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Biomedical subjects

J Uson

Publications and source records attributed to J Uson.

At least 19 recordsLinked to original sources
PubMed2006

Assessing the intra- and inter-reader reliability of dynamic ultrasound images in power Doppler ultrasonography.

OBJECTIVE: To assess the intra-reader and inter-reader reliabilities of interpreting ultrasonography by several experts using video clips. METHOD: 99 video clips of healthy and rheumatic joints were recorded and delivered to 17 physician sonographers in two rounds. The intra-reader and inter-reader reliabilities of interpreting the ultrasound results were calculated using a dichotomous system (normal/abnormal) and a graded semiquantitative scoring system. RESULTS: The video reading method worked well. 70% of the readers could classify at least 70% of the cases correctly as normal or abnormal. The distribution of readers answering correctly was wide. The most difficult joints to assess were the elbow, wrist, metacarpophalangeal (MCP) and knee joints. The intra-reader and inter-reader agreements on interpreting dynamic ultrasound images as normal or abnormal, as well as detecting and scoring a Doppler signal were moderate to good (kappa = 0.52-0.82). CONCLUSIONS: Dynamic image assessment (video clips) can be used as an alternative method in ultrasonography reliability studies. The intra-reader and inter-reader reliabilities of ultrasonography in dynamic image reading are acceptable, but more definitions and training are needed to improve sonographic reproducibility.

Arthritis↗
PubMed2005

Interobserver reliability in musculoskeletal ultrasonography: results from a "Teach the Teachers" rheumatologist course.

OBJECTIVE: To assess the interobserver reliability of the main periarticular and intra-articular ultrasonographic pathologies and to establish the principal disagreements on scanning technique and diagnostic criteria between a group of experts in musculoskeletal ultrasonography. METHODS: The shoulder, wrist/hand, ankle/foot, or knee of 24 patients with rheumatic diseases were evaluated by 23 musculoskeletal ultrasound experts from different European countries randomly assigned to six groups. The participants did not reach consensus on scanning method or diagnostic criteria before the investigation. They were unaware of the patients' clinical and imaging data. The experts from each group undertook a blinded ultrasound examination of the four anatomical regions. The ultrasound investigation included the presence/absence of joint effusion/synovitis, bony cortex abnormalities, tenosynovitis, tendon lesions, bursitis, and power Doppler signal. Afterwards they compared the ultrasound findings and re-examined the patients together while discussing their results. RESULTS: Overall agreements were 91% for joint effusion/synovitis and tendon lesions, 87% for cortical abnormalities, 84% for tenosynovitis, 83.5% for bursitis, and 83% for power Doppler signal; kappa values were good for the wrist/hand and knee (0.61 and 0.60) and fair for the shoulder and ankle/foot (0.50 and 0.54). The principal differences in scanning method and diagnostic criteria between experts were related to dynamic examination, definition of tendon lesions, and pathological v physiological fluid within joints, tendon sheaths, and bursae. CONCLUSIONS: Musculoskeletal ultrasound has a moderate to good interobserver reliability. Further consensus on standardisation of scanning technique and diagnostic criteria is necessary to improve musculoskeletal ultrasonography reproducibility.

Adult↗
PubMed2005

Assessment of inflammatory activity in rheumatoid arthritis: a comparative study of clinical evaluation with grey scale and power Doppler ultrasonography.

OBJECTIVE: To compare the clinical assessment of overall inflammatory activity in patients with rheumatoid arthritis (RA) with grey scale and power Doppler (PD) ultrasonography (US). METHODS: Ninety four consecutive patients with RA were included. Demographic and clinical data, C reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) were recorded for each patient. The presence of tenderness, swelling, and a subjective swelling score from 1 to 3 were independently assessed by two rheumatologists, who reached a consensus in 60 joints examined in each patient. All patients underwent a US examination by a third blinded rheumatologist, using PD. US joint effusion, synovitis, and PD signal were graded from 1 to 3 in the 60 joints. Joint count and joint index for effusion, synovitis, and PD signal were recorded. A 28 joint count for clinical and US variables was calculated. Interobserver reliability of the US examination was evaluated by a fourth blinded rheumatologist. RESULTS: US showed significantly more joints with effusion (mean 15.2) and synovitis (mean 14.6) than clinical examination (mean 11.5, p<0.05). A significant correlation was found between joint count and joint index for swelling, US effusion, synovitis, and PD signal. The 28 joint count for effusion, synovitis, and PD signal correlated highly with the corresponding 60 joint counts. US findings correlated better with CRP and ESR than clinical measures. Interobserver reliability was better for US findings than for clinical assessment. CONCLUSION: US is a sensitive method for assessing joint inflammatory activity in RA, complementary to clinical evaluation.

Adult↗
PubMed2002

The cybergut. An experimental study on permanent microchip neuromodulation for control of gut function.

UNLABELLED: Acute electrical stimulation of vagal nerve changes gut motility, secretion as well as absorption, and it may have effect on food intake and satiety regulation. The aim of the study was to evaluate the effect of permanent microchip mediated neuromodulation (McNm) of vagal afferent activity on GI function and body mass in the experimental model. MATERIAL AND METHODS: Two-steps study was performed. In the first step (evaluation of food intake) 16 rabbits were divided in two groups, 8 animals each. Group A was subjected to microchip mediated neuromodulation (McNm), and control group B was sham operated. In both groups laparotomy and vagal exploration were performed. In the second step pathomechanism of Mc action was analysed in fourteen Wistar rats divided in two groups (C and D), 7 animals each. Group C was subjected to Mc implantation and gastrostomy placement and group D (controls) to gastrostomy placement alone. RESULTS: Food intake and body mass significantly decreased in group A after Mc implantation compared with the preoperative period and control group B. No differences were found in the frequency of gastric contractions between groups C and D, however, their amplitude was significantly stronger in group C. Neuromodulation had significant effect on BAO without changes in MAO levels. CONCLUSIONS: Low frequency permanent vagal neuromodulation affects gastric function and influences food intake in the experimental model.

Afferent Pathways↗
PubMed2002

Painful shoulder: comparison of physical examination and ultrasonographic findings.

BACKGROUND: High frequency ultrasonography is an accurate non-invasive imaging technique for evaluating patients with painful shoulder. OBJECTIVE: To compare the clinical diagnosis established by a physical examination with high frequency ultrasonographic findings in patients with painful shoulder. METHODS: Thirty one consecutive patients with a first flare of shoulder pain were prospectively included in the study. All had a physical examination performed by two blinded rheumatologists. Ultrasonographic examination was carried out within one week of the physical examination by a third rheumatologist experienced in this technique who had no knowledge of the clinical findings. Ultrasonography was considered the optimal diagnostic technique. RESULTS: Clinical assessment showed low accuracy in the diagnosis of periarticular shoulder lesions. CONCLUSION: Ultrasonography should be used wherever possible to improve diagnosis and treatment of painful shoulder.

Adult↗
PubMed2000

Pes anserinus tendino-bursitis: what are we talking about?

We studied the ultrasonographic (US) features of the pes anserinus insersion (PA) and subcutaneous medial knee fat in patients clinically diagnosed of pes anserinus tendino-bursitis (PATB) syndrome. Thirty seven consecutive patients with suspected PATB were clinically evaluated and their knees examined using a 7.5 MHz linear probe. In twenty-three patients with unilateral clinical PATB (group A) the painful knee was compared with their painless opposite knee. Six patients with bilateral clinical PATB (group B) were compared with 6 healthy controls (group C). All patients were women with radiographic knee osteoarthritis in 93% and body mass index > 27 in 75%. US pes anserinus tendinitis was found in one symptomatic knee and pes anserinus bursitis in two symptomatic knees and in one asymptomatic knee. No US signs of panniculitis were found in patients and controls. In conclusion, patients diagnosed of PATB syndrome in rheumatology rarely have US tendinitis or bursitis of the PA.

Aged↗
PubMed2000

A telemedicine system for enabling teaching activities.

In order to improve the distance teaching of minimally invasive surgery techniques, an integrated system has been developed. It comprises a telecommunications system, a server, a workstation, some medical peripherals and several computer applications developed in the Minimally Invasive Surgery Centre. The latest peripherals, such as robotized teleoperating systems for telesurgery and virtual reality peripherals, have been added. The visualization of the zone to be treated, along with the teacher's explanations, enables the student to understand the procedures of the operation much better.

Computer Communication Networks↗
PubMed2000

An integrated system of telemedicine for minimally invasive surgery.

We have developed a telemedicine project called Telesurgex, which is an integrated information system designed for several hospitals as well as the Minimally Invasive Surgery Centre. The project researches and develops telemedicine systems (both hardware and software) and their contents, ensuring that they are really useful and not just a videoconference with medical topics. Another aim of the project is the improvement of teleteaching systems as applied to medicine, mainly teleteaching of minimally invasive surgical techniques.

Computer Communication Networks↗
PubMed2000

Telereconstruction from computerized tomography images for the distance teaching of medicine.

A system for making remote two- and three-dimensional reconstructions from computerized tomography images has been developed in order to improve medical teleteaching. It allows the automatic two- and three-dimensional remote visualization of the anatomical structure of interest. As a part of this system, software has been developed which allows many visual operations or transformations on a remote three-dimensional model. It permits the remote workstation and the local workstation to visualize every transformation simultaneously. It allows a doctor to interact virtually and remotely with the anatomical structure. The software enables examination of the anatomical model from all angles, even from inside (including planar and three-dimensional presentations).

Education, Distance↗
PubMed2000

Image processing from computerized tomography images: virtual reconstruction for telediagnosis.

We have developed a system for remote three-dimensional reconstruction, which facilitates telediagnosis. The telereconstruction system is based on a computerized tomography (CT) scanner, a workstation connected to the CT scanner, a PC, which can be geographically far away from the workstation, and a computer program that we have developed. The workstation allows CT images to be stored and image processing to be carried out. The PC permits the user to control the workstation in making a three-dimensional reconstruction and allows the remote user to see that reconstruction. From the PC various graphical operations can be performed on the three-dimensional model, such as rotations, translations and cuts through the model. The program therefore allows a remote user to have three-dimensional images and to study them by means of all the options the program provides.

Image Processing, Computer-Assisted↗
PubMed1993

Still's disease in a 72-year-old man.

Adult onset Still's disease is an uncommon clinical entity, usually found in young adults. Occasionally it can be seen in patients over 55 years old. Our clinical report illustrates that Still's disease may occur even in a 72-year-old man.

Aged↗
PubMedDate not supplied

Muscular structural changes following fadenoperation.

The authors describe the macroscopic, histological, and ultrastructural findings observed in an experimental animal model of the fadenoperation . Grossly, muscular fibrosis and musculo-scleral adhesions were well established after the second postoperative month. Histologic findings demonstrated the development of a granulomatous, foreign body reaction around the musculo-scleral fixation suture, collagenization of the muscle tissue from the first postoperative month and degenerative phenomena in the muscle fibers. Electron transmission microscopic study showed atrophy and angulation with distortion of the myofibrillar matrix, along with alteration of the Z bands of muscle fibers, mitochondrial alteration, and dilatation of the sarcotubular system. All these experimental findings suggest the relative irreversible effects of the fadenoperation after the early postoperative period and for the first time, demonstrated that this surgical technique alters the muscle structure.

Animals↗
PubMedDate not supplied

Microchip vagal pacing reduces food intake and body mass.

BACKGROUND/AIMS: Morbid obesity is an increasing problem worldwide. In many patients pharmacotherapy is ineffective and these cases are treated by surgery. Different types of gastroplasty and gastric bypasses have been described. However, all of these ablative surgical methods are irreversible and often replace obesity by other disorders. Neuromodulation of vagal activity is a method of inducing significant changes in stomach motility. We developed a pre-programmed microchip able to pace vagal afferent activity by changing current parameters. The aim of our study was to evaluate long-term effects of vagal neuromodulation on food intake and body mass in rabbits. METHODOLOGY: Twenty-seven healthy male adult New Zealand white rabbits were included into the study and divided into three groups: A, B and C, 9 animals each. Microchips were implanted by laparotomy access. Anesthesia was obtained by continuous intravenous infusion of propofol. Microchips were fixed in the preperitoneal pocket and two electrodes were positioned on the posterior vagus in group A by forward, and in group B by backward pacing. Control group C was sham operated by laparotomy and only vagal nerves preparation was performed. The following parameters were estimated: daily solid food and liquids intake, amount of feces, body mass and heart rate. RESULTS: Within four weeks after operation body mass in group B had decreased up to 12% (P = 0.029), whereas in group A and C changed to -3% and +2%, respectively. An 87% solid food intake was observed in group A, 60% in group B (P < 0.01), and 143% in group C, compared to preoperative period. No significant differences were observed between groups A, B and C for liquids intake. Total feces weight changes corresponded to solid food intake. Heart rate decreased intraoperatively to 78% and 74% in groups A and B, respectively. CONCLUSIONS: Microchip mediated functional gastroplasty significantly reduces food intake and body mass. Obtained results encourage using similar treatment in morbid obesity human patients. However, further studies are required.

Animals↗