, 3% and 11% respectively, and decreased significantly in Gruen zones 1, 6 and 7 by 3%, 6% and 14% respectively, over the five-year period. The net mean BMD did not change over this time period. The changes in the BMD were not confined to the first 12 months after surgery. This investigation revealed no change in the overall periprosthetic BMD, but demonstrated a regional redistribution of bone mass from the proximal to distal zones.

Absorptiometry, Photon↗

[Percutaneous radiologically-guided vertebroplasty in the treatment of osteoporotic and tumorous spinal body lesions].

Vertebroplasty is a radiological intervention for the augmentation of bone lesions with bone cement. Main indications are the treatment of osteoporotic vertebral body fractures, however also the treatment of tumorous lesions becomes more and more established. The indication for vertebroplasty of tumorous lesions is therapy-refractory pain in symptomatic hemangiomas, metastases and myelomas. By minimal invasive therapy stabilization of vertebral bodies and pain reduction may be achieved.

Bone Cements↗

First experiences with multidetector CT in traumatized children.

INTRODUCTION: The aim of this study was to describe and discuss first experiences with multidetector CT (MDCT) in the assessment of traumatized children. MATERIAL AND METHODS: Since the implementation of a MDCT scanner in April 2002, 85 children (31 girls, 54 boys with a mean age of 9.2 years) consecutively underwent MDCT (Siemens, Erlangen, Germany) with different protocols depending on age, weight, trauma mechanism and clinical presentation. In all patients in whom pathology was suspected, multiplanar reformations (MPR) in coronal and or sagittal orientation was performed. Examinations were evaluated by two radiologists retrospectively and in consensus. RESULTS: In 55 (65%) children, a MDCT solely of the head was performed, in 46 there was no pathology found. In six (7%), head and facial bones were scanned. Head and abdomen was examined in two (2%), in two (2%) the abdomen only and in one (1%) the pelvis solely. Scans of the spine were obtained in seven (8%) children. A thorax and abdomen examination only was obtained in one (1%) child each. In 11 (13%) children, a polytrauma protocol was performed. In all patients, the time of examination did not exceed 17 min, including setup time. All children survived at the writing of this report. CONCLUSION: MDCT was promising in the management of traumatized children and seems to shorten the necessary time to reach diagnosis and to initiate life-saving treatment.

Child↗

Enteroclysis in adult celiac disease: diagnostic value of specific radiographic features.

The purpose of this study was to compare the diagnostic accuracy of various radiographic findings at enteroclysis in adult patients with untreated celiac disease. Twenty-seven adult patients underwent enteroclysis because of unspecific intestinal symptoms before definitive biopsy proof of celiac disease. Enteroclysis of 123 subjects with similar clinical presentation, including abdominal pain, diarrhea, occult intestinal bleeding, and weight loss, who had a definitive diagnosis other than celiac disease, served as controls. The radiographic features previously described in the literature as indicative of adult celiac disease (i.e., fold thickening, decrease of jejunal folds, increase of ileal folds, small bowel dilatation, flocculation) were evaluated in blinded fashion in all studies and the subjective likelihood of diagnosis of celiac disease was assessed. Assessing every finding separately, each feature proved to have a high specificity (78-100%) but low sensitivity (19-59%) for celiac disease. Reversal of jejunoileal fold pattern was the single best feature (specificity 100%, 95% CI 97-100%; sensitivity 59%, 95% CI 40-78%); however, combination of criteria enables establishment of the diagnosis of celiac disease quite accurately (specificity 100%, 95% CI 98-100%; sensitivity 78%, 95% CI 58-91%). Reversal of jejunoileal fold pattern as a single finding as well as combination at least three of the following features, i.e., fold thickening, decrease of jejunal folds ("colonization"), increase of ileal folds ("jejunization"), dilatation, and flocculation, make enteroclysis an accurate tool for diagnosis of celiac disease in adult patients with suspected intestinal disease.

Adult↗

[Stereotactic needle breast biopsy: Diagnostic reliability of various biopsy systems and needle sizes].

OBJECTIVES: To compare quality of harvested tissue, false-negative rate, and complication rate of large-core needle breast biopsy (LCNBB) and directional, vacuum-assisted breast biopsy (DVABB) in non-palpable breast lesions. PATIENTS AND METHODS: From 1994 to 1999, in 580 non-palpable breast lesions a stereotactically-guided breast biopsy was performed. 14-G LCNBB was used in 168 lesions (29 %). DVABB was used in 412 lesions (71 %; 11-G DVABB: 134 lesions 32.5 %, 14-G DVABB: 278 lesions 67.5 %). Following biopsy, patients underwent either surgical excision (n = 533; 93.8 %) or mammographical follow-up (n = 36; 6.2 %). Histological results of LCNBB, DVABB, surgical breast biopsy and follow-up results were compared and scored for their tissue quality on a three-point scale (1 = disagreement between biopsy and surgery; 2 = partial agreement; 3 = complete agreement). In addition, we determined the false negative and complication rate for both systems. RESULTS: Histological examination after surgery and follow-up proved 262 (45.2 %) to be benign, 15 (2.6 %) to be high-risk lesions and 303 (52.5 %) to be malignant. In the tissue quality there was no significant difference between 14-G LCNBB (score = 2.94), 11-G DVABB (score = 2.92) and 14-G DVABB (score = 2.91) (p > 0.05). Particularly, in calcifications 11-G DVABB scored better (score = 2.92) than 14-G DVABB (score = 2.88) (p > 0.05). 14-G LCNBB had a lower false negative rate (1.8 %) than 11-G DVABB (3 %) and 14-G DVABB (3.2 %) (p > 0.05). There was no difference in the complication rate between the different needle types. CONCLUSIONS: Our results indicate that both LCNBB and DVABB are reliable and safe techniques in the diagnosis of non-palpable breast lesions. However, the use of 14-G LCNBB seems to be advantageous in masses, the use of 11-G DVABB seems to be advantageous in asymmetric densities and calcifications.

Adult↗

[Computer-assisted radiologic quantification of hand and foot changes in rheumatoid arthritis].

Driven by the increasing implementation of electronical picture archiving and communications system (PACS) into every days practice a fully operative Java application software was developed to support the efficacy of the scoring process in rheumatoid arthritis. This software, namely the "Rheuma-Coach" offers the possibility to use the Larsen- or the Ratingen-Score. We measured time savings of approximately 20% per case if this computer assistance was used. The lack of a standard for the positioning of limbs was confirmed.

Arthritis, Rheumatoid↗

[Internal derangement of the temporomandibular joint].

Internal Derangement is one of the most common disorders of the Temporomandibular joint. It is defined as an abnormal anatomical relationship between the discus articularis and the other structures of the temporomandibular joint. More than 2/3 of patients with clinical symptoms of the temporomandibular joint have an internal derangement. The most frequent finding in internal derangement is an anterior dislocation of the disc with reduction after mouth opening. In more severe cases a complete anterior dislocation is found without reduction of the disc. Internal derangement is a risk factor for developing osteoarthritis with remodeling of the condylus and the fossa mandibularis. The most important modalities of radiologic diagnosis are arthrography, CT and MRI. The diagnosis of craniofacial dysfunction has been improved dramatically by modern imaging techniques, which have become essential tools for primary diagnostic and evaluation after conservative or surgical therapy. MRI has become the gold standard.

Humans↗

[Non-neoplastic arthropathies of the temporomandibular joint].

The pathologic conditions that involve the TMJ are similar to those conditions that involve other joints in the body. Therefore, many of the radiologic characteristics are also similar. Nevertheless, because of the complex structure and function of this small joint, it is essential to know the variety of diseases that can involve the temporomandibular joint. It is also important to understand that functionally both TMJ's act as a single unit and that any alteration in function caused by a pathologic process on one side may lead to dysfunction on the contralateral side. It is essential that the radiologist is familiar with the principles of TMJ function as well as TMJ pathology.

Diagnosis, Differential↗

[Traumatic temporomandibular joint injuries].

Injuries of the temporomandibular joint are mostly due to injuries or fractures of the mandibular condyle. Fractures of the skull base involving the temporomandibular joint are rare. Classification of fractures refers to their anatomical positions and the presence or absence of a luxation. Further, it is important whether the fracture is intra- or extra-capsular. The primary imaging method should be orthopantomography. As for therapy planning, especially surgery, also evaluation of soft tissue is necessary, computed tomography is the imaging method of choice. For diagnosis of complications or internal derangement of the temporomandibular joint, magnetic resonance imaging is to be recommended.

Humans↗

[Spinal injuries--diagnostic imaging].

Spinal trauma requires a prompt and detailed diagnosis for estimating the prognosis and installing proper therapy. Conventional radiograms are the first imaging modality in most cases. In the cervical and the lumbar spine, a CT has to be performed in patients with polytrauma and a higher risk of complications or with signs of instability. Especially for imaging the cervicocranium, multiplanar reformations in sagittal and coronal planes are necessary. For fractures of the thoracic spine, MR imaging is superior to CT because of the better detection of associated neurologic complications.

Adult↗

[The pharynx. The imaging of its normal anatomy].

BACKGROUND: The pharynx, being part of the digestive as well as the respiratory system, is embedded in the complex spatial anatomy of the neck and, due to its function and location, represents a very sophisticated region. DIAGNOSIS: Cross-sectional imaging with CT and MR imaging plays an indispensable complementary role to clinical work-up, as far as submucosal and deep cervical spaces are concerned. However, as dysphagia is a common symptom in clinical practice, interpretation of double contrast studies and videofluoroscopic investigations are also on frequent demand in the daily routine. CONCLUSION: Close interdisciplinary co-operation and the radiologist's familiarity with the anatomy of the region are required in order to use the diagnostic tools in an optimal fashion.

Cineradiography↗

[Congenital and benign changes with regard to the pharynx].

DEVELOPMENT: The first part of this article is supposed to present a brief overview on the development of tissues and structures related to the pharynx, as far as they provide a better understanding of the most congenital lesions in this area of the body. BENIGN LESIONS: The second part of this article focuses on benign lesions originating in the pharynx or in neighbouring structures. Functional pharynx abnormalities are beyond the scope of this paper.

Humans↗

[Teleradiology in dentistry].

Teleradiology is a means of electronically transmitting radiographic patient images and consultative text. This offers a new way to communicate with other radiologists and transferring clinicians. Different applications of teleradiology, such as on-call services for emergency departments or rural regions, as well as expert consultation (second opinion) already have been realized. Especially in concern of dental radiography, analog (film-based) imaging gets progressively replaced by digital imaging. The combination with ultrafast data transfer offers an increasing efficacy in diagnosis and therapy, acceleration of communication and new means of quality assessment in patient care. Various applications of teleradiology concerning dental medicine are discussed.

Humans↗

Pyrofluid inhalation in "fire-eaters": sequential findings on CT.

We report the sequential computed tomography (CT) findings in two fire-eaters after accidental inhalation of pyrofluid. The initial chest radiographic findings were ambiguous and the interpretation of the radiographs was biased by clinical history unrelated to fire eating. On CT, pneumatoceles were the major findings in both patients. The pneumatoceles resolved rapidly, leaving only minimal scarring. Our cases illustrate the sequential evolution of pneumatoceles in fire-eaters after the inhalation of pyrofluid and documents the rapidity with which the lesions regress. The rare accidental inhalation of pyrofluid in fire-eaters may produce a puzzling clinical and radiographic picture and can be confused with other lung disorders.

Adult↗

Mycobacterium xenopi infection of a 50-year-old oil plombage complicated by bronchopleural and pleurocutaneous fistulas.

We report the rare combination of simultaneous bronchopleural and pleurocutaneous fistulas 50 years after oil plombage, together with infection of both the plombage and the contralateral lung with Mycobacterium xenopi. Our case documents imaging patterns of complex fistula formation and subsequent infection resulting from oil plombage. Our case also emphasizes the infectious potential of Mycobacterium xenopi.

Aged↗