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At least 541 records · Page 30Linked to original sources

PubMed1990

Parametric assessment of myocardial perfusion during interventional cardiac catheterization by means of X-ray densitometry-short-and long-term results.

X-ray densitometric evaluation of digital subtraction angiocardiograms allows an assessment of myocardial perfusion by means of the parameter 'MEAN RISE TIME' (MRT), defined as the time from the onset of local myocardial contrast medium opacification to the point of maximum opacification. Best results are obtained when the response of that parameter is compared before and after stimulation of coronary flow by papaverine. A prolongation of this parameter, especially after papaverine, was indicative of an impairment of myocardial perfusion, when compared to the results of TL-201 scintigraphy. In 50 patients with single vessel coronary artery disease the results of MRT pre and post papaverine before and after coronary angioplasty, as well as after 6 months were evaluated for 204 post-stenotic regions-of-interest. Before angioplasty papaverine induced a significant prolongation of post-stenotic MRT was measured 2.3 s +/- 0.9 s vs 3.1s +/- 0.8s; p less than 0.01), while after successful angioplasty post-stenotic MRT was measured significantly shorter after stimulation of coronary flow (2.6s +/- 1.0s vs. 1.9s +/- 0.9s; p less than 0.01). This indicated an improvement in myocardial perfusion. Nevertheless, 16/50 patients still presented pathological results of post-stenotic MRT after papaverine, although angioplasty was regarded successful. These patients presented a markedly higher rate of restenosis (14/16 patients after 6 months), a higher rate of dissections at the dilation site and a higher rate of dilated vessels, supplying myocardial areas after a Q-wave myocardial infarction. Thus, these results demonstrate the additional information about the short-and long-term outcome of an angioplasty procedure by densitometric myocardial perfusion analysis.

Absorptiometry, Photon↗

PubMed1998

[Use of sodium ceftiofur in the combined therapy of complicated septic diseases in cattle].

The use of Sodium-Ceftiofur (Excenel) with a dosage regimen of 1 mg/kg body mass intramuscularly was evaluated in the therapy of complicated claw diseases, like septic arthritis of the distal interphalangeal joint, septic tenosynovitis of the digital flexor tendon sheath or complicated interdigital necrosis. Sodium-Ceftiofur was applied in 34 dairy cattle in addition to surgical intervention. 14 cattle of the control group perceived only surgical intervention without additional antibiotic therapy. Application of the cephalosporin proved to be necessary, with the untreated animals exhibiting far more disturbance of the reconvalescence course in the postoperative phase. Treated animals had a decreasing duration of the postoperative stay at the clinic. Sodium-Ceftiofur was found to be an effective antibiotic in the therapy, an application over a five- to 10-day-period is recommended in complicated digital diseases. As a side effect five cows exhibited slight diarrhea, which disappeared without additional treatment.

Animals↗

PubMed1998

Adventitial stripping: a digit saving procedure in refractory Raynaud's phenomenon.

OBJECTIVE: To assess the efficacy and role of adventitial stripping (i.e., digital sympathectomy) in patients with severe digital ischemia secondary to refractory Raynaud's phenomenon (RP). METHODS: A retrospective chart review of 13 consecutive cases of adventitial stripping in 9 patients with severe secondary RP was performed, examining patient characteristics, previous therapeutic interventions, and postoperative outcomes. An illustrative case is presented. RESULTS: All identified patients had evidence of systemic disease. After adventitial stripping, sustained longterm improvement was achieved in all 13 ischemic digits, 8 of which showed amelioration of symptoms immediately after surgery. In 2 patients, sustained improvement was noted despite progressive ischemia in nonoperated digits. The mean followup time was 28 months (range 10 to 47). No postoperative complications were observed. Pre-operative sympathetic nerve blockade was performed in 12 of the cases, of which 10 showed no clinical response. Pathologic specimens revealed adventitial fibrosis that caused extrinsic compression of the digital arteries. CONCLUSION: Adventitial stripping of digital arteries is an extremely effective and safe option for patients with severe digital ischemia secondary to refractory RP. The efficacy of this procedure results not only from sympathetic denervation but also from decompression of the ischemic vessel through removal of a fibrotic and noncompliant adventitia. Because of the effects of this extrinsic vascular compression, lack of response to pre-operative sympathetic nerve blockade is not predictive of postoperative outcomes.

Adult↗

PubMed1993

Vascular interventions in the abdomen: current status.

Vascular and interventional radiology has grown at a remarkable pace due to three major factors. Firstly, many disease processes are now amenable to definitive diagnosis and management in a less invasive manner, by the radiologist. Secondly, most interventional procedures have low and acceptable complication and morbidity rates compared to surgery. Additionally, an interventive procedure does not preclude the patient from having a surgical procedure, if subsequently deemed necessary. Thirdly, the continuing surge and development of new innovative technology has provided for increased safety and better results. The advent of digital subtraction angiography, small balloon catheters, safe-guide wires, expandable stents, new thrombolytic agents and non-ionic contrast media have all contributed significantly to the expansion of interventional radiology.

Abdomen↗

PubMed1997

[Digital subtraction dacrocystography].

The method of digital subtraction is based on the ability to eliminate interfering shadows from the X-ray picture, which makes it possible to make the parts of the picture containing contrast substance more visible. Digital subtraction dacryocystography makes better and more detailed imaging of the lacrimal pathways possible, in particular in the proximal part of the efferent lacrimal pathways, as compared with conventional dacryocystography. This is important for more detailed assessment of the necessary surgical intervention on the lacrimal pathways and its prognosis. The advantage is the possibility to deposit the image in the memory of the instrument as well as its digital processing and the smaller radiation load to which the lens is exposed. The authors examined by the method of digital subtraction dacryocystography 25 patients with disorders of the efferent lacrimal system and present some normal and pathological findings of the lacrimal pathways.

Humans↗

PubMed2000

Accuracy of digital tympanic, oral, axillary, and rectal thermometers compared with standard rectal mercury thermometers.

OBJECTIVE: To compare a number of electronic tympanic, oral, axillary, and rectal measurements with those taken with a standard rectal mercury thermometer. DESIGN: Prospective open study. SETTING: County hospital, Denmark. SUBJECTS: 200 patients. INTERVENTIONS: Each of 200 patients had 6 electronic measurements of body temperature: 3 in the auditory canal using Ivac Core Check 2090A, Diateck 9000, and Genius 3000A, 1 in the axilla using Terumo Digital C202. 1 in the mouth using Terumo Digital C402, and 1 in the rectum using a Terumo Digital C402. These were compared with readings from a standard mercury glass thermometer in the rectum. MAIN OUTCOME MEASURES: Accuracy of electronic thermometry. RESULTS: The rectal electronic measurements were closest to the rectal mercury readings, with a mean (SD) of -0.05 degrees C (0.12), whereas the other measurements gave unacceptable SDs of temperature differences ranging from 0.41 degrees C to 0.53 degrees C. CONCLUSIONS: We conclude that electronic rectal temperature measurements are the most accurate. We do not recommend electronic tympanic, oral, or axillary measurements.

Adolescent↗

PubMedDate not supplied

Failing hemodialysis arteriovenous fistula and percutaneous treatment: imaging with CT, MRI and digital subtraction angiography.

PURPOSE: To evaluate failing hemodialysis arteriovenous fistulas with helical CT angiography (CTA), MR angiography (MRA), and digital subtraction angiography (DSA), and to compare the efficacy of the three techniques in detecting the number, location, grade, and extent of stenoses and in assessing the technical results of percutaneous transluminal angioplasty (PTA) and stenting. METHODS: Thirteen patients with Brescia-Cimino arteriovenous fistula malfunction underwent MRA and CTA of the fistula and, within 1 week, DSA. A total of 11 PTAs were performed; in three cases an MR-compatible stent was placed. DSA served as the gold standard for comparison in all patients. The presence, site, and number of stenoses or occlusions and the technical results of percutaneous procedures were assessed with DSA, CTA, and MRA. RESULTS: MRA underestimated a single stenosis in one patient; CTA and MRA did not overestimate any stenosis. Significant artifacts related to stent geometry and/or underlying metal were seen in MRA sequences in two cases. CONCLUSIONS: CT and MRI can provide information regarding the degree of vascular impairment, helping to stratify patients into those who can have PTA (single or multiple stenoses) versus those who require an operative procedure (occlusion). Conventional angiography can be reserved for candidates for percutaneous intervention.

Aged↗

PubMed2004

Orthostatic tolerance in older patients with vitamin B12 deficiency before and after vitamin B12 replacement.

Orthostatic hypotension (OH) and vitamin B12 deficiency are common disorders in older people. Several case series have reported an association between vitamin B12 deficiency and OH. The effect of vitamin B12 replacement on this dysfunction has not been studied. We prospectively studied responses to head up tilt in patients over 70 years with vitamin B12 deficiency (intervention group) and compared their responses after replacement to those of matched patients with idiopathic OH and normal serum vitamin B12 concentrations (control group). Blood pressure (BP), heart rate (HR) and systemic vascular resistance (SVR) changes during orthostatic stress were evaluated using digital artery photoplethysmography. Eight patients and eight controls were studied. Initial head up tilt produced a mean BP decrease of 44/29 mmHg (s.e.m. 4/4 mmHg) in the intervention group and 33/12 mmHg (s.e.m. 3/2 mmHg) in the control group. Repeat head up tilt 6 months after vitamin B12 replacement produced a mean BP decrease of 15/9 mmHg (s.e.m. 5/2 mmHg) in the intervention group. The mean decrease in the control group was 30/12 mmHg (s.e.m. 2/2 mmHg). The difference in BP decreases between groups was statistically significant for both systolic and diastolic BP (p < 0.001 for both systolic BP and diastolic BP). Mean SVR in the intervention group decreased by 658 dynes/cm5/sec (s.e.m. 74 dynes/cm5/sec) during initial head up tilt. Mean SVR during repeat head up tilt decreased by 79 dynes/cm5/sec (s. e. m. 12 dynes/cm5/sec). Mean SVR in the control group decreased by 158 dynes/cm5/sec (s. e. m. 10 dynes/cm5/sec) during initial head up tilt and by 258 dynes/cm5/sec (s. e. m. 31 dynes/cm5/sec). The difference in SVR changes between groups was statistically significant (p = 0.02). We conclude that replacing vitamin B12 in older patients with vitamin B12 deficiency is associated with improved orthostatic tolerance to head up tilt.

Aged↗

PubMedDate not supplied

Stent placement for failed angioplasty of aortic stenoses: report of two cases.

In 2 patients, an aortic stenosis failed to respond adequately to balloon dilatation but was successfully treated by implantation of a self-expandable large caliber endoprosthesis and subsequent balloon angioplasty. Intravascular ultrasound helped to classify the characteristics of the lesion in preparation for intervention.

Angiography, Digital Subtraction↗

PubMedDate not supplied

Guidewire-controlled advancement of the Amplatz thrombectomy device.

The Amplatz Thrombectomy Device (ATD) is a percutaneous rotational catheter proven to homogenize thrombus. The catheter design allows neither application over a coaxial running guidewire nor the use of the device as a monorail system. We report a technical modification that provides guided advancement of the catheter over a wire in order to prevent failure of application and to facilitate the interventional procedure.

Angiography, Digital Subtraction↗

PubMed2001

[Radiation diagnosis of malignant neoplasms at the current stage].

The paper presents all currently available oncological radiation diagnostic tools as compared to the well-known ones. It discusses different methods of obtaining images depending on their physical features: digital plain radiography, computed tomography, magnetic resonance imaging, bone scintigraphy, positron emission tomography, radioimmunoassay, ultrasonography (by using Doppler, intraoperative ultrasound, laparoscopy and thoracoscopy ultrasound, endoscopy ultrasound, contrast-medium ultrasound). The feasibilities of interventional radiology in malignancies are more precisely defined. There are prospects for developing different radiology techniques with the advent of high-performance computer technologies that make it possible to set up a digital radiology unit. The developed PACS system of data reception, keeping, and transmission will accumulate and keep images during unlimited time, transmit them at any distances, process them in different 3 ways, modify and improve, make paper and film hard disks at any time.

Diagnostic Imaging↗

PubMed1991

[Neuroradiologic emergency diagnosis and therapy of cranial diseases].

The most efficient diagnostic procedures are described for cases of intracranial mass, cerebral sinus and venous thrombosis, thrombosis of vertebral and basilar arteries, subarachnoid hemorrhage, carotid-cavernous fistulas, intractable epistaxis, Wernicke's encephalopathy and inflammatory cranial diseases. The importance of CT, MRI and angiography is discussed for these cranial emergencies. The different forms of interventional therapy possible are specified.

Angiography, Digital Subtraction↗

PubMed2004

MR-guided intravascular procedures: real-time parameter control and automated slice positioning with active tracking coils.

PURPOSE: To implement and optimize a real-time pulse sequence and user interface to perform intravascular interventions using active catheter tracking. MATERIALS AND METHODS: In magnetic resonance (MR)-guided interventions, small radio-frequency coils can be used to rapidly determine the device position (active tracking). In this work, active catheter tracking was combined with a dedicated real-time pulse sequence and user interface. The pulse sequence offered the imaging contrasts fast low angle shot (FLASH), true Fast imaging with steady state precession (TrueFISP), and projection MR digital subtraction angiography (MR-DSA), which could be selected by the radiologist from within the scanner room at any time during the intervention. Automatic slice positioning was added to the real-time pulse sequence so that the location of the tracking coils defined the image slice position and orientation. The technique was assessed in phantoms and animal experiments. RESULTS: At a reaction time of 24 msec and a frame rate of three images per second, the movement of an active intravascular catheter could be monitored in the aorta and the renal arteries of a pig. With interactive contrast and orientation changes, the renal vasculature could be assessed by a fully MR-guided catheterization in less than 10 minutes. CONCLUSION: With carefully designed active catheters, a dedicated user interface, and an optimized pulse sequence intravascular interventions can successfully be performed by a single operator from within the MR scanner room.

Animals↗

PubMed1999

Mild carotid artery atherosclerosis: assessment by 3-dimensional time-of-flight magnetic resonance angiography, with reference to intravascular ultrasound imaging and contrast angiography.

BACKGROUND AND PURPOSE: Our aim was to evaluate the usefulness of 3-dimensional time-of-flight magnetic resonance angiography (3-D TOF MRA) in detection and quantification of mild atherosclerotic changes of carotid arteries with reference to intravascular ultrasound (IVUS) and contrast angiography. METHODS: TOF MRA at 1.5 T, IVUS, and selective digital subtraction angiography were performed on 31 extracranial carotid arteries of 27 patients (mean age, 52 years; age range, 17 to 75 years) undergoing neuroendovascular interventions. The atherosclerotic lesions were registered, and quantitative measurements of plaque thickness, luminal diameters, and diameter stenosis were independently performed for the imaging modalities. RESULTS: Among 170 arterial segments analyzed, IVUS revealed a total of 48 atherosclerotic lesions (mean diameter stenosis, 17%; range, 4% to 40%), only 25 of which were depicted on digital subtraction angiography. Analysis of the axial source images of TOF MRA resulted in sensitivity of 77% to 83% and specificity of 71% to 80% in lesion depiction for the 2 readers with reference to IVUS. The values of diameter stenosis measured from MRA and IVUS were closely interrelated (r=0.53 to 0.61, P<0.001). CONCLUSIONS: Three-dimensional TOF MRA is feasible and moderately accurate for evaluation of mild atherosclerotic changes of carotid arteries.

Adolescent↗

PubMed2005

Evaluating a tailored intervention to increase screening mammography in an urban area.

METHOD: The study was conducted over a four-year period, 1996 and 2000. Participants were recruited using Computer Assisted Telephone Interviewing (CATI) software and random-digit dialing (RDD). Study eligibility criteria included living in the King/Drew Medical Center service area in Los Angeles, having an operable telephone, being female > or = 40 years old and not having had a screening mammogram in the past year. Four-hundred-thirty respondents were randomly assigned to the intervention and comparison groups. English and Spanish focus-group-tested tailored interventions were administered telephonically by trained interviewers. African Americans and Latinas constituted 83.0% of the sample at assignment and 83.8% at six-month follow-up, which is representative of the study area. RESULTS: The main outcome variable of interest in this study was having a screening mammogram during the time interval between baseline and the six-month follow-up assessment. Multiple logistic regressions that revealed factors predicting the outcome variable included: 1) age (p < or = 0.05, OR=2.22, CI 0.98-5.0); 2) study group (p < or = 0.05, OR=1.76, CI 1.06-2.92); 3) prior mammograms (p < or = 0.05, O0R=2.51, 1.39-4.56); and 4) and knowledge of the age when a woman should begin getting mammograms on a regular basis (p < or = 0.05, OR=0.55, 0.33-0.92). CONCLUSION: Tailored telephone counseling increased the instances of screening mammograms by nearly 8% in the intervention group at follow-up. The results of this study confirm previous findings regarding the impact of structural and behavioral factors related to screening mammography.

Adult↗

PubMed2002

Cognitive engineering of film library transition from film medium to digital environment in a Texas teaching hospital.

Digital imaging technology promises efficient, economical, and fast service for patient care, but the challenges are great in the transition from film to a filmless (digital) environment. This change has a significant impact on the film library's personnel (film librarians) who play a leading roles in storage, classification, and retrieval of images. The objectives of this project were to study film library errors and the usability of a physical computerized system that could not be changed, while developing an intervention to reduce errors and test the usability of the intervention. Cognitive and human factors analysis were used to evaluate human-computer interaction. A workflow analysis was performed to understand the film and digital imaging processes. User and task analyses were applied to account for all behaviors involved in interaction with the system. A heuristic evaluation was used to probe the usability issues in the picture archiving and communication systems (PACS) modules. Simplified paper-based instructions were designed to familiarize the film librarians with the digital system. A usability survey evaluated the effectiveness of the instruction. The user and task analyses indicated that different users faced challenges based on their computer literacy, education, roles, and frequency of use of diagnostic imaging. The workflow analysis showed that the approaches to using the digital library differ among the various departments. The heuristic evaluation of the PACS modules showed the human-computer interface to have usability issues that prevented easy operation. Simplified instructions were designed for operation of the modules. Usability surveys conducted before and after revision of the instructions showed that performance improved. Cognitive and human factor analysis can help film librarians and other users adapt to the filmless system. Use of cognitive science tools will aid in successful transition of the film library from a film environment to a digital environment.

Cognitive Science↗

PubMed2000

Multiple-digit onychomycosis: a simple surgical cure.

The management of intractable onychomycosis involving multiple fingernails continues to be optimized. Failure of pharmacological treatment necessitates operative intervention. Current surgical procedures are complex and have frequent donor site complications. This report describes a safe, simple, and effective surgical treatment that eradicates the disease, results in low morbidity, and yields high patient satisfaction.

Adult↗

PubMed2004

Integrating surgery and radiology in one suite: a multicenter study.

PURPOSE: The study was performed to evaluate the performance of digital fixed-mounted angiographic C-arm systems in the operating room as used by surgeons, cardiologists, and interventional radiologists. METHODS: An observational study in the operating room was performed, along with a structured questionnaire and semi-structured interviews. Twenty interventions were observed at 5 sites. Workflow was analyzed. RESULTS: Integration of high-end angiographic imaging equipment in the operating room enables image-guided surgery with high-quality images, on-table quality assessment of surgical procedures, and "one-stop shopping" procedures. Integrated suites were run by surgery as well as radiology departments, and are used for a variety of procedures, including vascular, cardiothoracic, open surgical, percutaneous, and combined procedures. Operation of the angiographic system and its user interface design were not considered ideal for operating room use. Limited patient accessibility was observed, sometimes leading to uncomfortable positions for the operating physicians. Certain procedures, such as tibial artery surgery, were difficult to perform, owing to lack of accessories. Patient transfer was considered inadequate. Cleaning of the system was rated as poor. Operating room use puts an even higher demand on reliability of the system. CONCLUSION: Integration of digital angiographic systems into operating rooms has produced opportunities for new treatments and offers a superior solution for interdisciplinary work among surgeons, cardiologists, and radiologists. However, the context of use differs radically from that in the traditional radiologic examination room; the environment, users, and procedures are all different. Integration of imaging methods into the operating room can be more successful if special operating room conditions are taken into account by medical systems manufacturers.

Angiography↗