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Biomedical subjects

S Bondestam

Publications and source records attributed to S Bondestam.

At least 19 recordsLinked to original sources

Correlations of liver echo intensity with cytology and chemical measurements of fat, water and protein content in live burbots (Lota lota).

Six live burbot fish (Lota lota) were examined on the 1st, 7th and 15th day after capture. The echo intensity of the liver tissue was correlated with chemically measured fat and water content and with the tissue cytology. At the end of the study, the collagen and total protein contents of the livers were also measured. The increasing size of fat droplets and clustering of droplets correlated well with the echo intensity (p = 0.0012), but there was no statistically significant correlation between echo intensity and chemically measured fat concentration (p = 0.1989). These results indicate that the echogenicity is a function of the liver histomorphology. No significant correlation was found between the echo intensity and liver collagen, total protein content, or amounts of water. The burbots tolerated transport and repeated anesthesia and appear well suited for experimental ultrasound studies.

Animals

Tissue characterization by image processing subtraction: windowing of specific T1 values.

A method for windowing specific T1 values is presented. A 1.0 T imager with two routine pulse sequences was employed: A T1-weighted spin echo (SE) sequence and a short tau inversion recovery STIR sequence (fat-suppressed IR). A T1 window for fat was obtained by subtracting the STIR image from the SE image. Negative values were coded black. The method was tested on a normal human thigh, on a human liver with confirmed fatty infiltration, and on the livers of four live burbots. The fat-containing tissues of the two human volunteers were well depicted. The differences in fat concentration among the burbot livers were also clearly shown. The fat intensity seen in the images correlated well with the chemically measured fat concentration. This subtraction method for windowing T1 values proved feasible for fat. The method could be used for tissues with other short T1 values as well.

Adipose Tissue

Technique of renal biopsy by ultrasound guided percutaneous puncture with a spring loaded "gun".

The study consisted of 89 consecutive patients (mean age = 41.5, range = 16-82, 64 men, 25 women) referred for renal biopsy because of clinical suspicion of renal parenchymal disease. Neither transplant kidneys nor tumour evaluation were included. A biopsy "gun" (Biopty) and 14 (2.0 mm) and 18 (1.2 mm) gauge needles were used with ultrasound guidance. Sixtyseven renal biopsies were guided using a freehand technique 42 using a fixed angle guide attachment. The mean glomerular yield was 9.4 glomeruli. Almost 25% of the 18 gauge needle biopsies (n = 57) had to be repeated and 29.3% of the 14 gauge needle biopsies (n = 75). The yield difference was not statistically significant (Chi-squared = 0.37, p = 0.54). There was no statistically significant difference between the distributions of failure to obtain a significant material for evaluation caused by the biopsy technique used (Chi-squared = 0.08, p = 0.78). When analysing cases of single successful pass the thinner needle produced 6.7 glomeruli (n = 36, SD = 5.08) and the thicker needle 13.8 glomeruli (n = 18, SD = 6.82). No serious complications occurred.

Adolescent

The needle tip echo.

The echo of the needle tip used in sonographically guided needle aspiration biopsies was studied in A mode. The biopsy transducer was placed in a water tank and needles parallel to the beam axis were used. The beveled needle tip produced two echoes, which were probably generated by diffraction at the edge of the far end of the tip and by the sharp edge of the needle tip opening. The distal echo was more intense than the proximal one. When a stylet was inserted the proximal echo disappeared as the diffracting edges decreased to a single echo. Inserting a stylet did not enhance the echoes. Roughening of the needle shaft did not enhance echogenicity, whereas side ports in the shaft produced a greater number of echo peaks.

Biopsy, Needle

Determination of fat content of burbot (Lota lota) liver with low field MR imaging (0.04 T).

A reconstructed separate fat image was used for studying the fat content of the liver of 12 dead and six living fasting burbots (Lota lota) in a 0.04 T magnetic field with olive oil as a reference. The correlation between the MR intensities and the results of the cytological, histological and chemical fat measurements, as well as chemically measured water, collagen and total protein contents were examined. The MR signal intensity in reconstructed fat images correlated well with the changes in fat content of the liver in living fish (r = 0.69, P = 0.0014). Also the contents of water (r = -0.66, P = 0.003) and total protein (r = -0.91, P = 0.013) correlated significantly with the MR signal intensity. The reconstructed fat image is thus a reliable method for following the changes in tissue fat content. The living burbot is an applicable test animal for studying the hepatic fat content with MR.

Animals

Ultrasound guidance for pericardiocentesis.

Sonographic guidance with 41 punctures and 38 catheterizations was employed in 68 patients. The approach was either intercostal or subxiphoid. Most punctures were performed with a 1.4-mm-thick plastic-sheathed cannula after local anesthesia. Complications were observed in 7 patients. In one patient a catheter introduced with a movable core-type guidewire pierced the right ventricle wall with uneventful recovery after surgery. Intercostal drainage caused pleural pain in 2 patients, and in 2, leakage to the pleural space. Two patients with heart transplants had severe bradycardia and drop of blood pressure, one after needle drainage and the other during guidewire manipulation. Direct monitoring generally ensures a correct position of the instruments and hazards to adjacent organs can be avoided. In small effusions a simple needle aspiration with a plastic-sheathed cannula is safer than catheter drainage.

Adult

The assessment of colonic water retention prior to double-contrast enema.

The detection of colonic water retention prior to double-contrast enema (DCE) was studied in 41 outpatients. Ultrasound examination of the cecum (USC) correctly showed 4 of the 5 patients with water retention as well as all 14 cases with dry colon. Changes in patient's weight or in the number of cleansing enemas were not associated with water retention. The USC seems to offer a rapid and accurate method for the detection of colonic water retention prior to DCE. Aspects of the handling of colonic water retention are also discussed.

Adolescent

Imaging of congenital esophageal cysts in adults.

The radiologic imaging of esophageal cysts (EC) in adults is described. These rare cysts, often detected incidentally on routine chest radiographs, seldom produce symptoms, but they may cause precordial sensations, arrhythmias, and dysphagia. They may also bleed and become malignant. As surgical excision is the treatment of choice, the preoperative diagnosis must be exact. For this, magnetic resonance imaging (MRI) or endoscopic ultrasound seem to be the imaging methods of choice even if a plausible diagnosis can be advanced on computed tomography (CT). Chest x-ray or esophagus roentgenogram have little differential diagnostic value.

Adult

Diagnosis and treatment of subclavian artery aneurysms.

The diagnostic features and operative results in 13 patients with subclavian artery aneurysms were analysed. Symptoms related to subclavian artery aneurysms were present in seven patients, whereas six patients were asymptomatic and the aneurysm was discovered incidentally on chest X-ray. Angiography was the most valuable diagnostic examination and was also necessary in planning the operation. A correct preoperative diagnosis was made in five of six patients with computed tomography. Resection of the aneurysm was performed in nine and aneurysmal exclusion in the latest four patients. Direct reconstruction was used in nine and in four cases an extra-anatomic carotico-subclavian bypass was performed. Postoperative complications arose in two symptomatic and in four asymptomatic patients (46%: two strokes, two wound infections demanding extirpation of the prosthesis in one patient, two pareses of the recurrent nerve and one postoperative haemorrhage). Operative mortality was one patient. Follow-up data was available for all patients for periods of 6 months to 14 years. The vascular graft was patent in all patients. The authors conclude that subclavian artery aneurysm must be included in the differential diagnosis of all obscure upper mediastinal masses as seen on the chest X-ray and examined with CT and angiography. Exclusion of the aneurysm with extra-anatomical reconstruction is technically easier and gives the same postoperative long-term results as resection of the aneurysm and direct reconstruction. A relatively high complication rate after operation on asymptomatic subclavian aneurysms indicates a need for re-evaluation of operative indications in asymptomatic patients.

Aneurysm

Effect of suction on specimen size in fine-needle aspiration biopsy.

High incidences of unsatisfactory specimens in fine-needle aspiration biopsy for cytology have been reported previously. Inappropriate aspiration techniques may account partly for this. In this study, the effect of suction on specimen size was studied in vitro using an automatic sampler. Bovine liver, testis, and pig's kidney were used as target tissues and biopsies were performed with 18-, 20- and 22-gauge needles. Specimen weight increased rapidly and linearly with suction force (P less than .001), regardless of the target tissue or needle diameter, when standard needle movement was applied. In the absence of needle movement, the suction force, rate of increase of suction, and duration of suction had no effect on the weight of the specimens. Needle movement alone, without suction, also produced meager specimens. Suction alone does not seem to tear fragments off target tissues. Nevertheless, in combination with needle movement, suction force plays an important role in the determination of specimen size.

Animals

Prevalence and treatment of mental disorders and epilepsy in Zanzibar.

A survey on prevalence and treatment of mental disorders and epilepsy in Zanzibar was conducted in 1988 among 10,776 randomly selected people. Prevalence rates of 4.9/1000 for epilepsy and 3.2/1000 for psychotic disorders were found. Traditional treatment was common. This article discusses treatment practices and the distribution of target conditions according to age, sex, marital status, geographical area, literacy status and level of education.

Adolescent

Differential diagnosis in scrotal ultrasound. A review of 128 consecutive cases.

One hundred and twenty-eight male patients were examined by ultrasound during a period of two years. The hospital records of the patients were reviewed one to three years after the first examination. The role of the ultrasound diagnosis in the differential diagnosis of suspected scrotal diseases was re-evaluated from a radiologist's point of view. Ultrasound is useful in the differentiation of intra- and extratesticular pathology, especially when palpation is difficult. All the extratesticular lesions were benign. The pathological intratesticular findings are described and pitfalls in the differential diagnosis discussed. It seems possible that the patient history greatly affects the ultrasound diagnosis when there is an intratesticular finding. Ultrasound should be used to provide reference information for the necessary follow-up studies of the effects of treatment.

Diagnosis, Differential

Ultrasonography of jumper's knee.

The aim of the study was to evaluate the role of ultrasonography (US) in the management of jumper's knees. Sixty-two cases of clinically suggested jumper's knees, 52 asymptomatic contralateral knees and 100 asymptomatic knees of healthy middle aged men were examined. In the symptomatic group US was normal in 25 cases, all recovered with conservative therapy. In 31 symptomatic knees the findings were consistent with jumper's knee as a hypoechoic lesion located in the upper insertion of the patellar tendon in 23 cases and in the distal insertion in one case. In 7 cases the lesion was situated in the insertion of the quadriceps tendon. Surgery was performed on 20 knees and in all of them there was a lesion matching the lesion detected by US. In 6 cases US findings were pathologic, but different from jumper's knee. US findings consistent with jumper's knee could not be detected in the asymptomatic group.

Adolescent

Percutaneous evacuation of abdominal abscesses and fluid collections--aspiration or catheter drainage?

Ninety-three abdominal abscesses and fluid collections (pseudocysts, hematomas and bilomas) in 79 patients were treated under radiological guidance, for a total of 111 procedures (23 needle aspirations (NA) of 17 foci and 88 catheter drainages (CD) of 84 foci). In eight foci both methods were used. Catheter drainage was curative in 65% of abscesses and in 56% of pseudocysts and improved the patients' condition before surgery in another 11% or 10%, respectively. The aim of CD could not be achieved in 24% of the abscesses and in 34% of the pseudocysts. Needle aspiration showed little effect being curative in only 6% and partially beneficial in 24% as all the foci were considered. Complications occurred in 8% of CD:s and in 0% of NA:s. We suggest that radiologically guided CD of abscesses and fluid collections should be the primary therapeutic approach in all cases where this can be performed safely. The therapeutic effect of NA was poor.

Abdomen

Sample size in fine needle aspiration biopsy.

The weights of biopsy specimens from bovine liver taken for fine needle aspiration cytology (FNAC) by three groups of physicians, were compared. The groups differed from each other in their extent or degree of experience in FNAC. When the physicians used their normal technique, the mean sample weight increased significantly with experience, from 4.6 mg in the least experienced group to 17.2 mg in the group with the longest experience. Thirty-six per cent of the samples taken by the group with the least experience were in the weight class 0-2 mg, whereas no such samples were encountered for the other groups. When all the physicians were advised to use the same, standard technique there were no statistically significant differences in mean sample weight between the groups or in the proportion of samples in class 0-2 mg. Sample weights correlated significantly (P less than 0.001) with cell counts. This study shows that differences in the technique of FNAC are responsible for differences in sample weights and cell counts, including the number of the acellular samples obtained. This could explain in some part the wide variation in the reported accuracy rates of FNAC.

Animals

Needle tip echogenicity. A study with real time ultrasound.

During ultrasound-controlled biopsy, the visualization of the needle tip is essential for its exact guidance. We constructed a testing device to simultaneously measure the needle tip echo (NTE) intensity of several needles. The following needle parameters were studied: the angle of incidence, the needle diameter, the needle tip bevel angle, and the orientation of the needle tip opening to the transducer. Measurements were made in A-mode using the highest amplitude peak of the NTE and in B-mode using the gray level histogram map from a fixed area around the NTE. There was a positive linear correlation between the intensity of the NTE and the angle of incidence in A-mode as well as B-mode. In A-mode a similar linearity was found between the NTE and the needle diameter, which in B-mode was exponential. However, the needle tip bevel angle did not affect the NTE. Rotating the needle around its longitudinal axis rendered the highest echo at an orientation of 180 degrees from the transducer in A-mode as well as B-mode.

Biopsy, Needle