[Teacher training in university courses].
Explore the source record for details and available documents.
Education, Nursing, Baccalaureate↗
Biomedical subjects
J Beier
Publications and source records attributed to J Beier.
MRI-assisted specification/localization of target volumes. Aspects of quality control.
The transportation of MRI information on tumor extension into CT-based radiation therapy planning is desirable for several reasons. MRI's better contrast resolution is usually considered the most important, as it leads to a more exact definition of target volumes. Unlike diagnostic imaging, where a certain margin of error in depiction of tumor extension seems acceptable, radiation therapy planning makes it absolutely necessary, that the contents of every MR pixel (or voxel) correspond exactly to the corresponding area in the patient examined. This exact correspondence may be disturbed by a variety of influencing factors. Objects like various implants may lead to the most severe image distortions and--even worse--contrast alterations, some of which are not easily visible on the slices which are used for target volume definition. Additionally, MR images may have intrinsic faults which are able to change the correspondence between the voxel and the part of the patient's body it represents. Quality control has therefore to ensure that parameters like slice thickness are correct and kept constant by the imager. Image fusion may then be used to transfer MR information on tumor extension into the CT data. Electron density distribution provided by CT then allows for treatment planning. Implanted markers may then be used to ensure exact correspondence between the examined parts of the patient's body and the representing pixel or voxel. Care should be taken that landmarks themselves do not influence this relationship.
Brain Neoplasms↗
[Expanded palliative indications for transtracheal oxygen administration].
Transtracheal oxygen therapy (TTOT) is applied particularly to patients with chronic obstructive pulmonary disease. We treated four patients in a preterminal stage of their disease, the primary diagnoses being pulmonary fibrosis and bronchoalveolic carcinoma. Oxygen administered by nasal delivery devices had been inefficient in all patients. TTOT reduced dyspnoea, improved exercise tolerance and reduced hospital stay. We conclude that TTOT has a potential for being medically beneficial in a preterminal stage of pulmonary fibrosis and carcinoma.
Aged↗
[Multi-media presentation of radiologic image data with the Internet].
AIM: Recent developments of the Internet (World Wide Web) allow the integration of audio, video, digital film sequences, and three-dimensional data. The applicability of these innovations for medical documentation is demonstrated. METHODS: Our existing software for medical image processing and 3D reconstruction was extended to provide images, film sequences, and complex 3D models in an Internet-compatible data format. RESULTS: The multimedia results of the image processing were integrated into Internet documents. Specialized programs are no longer necessary for visualization. The Internet software allows for user-friendly handling and interactive presentation of the 2D and 3D data. CONCLUSIONS: The Internet offers public-domain software for display of images, audio/video, and 3D data. Thus, the tools of the Internet represent an ideal basis for local hospital information systems, computer-aided medical education, and teleconferencing.
Computer Communication Networks↗
Registered image subtraction for CT-, MR- and coronary angiography.
Conventional post-processing of digital subtraction angiography (DSA) by 3D spiral CT, 3D MRI and 2D DSA is often hampered by extended artefacts due to patient movements during examination. In this paper an image registration procedure prior to the digital subtraction is introduced allowing an enhanced visualization of the contrast agent. The object displacement is detected by analysis of image deformations in small local regions. The motion pattern is used to compute a new synthetic mask of maximum congruence with the contrast medium image. This new mask image is then used in the subsequent subtraction. The algorithm works fully automatically and does not need any interactive placement of landmarks. Results obtained from subtraction of uncorrected and corrected sequences were compared with each other. The registration procedure provided good results in the suppression of subtraction artefacts and in the enhancement of vascular structures. Results are presented from subtraction of 2D and 3D data from CTA, MR mammography and coronary angiography.
Artifacts↗
[Fractal surface analysis of intrapulmonary space-occupying lesions from high-resolution CT studies].
PURPOSE: The visual assessment of shape and surface structures of pulmonary nodules (PN) (smooth edges vs. spiculae) serves as a qualitative, subjective criterion in differential diagnosis. These properties must be quantified by computer-assisted evaluation, an adequate mathematical model, and new quantitative shape parameters. METHODS: 12 patients were investigated by high resolution CT. Based on 3D reconstructions with increasing thresholds, the PN surface S, volume V, fractal dimension (FD = In(S)/ In(square root of V)), and fractal index (F1 = square root of S/ square root of V) were calculated. RESULTS: The relations between the reconstruction threshold and the calculated tumour surface, respective volume, are of a fractal nature: S = c1 x thres1/d, V = c2 x thres1/D (c1, c2, d, D: real constants). Whereas the absolute values of surface and volume strongly depend on the chosen threshold (mean volume differences of 249%), the derived parameter of the fractal dimension for a specific PN is nearly constant for all thresholds under review (r = 0.998, SD = 0.05). CONCLUSIONS: FD and FI are new diagnostic features for the assessment of PN surface structure and morphology. Thus, the assessment of pulmonary nodules can be supported by new quantitative parameters representing surface irregularity due to invasive tumour growth into adjacent tissue.
Aged↗
Accuracy and precision of angiographic volumetry methods for left and right ventricle.
We imaged and quantified 60 ventricle casts (30 LV, 30 RV) to evaluate the accuracy and reliability of angiographic ventricle volumetry. We analyzed the seven biplane methods most frequently used in clinical routine: Arcilla, Arvidsson, Dodge, Ferlinz, Simpson (LV + RV) and Wynne. The ventricle contours were defined by (1) manual drawing on the computer screen, (2) manual drawing using a graphical tablet and (3) automatic contour detection. A high inter-class variation in volume accuracy between the different methods was observed (S.D. = 12.7 ml). The volume methods for the LV (mean differences MDLV: [-2.2, +8.5] ml, average MDLV = 1.8 ml) are more accurate than for the RV (MDRV: [-11.4, +33.1] ml, average MDRV = 12.1 ml). The intrinsic error is about the same for all approaches and is very high: average S.D. = 20 ml, RMS = 185 ml. Manual contour definition results in a volume over-estimation (average MDman = +32.8 ml, r = 0.731) compared with automatic contour detection (average MDauto = +6.2 ml, r = 0.810). LV hypertrophy results in a volume under-estimation of the LV (MDLV = -7 ml) and an over-estimation of the RV (MDRV = +6 ml). RV hypertrophy leads to the opposite effect. It was shown that ventricle volumetry and the calculation of derived parameters (ejection fraction) is extremely case dependent and can only be an estimate of the actual value.
Angiography↗
[3-D visualization of thoracic tumors from MR images].
AIM: In cooperation with the thoracic surgery department 3-D visualizations of tumors were generated to support the surgeons in preoperative planning. As opposed to 3-D reconstructions of CT data, those representations based on MRI images remain an exception. In this paper different methods of three dimensional visualization of lung tumors are presented and compared to each other. DESIGN: These methods are 1. contour based surface models, 2. threshold based surface models and 3. rendered scenes of segmented volume data with transparent, color-coded display. RESULTS: Combinations of all three methods in one single image are possible as well with the software we developed. Furthermore, cut planes through the original data can be integrated into the 3-D scene. The segmentation of anatomical objects is performed either manually or automatically with various procedures. CONCLUSIONS: Adequate possibilities of manipulation and archiving allow a fast handling and processing even of large data sets. The calculated volumes of the anatomical objects can be used for quantitative studies. Arbitrary views of the three dimensional reconstructions can be generated within a few seconds. Even animation can easily be calculated and displayed with 30 frames/second.
Adult↗
[Spiral CT and color-coded three-dimensional surface reconstruction in the diagnosis of mandibulofacial arteriovenous malformation].
Explore the source record for details and available documents.
Adolescent↗
Randomized, placebo controlled trial of withdrawal of slow-acting antirheumatic drugs and of observer bias in rheumatoid arthritis.
Patients with rheumatoid arthritis, in stable treatment with methotrexate, penicillamine, or sulfasalazine, were randomized in a double-blind fashion either to continuation of their usual treatment or to placebo. 112 patients were included; 52 patients who refused participation had no more severe disease than the others. The patients felt worse on placebo than on active drug (p = 0.002). The mean differences in number of tender, painful and swollen joints after one month were 2.4 (p = 0.08), 3.0 (p = 0.12) and 2.2 (p = 0.03), respectively. Treatment failure occurred for 42 patients of whom 33 received placebo (p = 0.000,001). There was no difference in the severity of side effects (p = 0.91). The patients guessed their treatment correctly more often than expected (p = 0.02) because of the perceived effect. None of the two observers guessed better than chance, and there were no differences between the observers' evaluations of the joints. The effect of slow-acting antirheumatic drugs was unequivocal and no observer bias occurred.
Aged↗
[clinical application of multiplanar and 3D reconstruction of spiral CT in diagnosis of acetabulum fractures].
This review describes recent visualizations of computed tomography for the diagnosis of acetabular fractures. The techniques of conventional and helical-CT for the imaging of the acetabulum are compared. Furthermore, the different methods of multiplaner and three-dimensional reconstructions e.g. shaded surface display, maximum intensity projection, and volume rendering are presented. Figures of each method are demonstrated and the diagnostic potential of multiplanar and three-dimensional imaging for fractures of the pelvis is discussed.
Acetabulum↗
[3-dimensional post-myelographic CT reconstruction in diagnosis and therapy planning of spinal dysraphism].
Dysrhaphia is often associated with severe osseous aberrations of the spine such as, for example scoliosis, hemivertebra, and synostosis. With the advanced possibilities of the post-processing of CT-data (segmentation, three-dimensional reconstruction), post-myelo-CT is an excellent method for the evaluation of osseous structures and the myelon in preoperative planning.
Adolescent↗
[Computer graphics methods for 3-dimensional imaging of intrapulmonary space-occupying lesions of CT and MRI images].
AIM: To improve the pre-operative planning of interventional procedures in thorax surgery different methods of computer-graphical visualization of intrapulmonary lesions and adjacent anatomical structures based on CT and MR data were realized and compared to each other. DESIGN: In 21 patients with intrapulmonary lesions the image data was segmented by interactive and automatic algorithms and different reconstruction techniques were applied (maximum intensity projection; color-encoded and transparent surfaces; volume rendering). Based on these three-dimensional reconstructions, different views from arbitrary perspectives (including simulated endoscopic images) were generated and animated film sequences of the 3D scene were displayed with 30 frames/second. RESULTS: For all patients under review, a high-quality presentation of the relevant structures was obtained by use of the applied computer-graphical techniques. Even combinations of different visualization methods in one image can be generated with the software we developed. CONCLUSIONS: The various methods for image segmentation allow a fast and comfortable processing even of large data sets. The calculated values of tumor surface and volume can be used for quantitative studies and therapy control. The planning of surgical and interventional procedures can be supported by the simultaneous visualization of the intrathoracic lesion and the surrounding structures.
Aged↗
Thrombospondin-related adhesive protein (TRAP) of Plasmodium falciparum: expression during sporozoite ontogeny and binding to human hepatocytes.
Plasmodium sporozoites collected from oocysts, haemocoel and salivary glands of the mosquito show profound differences in their biological properties such as motility, ability to induce protective immune response and infectivity for vertebrate host cells. Sporozoites from salivary glands are much more infectious than those from oocysts and haemocoel. Differential expression of proteins, such as the circumsporozoite (CS) protein and the thrombospondin-related adhesive protein (TRAP), implicated in sporozoite recognition and entry into hepatocytes may account for the development of infectivity during ontogeny. We have carried out a series of experiments to: (i) analyse the expression and localization of TRAP in P.falciparum sporozoites during development in the mosquito; and (ii) elucidate the biochemical and adhesive properties of recombinant TRAP. Our data indicate that TRAP is not expressed in oocysts, whereas variable amounts of CS protein are found in this parasite developmental stage. Hemocoel sporozoites display the distinct phenotypes TRAP- CS protein+ and TRAP+ CS protein+ at a frequency of 98.5 and 1.5% respectively. Salivary gland sporozoites are all TRAP+ CS protein+. We also provide experimental evidence showing that recombinant TRAP binds to the basolateral cell membrane of hepatocytes in the Disse's space and that sulfated glycoconjugates function as TRAP ligands on human hepatocytes.
Amino Acid Sequence↗
[The correction for motion and visualization of subtraction angiographic data from the spiral CT].
Conventional image subtraction of CT sequences is hampered by extended motion artifacts. In this paper a motion correction procedure for the subtraction of images from two time-separate CT investigations is introduced. Native images are obtained in the first CT sequence, and a contrast medium examination is imaged in the second. The aim of image subtraction is sole presentation of the contrast medium. In contrast to conventional digital subtraction angiography (DSA), CT angiography rules out the possibility of direct image subtraction due to occurrence of extended motion artifacts in the time-shifted images. Such shortcomings can now be corrected by means of a new registration method developed for determination of local displacement vectors between the two images. This motion pattern is used to compute a new synthetic mask of maximum congruence with the contrast medium image. The resulting three-dimensional data record is presented by means of a special-purpose hardware enabling fast rotations and cut planes. New diagnostic possibilities can be achieved such as the creation of views that are not obtainable with conventional modalities and the assessment of calcified vessels.
Angiography, Digital Subtraction↗
[3-D reconstruction of CT images with a peripheral peripheral 3-D image processing computer--initial experiences].
Explore the source record for details and available documents.
Algorithms↗
Determinants for hospitalization from an emergency mental health service.
There has been limited systematic study of determinants of acute psychiatric hospitalization of children and adolescents. This study reviewed the records of children and adolescents who received emergency mental health services in one New Jersey county during 6 months of 1990 (N = 226). Using a structured form to abstract data, information was obtained on demographics, precipitating problems, past mental health services, substance use, family problems, and disposition. While suicidal behavior was not a predictor of acute hospitalization, the interaction of assaultive and suicidal behavior was predictive. Other contributory factors identified in the multivariate analysis included: child's substance use, family member's substance use, and initial emergency screening site. Recognition of present utilization patterns will facilitate the development of intensive community-based options for those with acute mental health problems.
Adolescent↗
[Benign metastatic leiomyoma of the lung].
The authors report on the case of a woman of 41 years of age presenting with asymptomatic multiple circular foci in the lung that were primarily suspected of being malignomas. Diagnosis of benign metastasising leiomyomas was confirmed for bilateral multiple circular foci suspected of lung metastasising originating from an unknown tumour of the lung. This diagnosis was achieved by open biopsy. The seemingly contradictory diagnosis of a benign but metastasising tumour is characteristic of a rare disease pattern that, however, is well documented in the literature. The course of the disease is compared with the data given in the literature.
Adult↗