Biomedical subjects

A Magnusson

Publications and source records attributed to A Magnusson.

At least 19 recordsLinked to original sources

PubMed2006

Insight, symptoms and neurocognition in bipolar I patients.

BACKGROUND: Level of insight and its relationship to clinical variables and neurocognitive functions was assessed in bipolar I patients. METHODS: Verbal memory, executive functioning, sustained attention, general intelligence and other neurocognitive functions were compared between 37 chronic in- and outpatients and 31 matched normal controls. Detailed psychiatric interviews were completed to define the level of symptomatology and psychosocial functioning. Insight was assessed by the Scale to Assess Unawareness of Mental Disorder (SUMD). RESULTS: Seventy percent of the patients were classified as having impaired insight. Prevalence of impaired insight was 47% and 94% in remitted and symptomatic patients, respectively. Symptomatic patients scored significantly below remitted patients on insight and neurocognition. Illness and symptom unawareness were related to overall level of symptoms, measures of memory, conceptual ability and right hand psychomotor speed and accuracy. Misattribution of symptoms and signs was correlated to visuomotor speed and visuospatial performance in addition to affective symptoms and thought disturbance. CONCLUSIONS: Our findings support the hypothesis that impaired insight and other neurocognitive dysfunctions were present in a large percentage of cases among symptomatic as well as remitted bipolar patients. This may be of clinical relevance and raises important questions about the course and outcome of the illness.

Adult↗

PubMed2006

Split renal function in patients with suspected renal artery stenosis: a comparison between gamma camera renography and two methods of measurement with computed tomography.

PURPOSE: To validate a method for calculating split renal function from computed tomography (CT) compared with gamma camera renography, and to test a new method for the measurement based on a volume-rendering technique. MATERIAL AND METHODS: Thirty-eight patients, aged 65.7 +/- 11.6 (range 37.8-82.1) years, who had undergone both CT angiography and gamma camera renography for a suspected renal artery stenosis were included in this study. Split renal function was calculated from the CT examinations by measuring area and mean attenuation in the image slices of the kidneys, and also by measuring volume and mean attenuation from a 3D reconstruction of the kidneys. Gamma camera renography with 99mTc-MAG3 with or without captopril enhancement was used as a reference. RESULTS: The 2D CT method had good correlation with renography (r=0.93). Mean difference was 4.7 +/- 3.6 (0-12) percentage points per kidney. There was also excellent correlation between the two CT methods (r=1.00). CONCLUSION: CT is equivalent to renography in determining split renal function, and the measurement from the CT examination can be made more quickly and equally accurately with a 3D technique.

Adult↗

PubMed2006

Survival time and period of catheterization in patients treated with percutaneous nephrostomy for urinary obstruction due to malignancy.

PURPOSE: To assess patient mortality and survival time, period of catheterization, and indications for percutaneous nephrostomy (PCN) withdrawal in patients treated with PCN for urinary obstruction due to malignancy. MATERIAL AND METHODS: A retrospective analysis of 151 patients treated with 257 PCNs in a 5-year period was performed. Data on survival time, duration of catheterization, and clinical end-points for PCN treatment were collected. RESULTS: The median survival time of the patients was 255 days, while median catheterization time was 62 days. The majority of patients (84) died with the catheter. Indications for PCN withdrawal were surgery, stent treatment, catheter displacement, and response to medical treatment. CONCLUSION: The majority of patients with malignancy treated with PCN have advanced disease and short life expectancy. Factors such as diagnosis, prognosis, economy, and the patient's preference influence the choice of urinary diversion method. However, PCN should be considered in patients with malignancy on grounds of safety and low cost.

Aged↗

PubMed2006

A prospective comparison of duplex ultrasonography, captopril renography, MRA, and CTA in assessing renal artery stenosis.

PURPOSE: To prospectively compare the diagnostic accuracy of duplex ultrasonography, captopril renography, computed tomography angiography (CTA), and 3D Gd magnetic resonance angiography (MRA) in diagnosing hemodynamically significant renal artery stenosis (RAS). MATERIAL AND METHODS: The standard of reference was measurement of transstenotic pressure gradient. Fifty-eight hypertensive patients with suspicion of RAS were evaluated, when possible, by all five techniques. Sensitivity and specificity to detect RAS were compared for each technique on both a patient and kidney basis. Discrepancies were evaluated separately and classified as borderline, method dependent, or operator dependent. RESULTS: The prevalence of RAS was 77%. The sensitivity/specificity of ultrasonography, captopril renography, CTA, and MRA in detecting kidneys with RAS was 73/71%, 52/63%, 94/62%, and 93/91%, respectively. Ultrasonography had a significantly lower sensitivity than CTA and MRA (P<0.001) but higher than captopril renography (P = 0.013). Borderline RAS was the main cause for discrepancies. CONCLUSION: MRA and CTA were significantly better than duplex ultrasonography and captopril renography in detecting hemodynamically significant RAS. The ultrasonography criteria for RAS based on the evaluation of renal peak systolic velocity and renal/aortic ratio are questionable. Captopril renography cannot be recommended for assessing RAS.

Adult↗

PubMed2006

Pelvicaliceal biomodeling as an aid to achieving optimal access in percutaneous nephrolithotripsy.

PURPOSE: To investigate prospectively the benefits of three-dimensional stereolithographic biomodeling produced from CT data as an aid to achieving optimal access for percutaneous nephrolithotripsy (PCNL). PATIENTS AND METHODS: Eight patients with complex urinary calculi were selected. Multislice CT scans of the kidney in native and excretory phases were acquired with the patient in the prone position to simulate the position during surgery. Contiguous reconstructed slices were produced from the data volume. The data of interest were processed to transform them into a format acceptable for production of a biomodel. Exact plastic replicas of the pelvicaliceal system and the calculi were created and used for morphologic assessment, preoperative planning, patient education, and surgical navigation. RESULTS: The survey results were based on subjective opinions rather than objective data. The biomodels enhanced the ability to visualize a patient's unique anatomy before surgery. This aided the planning and rehearsal of endourologic procedures. CONCLUSION: Although this study is only a preliminary investigation, we postulate that biomodeling has the advantage of allowing imaging data to be displayed in a physical form. In difficult cases, this technique may improve treatment, operative planning, and communication with colleagues and patients. The limitations of the technology include the manufacturing time and cost, but more accurate puncture-site selection may reduce costs by saving operating time.

Adult↗

PubMed2006

Living by themselves? Psychiatric nurses' views on supported housing for persons with severe and persistent mental illness.

The main principle directing the development of supported dwellings for persons with long-term mental illness is that to live in the community would improve their quality of life. The aim of this study was to describe psychiatric nurses' experiences of different types of supported dwelling for persons with long-term mental illness, and their views on what they consider to be important principles to provide for in order to facilitate their social integration into the community. Nine psychiatric nurses were interviewed. A qualitative content analysis revealed 'attempting to uphold the principle, respect for the patient's right to self-determination' as the main theme, which was linked to three sub-themes: the nurses' view on their moral responsibility; the nurses' views on social norms that patients must follow in order to be accepted by their neighbours; and the nurses' views on supported dwelling of good quality. The nurses perceived that personal contact between the neighbour and the mentally ill person was one essential way to reduce fear of the mentally ill person. They viewed themselves as a link between the mentally ill person and other neighbours. Without the personal contact between the mentally ill person and the neighbours, there may be a risk that the integration will fail no matter how excellent the supported dwelling is framed.

Adult↗

PubMed2005

Artifacts in 3D rotational angiography: an experimental study.

PURPOSE: To investigate artifacts in three-dimensional rotational angiography (3D-RA) in an experimental model and to evaluate which parameters influence their distribution. MATERIAL AND METHODS: 3D-RA was carried out in a circular vessel phantom filled with contrast medium. Two different rotational angulations were used: 160 degrees causing 64 images and 180 degrees causing 90 or 120 images. The images were transferred to one workstation for reconstruction of axial slices and then to another workstation for 3D reconstructions. The 3D reconstructions were compared with standardized threshold settings. RESULTS: The artifacts occurred where the vessel had a longer path parallel to the rotation plane and became increasingly pronounced when the threshold level was raised. The artifacts decreased in size when rotation angle and number of projections were increased. CONCLUSION: The quality of the 3D reconstructions from RA was degraded by beam-hardening and sampling artifacts. The sampling artifacts were diminished by increasing both the rotation angle and the number of projections. The distortions in the 3D reconstructions caused by beam-hardening remain to be resolved. The threshold values also had a considerable influence on the 3D reconstructions.

Angiography↗

PubMed2005

Three-dimensional rotational angiography of transplanted renal arteries: influence of an extended angle of rotation on beam-hardening artifacts.

PURPOSE: To investigate whether three-dimensional rotational angiography (3D-RA) of the transplant renal artery performed with an extended angle of rotation can reduce beam-hardening artifacts in 3D reconstructed images without image quality being lost or side effects to the transplanted kidney being increased. MATERIAL AND METHODS: 3D-RA with a C-arm rotation of 180 degrees was performed consecutively in 12 renal transplanted patients with suspicion of renal artery stenosis. A 1.7-mm balloon occlusion catheter was placed using the crossover technique and this was compared to a protocol with 160 degrees rotation and a traditional 1.4-mm catheter in 10 patients. The occurrence of beam-hardening artifacts was registered and the effects of the reduced contrast load on image quality and of arterial occlusion on renal function were assessed. RESULTS: The extended angle of rotation, from 160 degrees to 180 degrees, reduced the beam-hardening artifacts. Artifacts were observed in 4/11 patients (36%) in the study group and in all 10 (100%) of the controls. There was no statistical difference regarding image quality between the two protocols. Renal function was equally affected in both protocols. CONCLUSION: 3D-RA with an extended C-arm rotation reduced the beam-hardening artifacts. Image quality was not reduced despite the reduced contrast medium load. The different protocols had no effect on patient outcome.

Adult↗

PubMed2005

Computed-tomography-guided punctures using a new guidance device.

PURPOSE: To evaluate a new adjunctive guidance device, a puncture guide, constructed to simplify computed tomography (CT)-guided punctures and to make the procedure more accurate and safe. MATERIAL AND METHODS: 17 patients referred for CT-guided punctures were included in the study. There were 10 thoracic and 7 abdominal or pelvic lesions with a mean maximum diameter of 29 +/- 18 mm. All punctures were performed using a laser guide combined with the new device. The needle guide created a streak artefact in the image, indicating the needle path. RESULTS: The puncture was successful at the first attempt in 15 of the 17 patients. The artefact was visible in all patients, and in the majority there was a distinct artefact reaching from the entry point to the lesion. The deviation between the angle of the streak artefact and the final angle of the needle was 1.1 degrees. CONCLUSION: The benefits of the puncture guide were the artefact pointing at the target, the needle support, and accuracy when performing CT-guided punctures.

Abdominal Cavity↗

PubMed2005

Distribution of emamectin benzoate in Atlantic salmon (Salmo salar L.).

The aims of this study were to investigate the content of emamectin in blood, mucus and muscle following field administration of the recommended dose, and correlation with sea lice infection on the same fish (elimination study). The tissue distribution of tritiated emamectin benzoate after a single oral dose in Atlantic salmon was also investigated by means of whole-body autoradiography and scintillation counting (distribution study). In the elimination study, concentrations of emamectin benzoate reached maximum levels of 128, 105 and 68 ng/g (p.p.b.) for blood, mucus and muscle respectively, on day 7, the last day of administration. From day 7, the concentration in the blood declined until concentration was less than the limit of detection on day 77. The concentration was higher in mucus compared with plasma (P < 0.05) except on days 7 and 21. The concentration of emamectin benzoate decreased gradually from the end of treatment (day 7) to day 70 with half-lives of 9.2, 10.0 and 11.3 days in muscle, plasma and mucus respectively. The distribution study demonstrated a high quantity of radioactivity in mucous membranes (gastrointestinal tract, gills) throughout the observation period (56 days). Activity was high in the epiphysis, hypophysis and olfactory rosette throughout the study. The highest activity was observed in the bile, indicating this to be an important route for excretion. The distribution study confirmed the results from the elimination study with respect to concentrations in blood, skin mucous and muscle.

Administration, Oral↗

PubMed2004

Complications associated with percutaneous nephrostomies. A retrospective study.

PURPOSE: To determine the morbidity and mortality associated with radiologically guided percutaneous nephrostomy (PCN). MATERIAL AND METHODS: A retrospective analysis of 401 patients treated with 569 PCN over a 5-year period was performed. Using the Seldinger technique, the catheters (6-10 F) were placed under fluoroscopic, ultrasonographic, or CT guidance. Data on underlying disease, complications, subsequent management, and long-term management were collected. RESULTS: PCN was successful in 558 of the 569 attempts (98%). There were 22 major complications (4%) in 569 procedures, including cardiac arrest, bleeding requiring transfusion or embolization, septicemia, hydrothorax or pneumothorax. There were 38% minor complications, including urinary tract infection, catheter dislodgement, catheter obstruction by debris, urinary leakage, and inflammation of the skin at the site of insertion of the percutaneous catheter. Seventy-seven (14%) of the procedures were followed by urinary tract infection during the PCN treatment. Seventy-nine (14%) catheters slipped out unintentionally. CONCLUSION: Percutaneous nephrostomy is a gentle procedure associated with high technical success and low morbidity. However, the risk of the procedure has to be weighed against the expected benefit.

Humans↗

PubMed2004

Multicenter evaluation of a new laser guidance system for computed tomography intervention.

PURPOSE: To measure the accuracy of laser-guided punctures and to evaluate the usefulness of the developed laser-guided system. MATERIAL AND METHODS: The study included 67 patients referred for computed-tomography-guided puncture. The majority of the punctured lesions were located in the chest (28 patients) or abdomen (19 patients). The mean diameter of the lesion was 3.1 cm, and the mean path length was 6.8 cm. The laser guide was movable along a horizontal or vertical rail and not physically connected to the CT unit. The angle of insertion was entered manually into the display of the unit by the interventional radiologist. A prospective multicenter trial was carried out. RESULTS: A mean of 1.1 needle passes were necessary to reach the target, and in 55 (84.6%) of the patients the target was reached on the first needle pass. The mean deviation of the needle from the preselected angle was 1.8 degrees. The mean targeting time (from the initial localizing scan until the needle was in the target) was 15.6 min. In every case, both the usefulness and the ease of use of the laser guidance system were subjectively evaluated on a 5-point scale; the mean usefulness score was 4.5, while the mean ease of use score was 4.7. CONCLUSION: Different users at four different centers found the laser guidance system useful and easy to use. A high level of accuracy of the puncture angle was obtained in most cases.

Adult↗

PubMed2004

Measuring split renal function in renal donors: can computed tomography replace renography?

PURPOSE: To develop and evaluate a method of calculating split renal function from computed tomography (CT) images based on the assumption that the accumulation of contrast medium is proportional to the renal function, and to compare the results with the renogram. MATERIAL AND METHODS: The study comprised a retrospective analysis of CT images and renograms from previous donors. Twenty-seven potential renal donors were studied using a technique for measuring the area and mean attenuation of the separate CT slices, and for calculating the volume and total attenuation of the whole kidney. RESULTS: Correlation between CT and renography was moderate (r = 0.43), but the range of results was narrow. The ratio between the two kidneys was more even with CT (50 +/- 2.1%) than with the renogram (48 +/- 2.9%) (right kidney), and the mean difference between the two methods was 3 +/- 2.3 percentage points. CONCLUSION: The renogram can be replaced using calculations from the CT examination in estimating split renal function in potential renal donors.

Adult↗

PubMed2004

Oleic acid lung injury: a morphometric analysis using computed tomography.

BACKGROUND: The oleic acid-induced lung injury (OAI) model is considered to represent the early phase of acute respiratory distress syndrome (ARDS). Its inherent properties are important for the design and the interpretation of interventional studies. The aim of this study was to describe the evolution of morphometric lung changes during OAI using computed tomography (CT) analysis. Furthermore, the effect of a temporary change in positive end-expiratory pressure (PEEP) was evaluated. METHODS: Fifteen anaesthetized pigs were ventilated in volume-controlled mode with a baseline PEEP of 5 cm H(2)O. Helical CT scans were taken at baseline and 1 h after oleic acid injection. The PEEP was then either increased to 10 cm H(2)O (n = 5), decreased to 0 cm H(2)O (n = 5) or kept constant (n = 5) for 30 min. For the next 30 min, the baseline PEEP level was applied in all animals before the final CT scans 2 h after the induction of OAI. Dimensional and volumetric changes were determined from radiographical attenuation values. RESULTS: There was a major decrease in gas volume and an increase in tissue volume within the first hour. A net increase in total lung volume, with a larger transverse area but no displacement of the diaphragm, was manifest after 2 h. A minor increase in volume of non-aerated lung, located to the caudal region, was observed during the second hour. The tidal volume was redistributed to the middle and apical regions. The temporary change in PEEP did not influence the morphological progress of OAI. CONCLUSION: Decreased gas volume and increased tissue volume are the dominating morphometric characteristics of oleic acid lung injury, occurring mainly within the first hour. With these changes manifest, the course of injury is not affected by a limited period of moderately changed PEEP during the second hour. The net increase of total lung volume suggests a predominance of oedema formation over airway and alveolar collapse.

Animals↗

PubMed2003

An unusual case of tumor thrombus in the inferior vena cava. A case report.

Adrenal cortical carcinoma (ACC) is a rare malignancy. Patients present either with a functional tumor or secondary to mass effect. In non-functioning tumors, the tumor size often exceeds 5 cm by the time of diagnosis, and tumor thrombus can occur. We report on a case of a small non-functioning ACC causing a large tumor thrombus in the inferior vena cava.

Adrenal Cortex Neoplasms↗

PubMed2003

3D rotational angiography of transplanted kidneys.

PURPOSE: To develop a protocol for 3D rotational angiography (3D-RA) of the transplant renal artery. MATERIAL AND METHODS: 3D-RA was consecutively performed in 39 renal transplanted patients with suspicion of renal artery stenosis. A series of images were acquired while the C-arm of the equipment rotated around the region of interest. Contrast media in different concentrations were given through a 1.4 mm catheter with different sites of injection in the ipsilateral iliac artery. The 3D reconstructions were done at a workstation. Suspected stenoses were in most cases verified with pressure measurement, and a systolic pressure gradient of 10 mm Hg or more was regarded as significant. RESULTS: 28 stenoses were found in 24/39 patients (62%); 21/28 (75%) were verified by pressure measurement. The 3D reconstructions gave a better description of the stenoses in 10 patients. CONCLUSION: 3D-RA is a helpful supplement in cases with complicated vascular anatomy, especially when intervention may be indicated. The best results were achieved with the catheter tip in the proximal iliac artery and 70-75 ml of a high concentration contrast medium at a flow rate of 8-10 ml/s.

Adult↗

PubMed2003

Complications associated with percutaneous nephrolithotripsy: supra- versus subcostal access. A retrospective study.

PURPOSE: Percutaneous nephrolithotripsy is an essential procedure for treating complex urinary calculi. To achieve optimal access to a large and complicated stone, an upper calyx puncture is often preferable. However, when performing a puncture above the 12th rib there is risk of an increased number of complications. In this retrospective study, we assessed the kind and frequency of complications after sub- and supracostal punctures of the collecting system of the kidney. MATERIAL AND METHODS: Between 1996 and 2001, 85 patients were treated with percutaneous nephrolithotripsy. In 63 patients a subcostal track, below the 12th rib was established. Puncture was performed under ultrasonic or fluoroscopic guidance in 61 patients and CT-guided in 2 patients. In 17 patients a supracostal puncture, above the 12th rib, was performed under CT guidance and in 5 patients with US or fluoroscopic guidance. RESULT: The main difference regarding preoperative complications was the number of patients complaining of respiratory correlated pain, 7 (32%) in the supracostal puncture group compared with 3 (5%) in the subcostal puncture group. No significant difference regarding peroperative complications was found. Postoperatively, there were 2 major bleedings, one in each group, which had to be treated with arterial embolization. In the supracostal puncture group there were 2 patients with pleural effusion and 2 patients with pneumothorax. CONCLUSION: The complication rate was slightly higher after supracostal puncture as compared with a subcostal approach, especially regarding respiratory correlated pain. When performing a supracostal puncture there is an increased risk that the track passes through the pleural space, which might explain the difference in the panorama of complications.

Fluoroscopy↗

PubMed2003

Passive smoking and respiratory symptoms in the FinEsS Study.

The aim of the present study was to examine the relationship between reported environmental tobacco smoke (ETS) exposure and respiratory symptoms. In 1996, a postal questionnaire was randomly distributed in three areas of Estonia to a population-based sample, of which 4,995 females and 1,822 males had never smoked. The main outcome measures were current respiratory symptoms and the amount of reported ETS exposure outside the home. ETS exposure at home was more common in females (31% versus 19%), while exposure outside of the home was more common in males (53% versus 7%). Females reported more symptoms from tobacco smoke than males (37.7% versus 21.6%). If ETS exposure outside of the home exceeded 5 h daily, the risk for wheeze (odds ratio (OR) 2.67, 95% confidence interval (CI) 1.98-3.61) and physician-diagnosed asthma (OR 1.79, 1.02-3.16) were increased. ETS exposure outside of the home was shown to be strongly related to almost all respiratory symptoms in a dose/response manner. ETS exposure at home did not show significantly elevated ORs for any respiratory symptoms. This study shows that females seem to be more troubled by environmental smoke exposure than males and provides further evidence of the serious health hazards associated with environmental smoke exposure. Indeed, the findings of this study support a ban on smoking in the workplace and public areas.

Adolescent↗