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At least 487 records · Page 27Linked to original sources

PubMed1999

Necrotizing fasciitis of the pharynx following adenotonsillectomy.

Necrotizing fasciitis is a rare clinical entity in the head and neck region. We report a case of necrotizing fasciitis following adenotonsillectomy in a previously healthy 2-year-old girl. The child presented in a septic state with impending airway compromise. Computed tomography (CT) showed massive soft tissue widening with air in the retropharyngeal, parapharyngeal and retromandibular spaces. Intraoperative exploration showed necrosis of the posterior pharyngeal wall from the skull base to the cricoid, with extension into the parapharyngeal and retropharyngeal spaces. Cultures from the debrided tissues grew two aerobes and three anaerobes. Management involved airway support, surgical debridement, broad spectrum antibiotic coverage and nutritional support. The patient ultimately developed nasopharyngeal and oropharyngeal stenosis requiring tracheostomy and gastrostomy tube placement. This case report highlights an extremely rare complication of adenotonsillectomy.

Adenoidectomy↗

PubMed1978

Cross-sectional area of the thigh muscle in man measured by computed tomography.

Nine subjects with different training background were studied by means of muscle biopsy from musculus vastus lateralis. The cross-cut area of the different muscle fibre types was measured. By the use of a soft tissue X-ray technique, computed tomography, a cross-sectional picture of the thigh was produced at the same level as the biopsy was taken. The total cross-cut area of the vastus lateralis muscle was measured from this picture. This technique to measure a cross-cut muscle area from an X-ray picture was evaluated and found to be accurate and reproducible. The mean fibre area was highly correlated (r = 0.91; P less than 0.001) to the cross-cut area of the vastus lateralis muscle. The total number of fibres in the vastus lateralis muscle was estimated. It was concluded that the cross-sectional area of the thigh muscle can be accurately determined by means of computed tomography. The larger cross-sectional area of the vastus lateralis muscle in well trained subjects was primarily explained by a larger cross-sectional area of the fibre, while the total number of fibres in the vastus lateralis muscle seemed to be fairly equal among the subjects.

Adipose Tissue↗

PubMed2002

Intraperitoneal haemorrhage secondary to perforation of uterine fibroid after cystic degeneration. Unusual CT findings resembling malignant pelvic tumor: case report.

Intraperitoneal haemorrhage is a rare complication of myomatous uterus. We present a case of a 37-year-old white nullipara who presented in the emergency room with acute, lower-abdominal pain which reportedly started after riding over a bump on a motorcycle. On examination, the abdomen was diffusely tender, with moderate spasm and rebound tenderness in both iliac fossae. Pregnancy test was negative. Computed tomography revealed a soft-tissue mass with cystic components and inhomogeneous appearance. Free fluid in the peritoneal cavity suggested ascites. The patient underwent an exploratory laparotomy. A ruptured, actively bleeding, subserosal, nonpedunculated, cystic degenerated uterine fibroid was found, as well as approximately two liters of free, bloodstained peritoneal fluid and clots. Subtotal hysterectomy without salpingo-oophorectomy was performed, followed by evacuation of the fluid and clots. The patient's postoperative course was uneventful. In conclusion, definitive, preoperative diagnosis of a perforated, haemorrhaging, uterine fibroid is difficult; exploratory laparotomy is both diagnostic and therapeutic in this rare, life-threatening condition.

Abdominal Pain↗

PubMedDate not supplied

Soft copy using image processing in place of hard copy for detection of subtle pulmonary lesions: is it actually cost-effective?

PURPOSE: To comparatively assess the interpretation performance of hard-copy versus soft-copy presentations for detecting subtle pulmonary lesions and to estimate soft-copy cost-effectiveness. METHODS: Computed radiography was used to obtain images with a 1,600x 1,200 matrix having 8 bits of gray-scale definition. The two separate image formats (hard and soft copy), which consisted of 60 chest radiograph combinations, were shown to five board-certified radiologists. The costs of hard copies, chemicals, waste disposal, and labor were calculated. RESULTS: The mean accuracies and Az values were 0.63 (hard) vs. 0.64 (soft) and 0.657 (hard) vs. 0.729 (soft), respectively. Reading one set of hard copies took on average 8.0 sec less than reading soft copies (30.3 vs. 38.3 sec). Estimated savings resulting from replacement of hard copy with soft were US$128,004 per year or US$6.20 per patient at our hospital. CONCLUSION: Conversion from hard copy to soft copy, using image processing, is feasible and cost-effective.

Adult↗

PubMed1999

A computer-assisted training/monitoring system for TURP structure and design.

A generic framework for a computer-assisted system for both soft tissue endoscopic surgery and surgical training is being researched and developed. The concept demonstrator is a specific system for transurethral prostatic resection (TURP). The main novelty of the research is that it is not confined to an in vitro trainer system. An in vivo monitoring version of the system, for use in the operating theater, is also being researched. This paper presents the framework's structure and design using the United Modeling Language. It also discusses and justifies the underlying information technologies chosen to implement this approach. Object-oriented concepts and well-proven mathematical tools have been adopted as the foundation of this research and development. The rationale for having chosen such tools is presented. The objectives are to arrive at a system which is modular, general, and reusable.

Computer Simulation↗

PubMed1985

[CT diagnosis of soft tissue injuries in habitual shoulder dislocation].

Computed tomography can demonstrate most glenohumeral structures accurately. If the articular cavitz is filled with air, CT ist the method of choice in preoperative diagnosis to determine the capsular extension and to assess the destruction of the glenoid bone rim and glenoid labrum.

Arthrography↗

PubMed2005

Perineal-onset Fournier's gangrene in a patient undergoing hemodialysis--importance of perineal-onset manifestation.

We present a rare case of perineal-onset Fournier's gangrene in a patient undergoing hemodialysis. A 51-year-old Japanese man manifested an acute-onset perineal pain with perirectal abscess; subsequently, the pain extended to the abdomen, chest, and loin despite quick treatment. His consciousness deteriorated to delirium and he died of septic shock on the third day of admission. Computed tomography (CT) revealed soft-tissue air along the right rectal wall, moreover, the infection extended to the anterior wall of the bladder and the right peripsoas muscle. On the basis of the clinical course and CT findings, the patient was diagnosed as having the complications of Fournier's gangrene, however, no scrotal lesions were detected. Fournier's gangrene is considered to be easily diagnosed on the basis of skin lesions, such as scrotal erythema and swelling. However, in the early stage, the diagnosis of Fournier's gangrene is difficult in a patient with perineal pain before the detection of skin lesions. In conclusion, definitely the key to improving the prognosis of this fulminant infection is the prompt recognition of the pathological process. Therefore, Fournier's gangrene should always be considered when patients undergoing hemodialysis manifest perirectal disorders, even when no scrotal lesions are detected, because there is the possibility of intra-abdominal and intra-retroperitoneal infections resulting in septic shock.

Abscess↗

PubMedDate not supplied

[A system of digital analysis for the diagnosis of vascular pathologies of the fundus oculi].

A diagnostic tools' set was worked out for the digital analysis of eye-fundus images; it comprises a retinophot and a digital camera adapted to it as well as a computer system and a special soft. A new mathematical model of a fragment of the ocular main microcirculation vessel and the below related global diagnostic parameters of the vascular system were elaborated: mean diameter, deviation from linearity, image acutance, fluctuations' amplitude for thickness and route, and sinuosity of thickness and route. The system of eye-fundus image processing provides for precising a nature of changes in vascular thickness along the route and for assessing the local diameter by using the vascular profile; it can also be used for determining the angle of vessels' branching. A set of expert diagnostic etalons was set up for vascular pathologies of the eye fundus and an appropriate database was created. The advantages of the designed system are: the possibility to use it comprehensively in clinical practice, less time needed to make and to analyze the eye-fundus images, a higher accuracy in determining the local vascular diameter, the possibility to perform simultaneously an analysis of diagnostic signs of retinal vessels on the basis of using a radically new approach towards assessing the vascular system ("tracing-type isolation of segments"), a higher diagnostic efficiency, the possibility to perform the differential diagnosis and the capability of preserving data without any limitations by volume and store duration time.

Databases as Topic↗

PubMed1994

Radiographic patterns of osteomyelitis in the mandible. Plain film/CT correlation.

Mandibular osteomyelitis often is associated with involvement of the masticator space. Assessment of mandibular osteomyelitis should therefore involve assessment of soft tissue involvement of the lesion. The purpose of this study was to clarify the relationship between computed tomography patterns and the presence of inflammation in soft tissues. Thirty-three cases diagnosed with osteomyelitis of the mandible were analyzed radiologically with conventional radiographs and with computed tomography scans. Computed tomography patterns of osteomyelitis were classified into four types, lytic, mixed, sclerotic, and sequestrum patterns. Location, extent of the lesion, and change of the cortical plate were evaluated and compared with conventional radiographic findings. Mixed pattern cases displayed diffuse bone abnormalities, which sometimes were accompanied by cortical plate disruption and periosteal reaction. In addition, most mixed pattern cases showed soft tissue involvement, especially of the masseter muscle. Inflammation of the masseter muscle was found to be related to periosteal reaction and disruption of the buccal cortical plate. The data demonstrate a close interaction between cortical plate disruption and muscle inflammation. The extent of inflammation including soft tissue involvement was better appreciated with computed tomography in osteomyelitis, especially in mixed pattern cases.

Adolescent↗

PubMed1999

Magnetic resonance imaging of the postoperative hip.

Magnetic resonance imaging (MRI) of the postoperative hip for delineation of various pathological conditions has been established in addition to conventional radiography and computed tomography. MRI provides superior soft-tissue contrast than the other imaging modalities, and it can be used for visualization of structures and pathological entities that cannot be depicted by conventional radiography and computed tomography. These entities include bone marrow changes such as bone marrow edema and avascular necrosis, and infiltration of the bone marrow by tumor recurrence or infections after insertion of metallic osteosynthetic material. The image quality of MRI, which is reduced as result of artifacts caused by metal alloys, can be optimized by using spin-echo or fast spin-echo sequences, and by adapting phase- and frequency-encoding directions in cases where metallic osteosynthetic materials were used. MRI, in addition to computed tomography and conventional radiography, appears to be a valuable tool for imaging the different pathological conditions of the postoperative hip, including after implantation of metallic osteosynthetic material.

Arthroplasty, Replacement, Hip↗

PubMed2000

Fast algorithm for soft straightening of the colon.

RATIONALE AND OBJECTIVES: In this study, the authors developed a fast algorithm for soft straightening of the colon with computed tomographic data that greatly accelerates the unraveling process based on the interpolation of representative electric force lines. MATERIALS AND METHODS: Each curved cross section of the colon is defined by electric force lines of a common origin on an electrically charged central path and is constructed by interpolating most of these force lines from a limited number of representative force lines that are traced directly. Both a synthetic colon phantom and a colon in a living patient were used to demonstrate the feasibility of the fast interpolation algorithm compared with direct implementation for soft straightening of the colon. RESULTS: The interpolation-based soft-straightening algorithm ran approximately 40 times faster than the direct implementation of the electric field-based soft-straightening algorithm. CONCLUSION: The fast algorithm for soft straightening of the colon has potential for use in computed tomographic colonography.

Algorithms↗

PubMed1999

Low back pain and the lumbar intervertebral disk: clinical considerations for the doctor of chiropractic.

BACKGROUND: Low back pain exists in epidemic proportions in the United States. Studies that demonstrate innervation to the intervertebral disk provide evidence that may account for instances of discogenic low back pain encountered in general medical and chiropractic practice. Many patients and health care practitioners believe that intervertebral disk lesions require surgery as the only method of treatment that will result in satisfactory outcome. Surgery rates vary widely across geographic regions. Only one randomized prospective study exists that compares surgical and nonsurgical treatment; it demonstrated essentially equal outcomes in the long run. OBJECTIVE: To review specific aspects of the examination, history, imaging, and treatment of patients with suspected intervertebral disk lesions and to provide guidelines for conservative management, imaging, and relative and absolute indications for surgical referral. DATA SOURCES: Review articles, texts, and original articles from indexed refereed sources that discuss the lumbar intervertebral disk in regard to patient history, physical examination, imaging, treatment, and referral for surgery. RESULTS: Patients with low back pain who do not present with so-called red flags (fever, history of cancer, unexplained weight loss, urinary tract infection, intravenous drug use, saddle anesthesia, or prolonged use of corticosteroids) may be treated initially with conservative methods. Imaging studies are helpful in determining the patient's diagnosis, and computed tomography, magnetic resonance imaging, or other special imaging studies should be ordered judiciously. The only prospective, randomized study of conservative versus surgical management of herniated lumbar intervertebral disk lesions indicates both methods provide adequate outcome in the long run. Little consensus exists on the best method of management for patients with intervertebral disk lesions without absolute indications for surgery. CONCLUSION: Patients should be screened for "red flags" to determine whether they are candidates for conservative treatment. Magnetic resonance imaging is perhaps the most practical imaging study for evaluation of lumbar disk lesions because it involves no use of ionizing radiation and because magnetic resonance imaging has other advantages over computed tomographic scanning such as excellent delineation of soft tissue structures, direct multiplanar imaging, and excellent characterization of medullary bone. Provocation computed tomography-diskography is an invasive procedure and should be reserved for patients with normal magnetic resonance imaging findings and continuing severe pain who have not been helped by conservative treatment attempts and for whom surgical intervention is contemplated. Both conservative and surgical interventions have been shown to be effective in the treatment of discogenic and radicular pain syndromes.

Chiropractic↗

PubMed1986

In vivo delineation of facial fractures: the application of advanced medical imaging technology.

Advanced medical imaging technology has important advantages over ordinary skull radiography and conventional tomography in the study of facial fractures. Computer-based imaging methods, including computed tomography and magnetic resonance imaging, provide exquisite soft tissue contrast, superior geometrical accuracy, and freedom from overlapping shadows, and permit computer reformating of images. The advantages of computer-based medical imaging for study of facial fractures are identified and illustrated with computed tomographs. Three-dimensional surface reconstruction methods applied to serial high-resolution computed tomography scans of facial fractures are described and evaluated.

Facial Bones↗

PubMed1985

Comparison of the diagnostic methods used in maxillofacial trauma.

A prospective study was performed to evaluate the diagnostic methods used in acute maxillofacial trauma. Clinical examination, routine facial x-rays with linear tomography, and computer tomography were compared in 49 patients. Computer tomography was found to be the most accurate test in the diagnosis of facial bone injury, especially complex fractures. Computer tomography also provided valuable information regarding soft-tissue injury of the face. The radiation doses of linear tomography and computer tomography were calculated to be below the level known to cause cataract formation. Computer tomography is a safe, reliable adjunct in the diagnosis of acute maxillofacial trauma and should be strongly considered after initial screening measures are completed.

Adolescent↗

PubMed1978

[Extension of thoracal diagnostics through computer tomography (author's transl)].

The utilization of transverse layers in computer tomography opens up a new level of examination for localization of pathologic processes in the thorax and their spread. The good resolution of roentgen absorption differences in the soft parts enables the use of computer tomography in the diagnosis of pericardial effusions and for further differentiation of known mediastinal growing and displacing processes. This method is also suitable for the identification of aneurysms, since it is not invasive and places hardly any strain on the patient. Finally, computer tomography can also be used for radiotherapy and operation planning, as well as in target biopsy on account of the true-to-scale and reproducible image of the body cross-sections.

Aortic Diseases↗

PubMed2001

Mandibular contour reconstruction with three-dimensional computer-assisted models.

Facial contours are thought to depend on the appropriate balance of hard and soft tissue. To obtain aesthetically good results in head and neck reconstruction, surgeons should know the exact three-dimensional shape and volume of both hard and soft tissue to be reconstructed. The authors used computer-assisted three-dimensional solid models of the mandible in 7 patients (4 women and 3 men) who underwent mandibular contour reconstruction. Scapular osteocutaneous flaps were used in all 7 patients. The follow-up periods ranged from 7 to 57 months (mean follow-up, 29 months). No flap was lost. One patient died of metastatic cancer. In 2 patients the aesthetic results were excellent and in 4 patients they were good. Computer-assisted three-dimensional models for mandibular contour reconstruction in head and neck reconstruction are quite useful.

Adolescent↗

PubMed1996

Unusual endocrine presentations of nasopharyngeal carcinoma.

BACKGROUND: Nasopharyngeal carcinoma is endemic in Southern China and the majority of patients present with local symptoms due to the tumor. METHODS: This report describes two unusual cases of occult nasopharyngeal carcinoma in which the patients initially presented with endocrine manifestations. RESULTS: The first patient presented with Cushing's syndrome secondary to ectopic adrenocorticotropic hormone (ACTH) production. Nasolaryngoscopy showed a growth in the left nasal fossa and biopsy revealed a poorly differentiated nasopharyngeal carcinoma that exhibited positive immunostaining for ACTH. The second patient presented with a 10-month history of bone pain over both lower limbs. She was normocalcemic but her serum alkaline phosphatase was markedly elevated. A bone biopsy showed both osteoclastic and osteoblastic activity with widespread fibrosis suggestive of Paget's disease. Three months later, she developed third cranial nerve palsy. Computed tomography investigation revealed a soft tissue mass filling the sphenoid and ethmoid sinuses. Biopsy showed a poorly differentiated nasopharyngeal carcinoma. The bone biopsy was reviewed and immunohistochemistry demonstrated the presence of cells positive for the epithelial marker AE1/3 within the fibrous stroma. Radio-labeled in situ hybridization showed that Epstein-Barr virus early RNA was present in these tumor cells and the bone lesions were in fact metastases. CONCLUSIONS: Nasopharyngeal carcinoma can present with rather atypical symptoms that may lead to a delay in diagnosis. Therefore, in high risk populations, it is important to consider nasopharyngeal carcinoma as a possible primary tumor in patients with occult carcinomas.

ACTH Syndrome, Ectopic↗

PubMed2000

Optomotor and neuropsychological performance in old age.

While a delayed initiation of visually guided saccades with increasing age has been documented in a number of studies, little research has been done on the control of antisaccades. The present study investigates aging effects on the control of visually guided saccades (prosaccades) and antisaccades as well as a selection of neuropsychological functions by the cross-sectional comparison of 14, 22, and 16 participants aged 20-35 years, 59-73 years, and 74-88 years, respectively. The geriatric and neurological status of the elder participants (including evidence from computed tomography, electroencephalography, and neurological soft signs) was assessed. In four task blocks of 200 trials each, pro- and antisaccades were elicited under the 200-ms-gap and overlap conditions. Left- and right-sided stimuli were presented in random order at 4 degrees, and the order of the task blocks was varied within each age group. In addition, the Wisconsin card-sorting test (WCST) and working memory, go-nogo discrimination, alertness, and stimulus-response incompatibility tests were administered. Participants aged 59-73 years exhibited widespread reductions of optomotor and neuropsychological performance, with greatest effect sizes of age differences in the optomotor parameters and the WCST measures. A further decay after the age of 73 years was discernible in those optomotor functions reflecting saccade disinhibition (in particular, directional errors during the antisaccade task and premature responses) and the performance in some neuropsychological tests. In line with previously published reports, variance in optomotor performance could be explained by two factors, accounting for a total of 76% of the age variance. Our results suggest that the investigation of saccade control may be a highly sensitive tool for neurodevelopmental aging research.

Adult↗