Biomedical subjects

G Bodner

Publications and source records attributed to G Bodner.

At least 55 records · Page 3Linked to original sources

PubMed2000

[Results of doppler sonography in normally functioning transjugular portosystemic shunts].

PURPOSE: The objective of this study was to evaluate blood flow changes inside normally functioning transjugular intrahepatic portosystemic shunts (TIPS), using Colour Doppler ultrasound (CDUS) and pulsed Doppler ultrasound (PDUS). MATERIAL AND METHODS: In a prospective study 72 patients (mean age 54, range 36-78 years) underwent TIPS placement, portal angiography, CDUS and PDUS examinations. Along the TIPS Doppler measurements were taken at the portal in the central part and at the venous end of the TIPS. RESULTS: In well functioning TIPS the mean peak velocity (PV) on the portal side was 39 cm/s (range 22-72 cm/s), in the area of the incoming right portal end, branch 62 cm/s (range 40-109 cm/s) and at the site of the incoming hepatic vein 139 cm/s (range 88-220 cm/s). In the punctured portal and hepatic vein the mean PV was 25 cm/s (range 15-30 cm/s) and 18 cm/s (15-22 cm/s) respectively. CONCLUSION: A velocity gradient between the portal and the venous side of the TIPS is a normal finding, caused by the branches of the portal and hepatic vein, joining the TIPS from the side and is characteristic of a normally functioning TIPS.

Adult↗

PubMed2000

[On the fate of lost gallstones].

The spilling of stones during laparoscopic cholecystectomy occurs in 10% of the operations. Late complications associated with this type of surgical procedure are abscesses and fistulas in the abdominal cavity and abdominal wall. The time elapsing between laparoscopy and clinical manifestation may be as long as 12 months. We present a case of a patient with localised abdominal pain in the upper right abdomen two months after laparoscopic cholecystectomy. Sonography and CT revealed a fat necrosis posterior of the rectus muscle. Examination of the histological specimen confirmed a fat necrosis caused by two small pigmented stones, spilled during laparoscopic cholecystectomy.

Abdominal Pain↗

PubMed1999

Characteristics of benzodiazepine abuse in methadone maintenance treatment patients: a 1 year prospective study in an Israeli clinic.

We aimed to study the prevalence patterns and course of benzodiazepine (BZD) abuse in an Israeli methadone maintenance (MMT) clinic using repeated random observed urine analysis as well as self-report data. Lifetime and current prevalence of BZD abuse were found in 66.3 and 50.8% patients, respectively. It was found that 44.6% of patients who abused BZDs during their first month of treatment ceased to do so after 1 year, while 27.4% who had not abused BZDs at the beginning of MMT did so after 1 year in treatment. Flunitrazepam was the most commonly abused BZD (92.9%), followed by diazepam (54.3%) and oxazepam (38.6%). Most of the patients swallowed BZDs (92.8%), 42.9% also smoked or snorted them while 8.6% injected BZDs intravenously. BZDs were used as self-medication for alleviating emotional problems rather than for recreational or other reasons. We conclude that BZD abuse is a significant clinical problem in heroin addicts both before entering and during MMT. MMT may have a positive as well as a negative influence on BZD abuse with the former being more prevalent.

Adult↗

PubMed1999

Correlates of benzodiazepine abuse in methadone maintenance treatment. A 1 year prospective study in an Israeli clinic.

AIMS: This study addressed the following questions for patients after 1 year of methadone maintenance treatment (MMT); (1) What are the demographic features and past history of drug use of benzodiazepine (BZD) abusers? (2) Do BZD abusers abuse more heroin, cocaine and/or cannabis and do they receive a higher methadone dosage level? (3) Do BZD abusers suffer more from hepatitis C (HCV) and do they have more HIV/HCV risk-taking behaviors than non-abusers? (4) Do BZD abusers have more psychopathology and more emotional distress than non-abusers? DESIGN: All 148 patients who completed 1 year of MMT underwent random and twice-weekly observed urine analysis for various drugs of abuse, responded to self-report questionnaires (SCL-90-R; POMS; HIV/HCV risk-taking behaviors), interviews (ASI) and underwent testing for hepatitis C. Abuse in this study is defined as any use during the 12th month of treatment. FINDINGS: After 1 year of MMT, more BZD abusers (n = 63) were single, had spent time in prison, were unemployed and had at least one parent with an addiction problem or mental illness in comparison to non-abusers (n = 85). They had started using heroin and cocaine earlier and currently abused more cocaine, heroin and cannabis. They had significantly more psychopathology and negative mood. They had significantly more HCV and reported more HIV/HCV risk-taking behavior. IMPLICATIONS: We suggest that this group of patients is in need of more intensive pharmacological and psychological treatment.

Adult↗

PubMed1999

Diagnosis of digital flexor tendon annular pulley disruption: comparison of high frequency ultrasound and MRI.

PURPOSE: The objective of this study is to assess accuracy of ultrasound (US) and MRI to diagnose completely disrupted annular pulley ligaments (APL) of the flexor tendons of the fingers. PATIENTS AND METHODS: In a prospective study 32 patients (all males 18-42 years, mean age 25 years) with clinically suspected annular pulley disruption were studied with US and MRI. As a control group we investigated 40 fingers of 10 healthy volunteers and a non-injured finger of the patients with US. A 10 MHz linear array was used for US examinations and a 1.5 Tesla unit for MRI. Imaging was performed between the accident and surgical repair within 6 weeks. Examinations were performed in an extended and forced flexed finger position. RESULTS: Complete disruption of the APL was diagnosed by US and MRI in 14 cases confirmed by surgery. The typical sign of disruption was a marked volar displacement of the flexor tendon in the area of the torn annular pulley during forced flexion. A distance between tendon and bone at the area of the ruptured pulley of 3 mm during extension and a distance of 5 mm at flexion was typical for complete disruption. CONCLUSION: Both diagnostic modalities, US and MRI are valuable techniques in diagnosing complete disrupted annular pulleys of the flexor tendons.

Adult↗

PubMed1999

Aneurysmal portosystemic venous shunt: a case report.

A case of an aneurysmal portosystemic venous shunt detected by colour Doppler ultrasound (CDUS) is presented. A young female patient complained of postprandial fatigue and had paroxysmal tachycardia. A direct vascular communication between right portal vein and right hepatic vein was found at CDUS and confirmed by direct portal angiogram. Using detachable coils a complete occlusion of the intrahepatic shunt was obtained. Reports from the literature regarding portovenous aneurysms are reviewed.

Adult↗

PubMed1999

Internal mammary vessels as a model for power Doppler imaging of recipient vessels in microsurgery.

The aim of this interdisciplinary study was to evaluate power Doppler imaging as a method of collecting reliable preoperative data concerning the diameters and topography of exemplary internal mammary vessels as recipient vessels in reconstructive microsurgery. Thirteen female patients (range, 37 to 58 years; mean, 45.6 years) were examined preoperatively with power Doppler imaging from the first to the fifth intercostal space parasternally and bilaterally. These data are compared with measurements obtained intraoperatively in each individual. Mean velocity in the artery in the second intercostal space on the right side is 47.11 cm/sec (range, 15 to 90 cm/sec) and on the left side is 42.25 cm/sec (range, 18 to 95 cm/sec). Mean velocity in the vein in the second intercostal space on the right side is 17.80 cm/sec (range, 10 to 30 cm/sec) and on the left side is 13.06 cm/sec (range, 5.3 to 32 cm/sec). The topographic results are in close agreement with intraoperative measurements and previous anatomical studies. Sonographic preoperative data of arteries (mean, 1.88 mm) show slightly smaller diameters than intraoperative measurements (mean, 2.08 mm), whereas veins show slightly larger diameters in sonography (mean, 2.33 mm) than intraoperatively (mean, 2.12 mm). Mean sonographic diameter of artery ranges from 2.14 mm (second intercostal space) to 1.46 mm (fifth intercostal space), of the vein from 2.76 (second intercostal space) to 1.25 mm (fifth intercostal space). In one case, a vein was not detectable. This noninvasive method leads to confirmation of the preoperative choice of the optimal recipient vessels for free tissue transfer and does not harm the patient.

Adult↗

PubMed1999

[Changes of renal blood flow during organ-associated foot reflexology measured by color Doppler sonography].

Using colour Doppler sonography blood flow changes of the right kidney during foot reflexology were determined in a placebo-controlled, double-blind, randomised study. 32 healthy young adults (17 women, 15 men) were randomly assigned to the verum or placebo group. The verum group received foot reflexology at zones corresponding to the right kidney, the placebo group was treated on other foot zones. Before, during and after foot reflexology the blood flow of three vessels of the right kidney was measured using colour Doppler sonography. Systolic peak velocity and end diastolic peak velocity were measured in cm/s, and the resistive index, a parameter of the vascular resistance, was calculated. The resistive index in the verum group showed a highly significant decrease (p </= 0.001) during and an increase (p = 0.001) after foot reflexology. There was no difference between men and women and no difference between smokers and non-smokers. Verum and placebo group significantly differed concerning alterations of the resistive index both between the measuring points before versus during foot reflexology (p = 0.002) and those during versus after foot reflexology (p = 0.031). The significant decrease of the resistive index during foot reflexology in the verum group indicates a decrease of flow resistance in renal vessels and an increase of renal blood flow. These findings support the hypothesis that organ-associated foot reflexology is effective in changing renal blood flow during therapy.

Adult↗

PubMed1999

Vascularized bone graft from the iliac crest for the treatment of nonunion of the proximal part of the scaphoid with an avascular fragment.

BACKGROUND: It was hypothesized that nonunion of the proximal third of the scaphoid associated with avascular necrosis could be treated successfully with a free vascularized bone graft obtained from the iliac crest. METHODS: Fifteen patients who had a nonunion of the proximal part of the scaphoid that had been present for an average of two years and three months (range, nine months to seven years) were managed with use of a free vascularized bone graft obtained from the iliac crest. Avascularity of the scaphoid, as assessed on preoperative radiographs, was characterized by loss of trabecular structure, collapse of subchondral bone, and formation of bone cysts. The results of the procedure were assessed in terms of osseous union, pain, active motion of the wrist, and osteoarthritis. Postoperatively, vascularity of the scaphoid was evaluated with use of magnetic resonance imaging and color Doppler ultrasonography. The average duration of follow-up was six years and one month (range, two years and one month to eight years and one month). RESULTS: Preoperatively, one patient had had pain with any movement of the wrist and fourteen had had pain after strenuous manual labor or sports activity. The average pain score, derived with use of a 10-point visual analog scale, was 2.4 points (range, 1.0 to 6.7 points). Postoperatively, union was achieved in twelve patients; six were pain-free, and six had occasional pain during strenuous manual labor or sports activity, or both. The average pain score for these twelve patients was 1.1 points (range, 0.0 to 4.2 points) on the visual analog scale. Preoperatively, osteoarthritis was limited to the region between the radial styloid process and the distal part of the scaphoid in fourteen patients and to the radioscaphoid region in one patient. Postoperatively, the degree of osteoarthritis remained unchanged in seven of the twelve patients who had union and progressed to the radioscaphoid region in five. Vascularity, as seen on the imaging studies, was restored in all twelve patients who had union. The nonunion persisted in three patients, all of whom had progressive osteoarthritis leading to carpal collapse. CONCLUSIONS: The index procedure was successful in twelve of the fifteen patients who had a symptomatic nonunion of the proximal part of the scaphoid associated with avascular necrosis and osteoarthritis that was limited to the radioscaphoid joint.

Adult↗

PubMed1999

Sonographic detection of radial nerve entrapment within a humerus fracture.

Radial neuropathy is frequently associated with fracture of the middle third of the humerus owing to the course of the nerve adjacent to the humeral shaft. The prevalence varies from 2 to 18% of humeral fractures. The therapeutic management is still controversial. Some authors recommend initial surgical exploration, whereas others prefer observation and intervention only if the injured nerve failed to recover after a period of more than 4 months. According to the literature, verification of an entrapped radial nerve in a fracture gap requires surgical exploration, but diagnostic tools to verify the existence of a pathologic condition are limited. We describe the sonographic findings of an entrapped radial nerve and review the literature regarding diagnosis and treatment of entrapped radial nerve in cases of humeral fracture.

Adult↗

PubMed1999

Beating heart axillocoronary bypass for management of the untouchable ascending aorta in coronary artery bypass grafting.

OBJECTIVES: Cannulation and clamping of a severely atherosclerotic ascending aorta during coronary artery bypass grafting (CABG) can lead to cerebral embolization of atheromatous debris and should therefore be avoided whenever possible. A variety of surgical techniques including performance of extraanatomical coronary bypass conduits has been described to solve this problem. We report on a preliminary series of four patients in whom the axillary artery was used as an inflow vessel for venous coronary artery bypass grafts which were performed on the beating heart in order to achieve an aortic no touch concept. METHODS: The axillary artery was exposed between the pectoralis major muscle and the deltoid muscle via an infraclavicular incision. A saphenous vein graft of at least 40 cm in length was sutured to the axillary artery and then brought into the pericardial cavity following an intercostal and transpleural route. The graft was anastomosed to the target vessel using local coronary occlusion. The procedure was carried out via sternotomy in three patients who also received additional internal mammary artery in situ grafts for adequate coronary revascularization. In one high risk patient an isolated axillocoronary bypass was performed in a minimally invasive fashion via anterolateral minithoracotomy. RESULTS: The procedure was completed without major technical difficulties in all four patients. The mean graft length required was 33.2 +/- 1.6 cm, postoperative ultrasonic duplex scans of the axillocoronary grafts revealed a mean flow of 62.5 +/- 23.6 ml/min. No stroke or brachial plexus injury occurred. Three patients are in angina class I (Canadian Cardiovascular Society Classification), one patient is in class II postoperatively. After a mean follow-up of 11.5 +/- 6.6 months postoperatively all grafts remain patent. CONCLUSION: Axillocoronary bypass grafting can be easily performed for management of the untouchable ascending aorta. Straightforward surgical technique and the accessibility to noninvasive diagnostics seem to offer advantages over other extraanatomical bypass grafts.

Aged↗

PubMed1998

Effect of endogenous cortisol levels on natural killer cell activity in healthy humans.

The aim of this study was to examine the effects of increasing and decreasing endogenous cortisol levels on natural killer (NK) cell activity in vivo. Normal healthy volunteers participated in the following studies: baseline (n = 27), metyrapone challenge test (n = 10), dexamethasone suppression test (n = 10), and adrenocorticotropic hormone (ACTH) stimulation test (n = 8). Each subject served as his own control for each study. Each subject was tested for NK activity and plasma cortisol levels at 9 a.m., just before the challenge drug administration, and at 10 a.m., except for the dexamethasone study, in which only the 9 a.m. blood was drawn, 10 h after the dexamethasone administration. On the baseline study day, a significant decrease in plasma cortisol levels was found from 9 to 10 a.m. (p <.02) along with a significant increase in NK activity (p <.001). On the metyrapone test day, plasma cortisol levels at 10 a.m. were significantly reduced (p <.005) as expected, while NK activity at the same time point was not affected and was increased to an extent equivalent to the baseline study day. On the dexamethasone test day, plasma cortisol concentrations were significantly decreased (p <.0001) as compared to the same time point on the baseline day, without any significant change in the NK activity. On the ACTH test day, plasma cortisol rose significantly at 10 a.m. (p <.02), with no change in NK activity. We conclude that plasma cortisol alone has no significant effect on NK activity in vivo.

Adrenocorticotropic Hormone↗

PubMed1998

Sonographic appearance of an appendix carcinoma.

Malignant appendix tumours are rare entities. Especially adenocarcinomas, which only appear in about 10% of appendix tumours, are very seldom. Preoperative diagnosis is very difficult due to a lack of typical clinical signs and a clinical appearance mimicking perforated appendicitis. Nevertheless, sonography is able to show indirect signs and therefore it can provide the surgeon with more information for a better operative treatment.

Adenocarcinoma↗

PubMed1998

[Doppler ultrasound determination of vascular resistance in arteriovenous shunts of the finger tip].

AIM: Doppler sonographic assessment of physiological bloodflow characteristic in arteriovenous shunts of the fingertip and calculation of vascular resistance. Identification and definition of a peripheral, physiological resistive index in healthy volunteers. METHOD: Doppler sonographic measurement of bloodflow values in Hoyer-Grosser organs of the fingertip in 20 healthy volunteers. Measurements were repeated at normal air temperature (21 degrees C) and after submersion in water (15 degrees C). The resistive index was calculated from peak systolic velocity and minimal diastolic velocity. RESULTS: Although bloodflow values vary in a wide range, the resistive index is constant with 0.54 (range 0.45-0.69) in healthy volunteers. Characteristic sonographic flow patterns could be achieved in all tests. CONCLUSIONS: Colour Doppler sonography allows identification of small arterio-venous shunts of the fingertip, measurement of bloodflow in these vessels and calculation of vascular resistance. At normal air temperature the physiological resistive index is 0.54.

Adult↗

PubMed1998

[Doppler ultrasound determination of average blood flow velocity and flow volume in transjugular intrahepatic portosystemic shunt (TIPS)].

AIM: To determine if duplex sonographic measured Time Average Motion (TAM) is an effective parameter for screening examination in routine follow-up after TIPS implantation. PATIENTS AND METHODS: 35 patients underwent duplex sonographic examination by a 3.5 MHz transducer with a follow-up for 12.4 months. RESULTS: A reduction of TAM about 60% from baseline proved with a sensitivity of 90% and a specificity of 93.7% the presence of a hemodynamic relevant stenosis, which was confirmed with angiography. We failed to establish a threshold which pointed out with acceptable accuracy the presence of shunt dysfunction. CONCLUSION: TAM is a good parameter in colour-duplex sonography which permits an objective view of TIPS-function. Angiography should be performed only in patients with suspect duplex-results or clinical worsening. A secondary sign of shunt dysfunction is increasing ascites.

Adult↗

PubMed1998

[Ruptures of the medial gastrocnemius muscle: diagnosis with high resolution ultrasound].

AIM: Evaluation of high resolution ultrasound to diagnose rupture of the medial head of gastrocnemius muscle in patients with uncharacteristic calf pain. METHOD: 66 patients with clinically unclear calf pain were examined in a prospective study. RESULTS: Out of 66 patients, 51 showed sonographic criteria of a partial rupture of the medial gastrocnemius head. 47 ruptures were located in musculotendineus transition zone. CONCLUSION: High resolution sonography detect minimal lesions of the medial gastrocnemius muscle in patients with clinically uncharacteristic calf pain.

Adult↗

PubMed1998

[ACOnet (Austrian Academic Computer Network) as data carrier for teleradiologic consultations].

PURPOSE: To assess the feasibility of image transfer for teleradiologic consultations using the Austrian Academic Computer Network (ACOnet). The ACOnet corresponds between the main universities to a MAN (Metropolitan Area Network) with a transfer rate of 4 Mbps. Its use is free of charge for university institutions. MATERIALS AND METHODS: 1740 test image data sets and 620 image data sets for teleradiological consultations were exchanged without annotations between the Departments of Diagnostic Radiology of the universities of Innsbruck and Graz, using the ACOnet. RESULTS: Data transmission was reliable and fast with an average transfer capacity of 170.2 kBytes/s (94-341 kBytes/s). There were no major problems with image transfer during the test phase. CONCLUSION: Due to its high transfer capacity, the ACOnet is considered a reasonable alternative to the ISDN service.

Austria↗

PubMed1998

The Austrian Academic Computer Network and its usefulness for teleradiology.

To study the value of the Austrian Academic Computer Network (ACOnet) for teleradiology, 1740 test image data-sets and 620 image data-sets were exchanged between the departments of diagnostic radiology of the Universities of Innsbruck and Graz using the ACOnet service. Data transmission was reliable and fast with an average transfer capacity of 170 kByte/s (range 94-341). During the test phase, no major problems with image transfer occurred. Assuming that problems like security of patient data-sets, data compression and data verification can be solved, the ACOnet service would be a useful additional tool for telemedicine applications throughout Austria and eastern Europe.

Austria↗