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Biomedical subjects

J G Johansen

Publications and source records attributed to J G Johansen.

At least 19 recordsLinked to original sources

Differentiation between contained and noncontained lumbar disk hernias by CT and MR imaging.

AIMS: The investigation was carried out in order to compare the accuracy of CT and MR imaging in depicting whether disk hernias were contained by the posterior longitudinal ligament (PLL). This is crucial in the evaluation of patients who are possible candidates for percutaneous nucleotomy, which is considered effective only in contained hernias. RESULTS: Of 124 pathologic disks examined in 114 patients, CT was more accurate than MR imaging in 7 patients due to misinterpretation of the integrity of the PLL by MR. These hernias were therefore erroneously classified as noncontained. There was consistency between the classification by CT and MR imaging in the other 117 disks, of which 109 were correct. Both methods overstaged a large hernia that was contained by the PLL, and failed to demonstrate that 7 others were noncontained. CONCLUSIONS: CT, which has higher sensitivity in depicting calcifications, representing further contraindications to percutaneous nucleotomy, is therefore recommended as the primary examination in these patients. Additional MR imaging should be considered if the results of CT are equivocal or at variance with the clinical presentation.

Adolescent

CT-diskography in patients with sciatica. Comparison with plain CT and MR imaging.

AIMS: The findings at CT-diskography (CT-D), including recording of the pain introduced at contrast injection, were compared with plain CT and MR imaging in 111 disks in 101 patients aged 18 to 68 years. RESULTS: Six disks which were normal at CT had normal CT-D and 5 of them had normal signal on MR imaging. The degree of annular degeneration and the depth of the annular tears were significantly associated with each other and with loss of disk height, but not with size or location of the hernias. Only the depth of the tears was significantly associated with loss of signal on MR. However, frequently complete annular tears and severe annular degeneration were seen in association with small bulges and hernias, even in disks with normal or slightly reduced signal on MR and with normal height. The type and intensity of the pain introduced were associated with each other and with the depth of the annular tears, but not with the degree of annular degeneration, size of the hernia or the MR signal intensity of the disks. CONCLUSIONS: Annular degeneration and tears on one hand, and the type and intensity of pain introduced on the other, seem to be related than separate phenomena.

Adolescent

Influence of CT on tumor classification of laryngeal carcinomas.

The routine use of CT in 51 consecutive patients with squamous cell carcinoma of the larynx revealed cartilage involvement or extralaryngeal tumor growth consistent with a T4 tumor which made 14 patients candidates for laryngectomy. Only 5 of these had a T4 classification by clinical examination while 8 cases were upstaged from T3. Except for one supraglottic tumor upstaged from T2 to T4, CT did not change the classification for T1 and T2 tumors, whose localization was mainly glottic, and there were 2 false-negative examinations. It is concluded that CT is mandatory only in advanced tumors of the glottic region or when the anterior commissure is involved. However, in suspected malignancies of the sub- or supraglottic regions CT should always be carried out because these patients are at an increased risk of unexpected deep tumor growth.

Adult

Iopentol in urography. A clinical comparison between iopentol and metrizoate including delayed reactions.

A double-blind comparative study of the nonionic contrast medium iopentol and the ionic contrast medium metrizoate for urography was carried out in 200 adult outpatients. Significantly less discomfort and other side effects were observed following iopentol than following metrizoate. No serious adverse reactions and no clinically significant alterations in heart rate or blood pressure were observed. A questionnaire was used to record delayed symptoms, from 30 min after contrast medium injection and for one week. The response rate was 92% and delayed adverse events were reported by 45%. The incidence of delayed reactions was significantly lower following iopentol than following metrizoate, i.e., delayed arm pain, fatigue, headache, diarrhea, nasal congestion, and rash. Delayed arm pain was probably due to contrast medium induced thrombosis in 1% following iopentol and in 8% following metrizoate. Most other symptoms were probably related to a combination of nocebo effect and coincidentally occurring symptoms. The urograms with both media were of similar high quality. Iopentol was found a suitable contrast medium for urography.

Adult

Computed tomography in assessment of myelographic nerve root compression in the lateral recess.

Thirty patients with myelographic shortening of a single nerve root sheath without indentation of the dural sac were studied by CT. Lateral disc herniation was diagnosed by CT in 18 patients. The myelograms of these patients were considered suspicious of disc herniation in three patients, uncertain in seven, and misinterpreted as lateral recess stenosis due to bony encroachment in eight. CT is more reliable than myelography in assessment of the etiology of nerve root compression in the lateral recess.

Adult

In vitro testing for the risk of arachnoiditis from myelographic contrast media.

The risk of arachnoiditis from aqueous myelographic contrast media has been assayed reliably only in experimental animals. The effect of contrast media on protein and collagen production by fibroblasts in vitro was studied. Iocarmate, metrizamide, and iopamidol added to the culture medium caused cells to produce more protein and collagen. The degree to which the contrast medium stimulated collagen production correlated with the risk of arachnoiditis from the intrathecal use of the contrast medium. In vitro testing appears to be an effective assay for arachnoiditis.

Arachnoiditis

Cervical radiculopathy: computed tomography and myelography compared.

The accuracy of CT in the determination of cervical disk herniation has not been measured as it has in the determination of lumbar disk disease. Cervical myelograms and CT scans of patients with cervical radiculopathy secondary to disk herniation or spondylosis, which was verified by clinical examination, surgery, and in most cases EMG, were evaluated blindly and independently, results were analyzed statistically, and receiver operating characteristic (ROC) curves were calculated. CT without or with the use of intrathecal metrizamide was more accurate than myelography in the identification of lesions that caused cervical radiculopathy. In some patients, CT obviates the need for cervical myelography. With improvement in CT techniques and more experience in interpreting the images, CT will be increasingly important in the evaluation of cervical radiculopathy.

Cervical Vertebrae

Retrosomatic clefts: computed tomographic appearance.

A case of bilateral clefts in the pedicles of the L1 vertebra, diagnosed by computed tomography, is presented. The differentiation from other clefts located laterally in the neural arch is briefly summarized, and the possible origin of this entity is discussed. It is improbable that the clefts represent persistent neurocentral synchondroses.

Adult