PubMed HealthSearch

Biomedical subjects

K Rehm

Publications and source records attributed to K Rehm.

14 recordsLinked to original sources

A symbolic environment for visualizing activated foci in functional neuroimaging datasets.

This paper presents a symbolic visualization environment known as the Corner Cube environment, which was developed to facilitate rapid examination and comparison of activated foci defined by analyses of functional neuroimaging datasets. We have performed a comparative evaluation of this environment against maximum-intensity projection and 'gallery of slices' displays, and the results suggest that the Corner Cube environment has definite advantages over both conventional display techniques. We conclude that the Corner Cube is an effective tool for summarizing the spatial characteristics of activated foci within an easily understood visual context and is especially useful for displaying the similarities and differences in functional neuroimaging datasets.

Brain

Improved resolution for PET volume imaging through three-dimensional iterative reconstruction.

UNLABELLED: It has been demonstrated that in two-dimensional iterative reconstruction, a resolution model can improve image resolution while controlling noise. With the lower noise levels of three-dimensional PET volume imaging, these iterative reconstruction advantages may be extended to three dimensions to further improve the reconstructed image resolution. METHODS: We have implemented three-dimensional versions of iterative filtered backprojection (IFBP) and the maximum likelihood by expectation maximization (ML-EM) reconstruction algorithms and applied them to three-dimensional PET volume datasets. The results were compared to images obtained using the standard three-dimensional reprojection reconstruction (3DRP) algorithm. RESULTS: For IFBP with 15 iterations and no regularization compared to 3DRP, both using a ramp filter, the transaxial resolution improved 52%, and the axial resolution improved 39%. With a strong regularization, the transaxial and axial resolution improvements were reduced to 6% and 5%, respectively. If a Hanning roll-off is applied to the ramp filter in the transaxial direction, the transaxial resolution for IFBP without regularization improved 35% compared to 3DRP; with regularization the improvement dropped to 19%. The axial resolution for IFBP and 3DRP was unaffected by this transaxial smoothing in the reconstruction filter. With the same Hanning roll-off, the noise for IFBP without regularization increased by a factor of 6 compared to 3DRP; with regularization the noise was increased only by a factor of 3. Compared to IFBP, the three-dimensional ML-EM reconstruction produced similar resolution improvements with a much smaller increase in noise and slower convergence. Resolution improvements from both IFBP and ML-EM reconstructions are visually apparent in three-dimensional FDG brain images and result in increased activation signals in a three-dimensional [15O]water functional activation study. CONCLUSION: Our results demonstrate that resolution improvement is possible for IFBP and ML-EM compared to 3DRP with or without noise increase.

Algorithms

Display of merged multimodality brain images using interleaved pixels with independent color scales.

UNLABELLED: This article reviews common methods for two-dimensional display of registered multimodality brain images and describes a software package for presentation of merged MRI and PET images that runs on a workstation with an eight-bit color display. The software package displays merged brain images from multiple modalities in a way that is readily manipulated, visually pleasing and easy to interpret. The display method used, i.e., interleaving of alternate pixels with independent color scales, is effective in producing merged images with high contrast-detail for each volume. Interleaving images from different volumes creates unusual perceptual effects, one of which is the apparent camouflage of low-contrast signals by high values in the paired volume. METHODS: The camouflage effect was thought to arise from perceptual merging of adjacent pixels. An observer experiment was conducted to investigate this tendency of high-activity PET data to obscure low-contrast detail in interleaved MRI data in spite of the digital independence of neighboring pixels. Four observers were presented with 20 combinations of signal plus background targets with uniform mask images, using a two-alternative forced-choice experimental design with 50 trials per combination. RESULTS: The psychophysical evaluation of the ability of human observers to detect the simple test objects in an interleaved image presentation indicated a statistically significant camouflage effect of one volume on the other for some combinations of target and mask. The concept of perceptual merging of adjacent pixels was able to predict which combinations caused the greatest degradations in performance. CONCLUSIONS: The image interleaving approach to the display of two-dimensional slices from registered image volumes makes efficient use of an eight-bit color display. Contrast resolution of both individual volumes is high compared with that in other techniques and the volumes are presented in familiar color scales. However, the method yields an unexpected camouflage effect that tends to obscure low-contrast signals. The practical effect of such camouflage on the interpretation of clinical images remains to be investigated.

Brain

Efficacy of digital radiography for the detection of pneumothorax: comparison with conventional chest radiography.

As part of our continuing evaluation of the clinical applicability of digital radiography, we compared the abilities of radiologists to detect pneumothoraces on conventional chest radiographs with their performances when using three formats of digitally obtained images. Twenty-three frontal-view chest radiographs with pneumothoraces and 22 other chest radiographs, either normal or showing miscellaneous abnormalities, were interpreted by five experienced radiologists in each of four formats: conventional film-screen chest radiographs, small-format (17.8 x 21.6 cm) computed radiographs, large-format (35.6 x 43.1 cm) computed radiographs, and digital images viewed on an interactive electronic workstation. The receiver-operating-characteristic curve areas for each observer for the four types of images were compared by a z test on a critical ratio, and the mean sensitivity and specificity values were compared by the sign rank test. The mean areas under the receiver-operating-characteristic curves ranged from 0.869 for the digital workstation to 0.915 for film-screen images. The differences observed among formats were not statistically significant. Mean specificities also were not significantly different, ranging from 0.90 for large-format computed radiographs to 0.96 for the digital workstation. Mean sensitivity ranged from 0.65 for the digital workstation to 0.82 for film-screen images. Radiologists interpreting digital workstation images were significantly less sensitive in detecting pneumothoraces than with film-screen and small-format computed images (p = .06). In this study, radiologists detected pneumothoraces equally well on conventional film-screen radiographs and digital images printed on film; however, they detected pneumothoraces less well on electronic viewing consoles. This latter finding reflects an important practical difference in the working behavior of radiologists interacting with a digital workstation.

Humans

Expiratory computed tomography for assessment of suspected pulmonary emphysema.

Results of computed tomography of the lung performed at two levels in upper lung zones at full inspiration and full expiration were compared with results of tests of ventilatory function, lung mechanics, and single breath carbon monoxide diffusing capacity in 64 subjects, many of whom had some form of airflow obstruction. From the CT scans, the mean percentage of pixels in the range -900 to -1,024 Hounsfield units, or pixel index, was determined for each subject. The highest correlations of pixel index with physiologic variables consistent with a diagnosis of emphysema were observed for CT taken at full expiration. In some subjects, the inspiratory CT would give a "false positive" for emphysema when the hyperaeration observed at inspiration was not observed at expiration. We believe that the CT scan taken at full expiration can effectively reveal the abnormal permanent enlargement of airspaces which defines emphysema and provides a noninvasive method of assessing lung morphology in the living human subject.

Adult

Design and testing of artifact-suppressed adaptive histogram equalization: a contrast-enhancement technique for display of digital chest radiographs.

One of the goals of our research in the field of digital radiography has been to develop contrast-enhancement algorithms for eventual use in the display of chest images on video devices with the aim of preserving the diagnostic information presently available with film, some of which would normally be lost because of the smaller dynamic range of video monitors. The ASAHE algorithm discussed in this article has been tested by investigating observer performance in a difficult detection task involving phantoms and simulated lung nodules, using film as the output medium. The results of the experiment showed that the algorithm is successful in providing contrast-enhanced, natural-looking chest images while maintaining diagnostic information. The algorithm did not effect an increase in nodule detectability, but this was not unexpected because film is a medium capable of displaying a wide range of gray levels. It is sufficient at this stage to show that there is no degradation in observer performance. Future tests will evaluate the performance of the ASAHE algorithm in preparing chest images for video display.

Algorithms

[Surgical indications and choice of procedure in distal radius fractures--wire, plates, external fixation].

The treatment of the typical fracture of the radius is predominantly conservative. Unstable fractures, bending fractures and open fractures will receive operative treatment. Hereby Kirschner wires, blade plates and screws are applied for osteosynthesis. Heavy comminuted fractures were stabilized, besides by minimal osteosynthesis, by a mini-external fixation unit. The results of operative treatment in the Unfallchirurgische Klinik Giessen were in 50% excellent and good, in 38% satisfactory and in 12% bad. The main complications were disturbances of sensibility in the area of the superficial branch of the radial nerve.

Adult

[Indications and results in shortening osteotomy of the ulna].

A relatively or absolutely too long ulna leads always to pain in the wrist, so that a compensation in length of both forearmbones is achieved by shortening osteotomy. The gradual ulna shortening osteotomy, the stylectomy and the resection of the caput ulnae with or without radius transposition osteotomy are available as shortening operation. In 17 patients of the Giessener Unfallchirurgischen Klinik we performed in 14 cases a shortening osteotomy of the ulna and in 3 cases a resection of the caput ulnae. The shortening osteotomy lead in all cases to a reduction of complaints and to an improvement of the mobility of the wrist. Due to frequent arthropathy the resection of the caput ulnae should be taken more often into consideration in older people.

Fracture Fixation, Internal

[On pharacokinetics and metabolism of the choleretic agent febuprol (author's transl)].

The pharmacokinetic behaviour as well as metabolization of 3-butoxy - 1 - phenoxy-propanol-(2) (febuprol) in rats and mice were studied. In addition, binding on human protein and in vitro absorption were determined. The distribution of tritium labelled Febuprol in the body after oral administration was studied in rats and mice: the product was found to circulate in enterohepatic circulation, including the intestines, liver and kidney, and, in the case of mice, also the gall bladder, whereas other organs or tissues show no activity. Upon oral adminstration over 90% Febuprol are absorbed via gastro-intestinal tract and as metabolites 85% of the substance were eliminated via bile, 4% via urine. The rate of metabolisation is high. Via bile only 0.2%, via urine only 0.6% unaltered Febuprol are excreted. Mainly conjugated Febuprol and hydroxy-Febuprol are found as metabolites. By means of the Sartorius absorption model Febuprol yeilded a rate constant common to pharmaceutical substances which are absorbed at a medium rate. This constant does not depend on the pH-range. The buccal tests and the distribution coefficients show the same results.

1-Propanol

[Hearing screening of newborn infants at risk for perinatal hearing damage].

630 neonates with risk factors of perinatal hearing impairment were screened of hearing loss by means of registration of transient otoacoustic emissions before discharge from the newborn nursery. Neonates were screened additionally by means of brainstem evoked response audiometry, if they had bilateral negative emissions. 810 healthy neonates were screened as control group. The investigations were carried out in incubator after the feeding of neonates. The prevalence of a bilateral negative cochlear response was 5.2% in the risk babies and 1.7% in healthy neonates. Neonates are high risk patients for hearing loss if they show craniofacial anomalies including alcohol embryofetopathy, connatal infections, or very low birth weight babies with additional risk factors. The pedaudiological control investigations of the babies with a negative bilateral cochlear response delivered in the risk group 15 cases (2.4%) with an important hearing impairment and in the healthy neonates 2 cases (0.25%) respectively. Prevalence and importance of perinatal hearing impairment explains the necessity of detection in the neonatal period.

Audiometry, Evoked Response