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C Czerny

Publications and source records attributed to C Czerny.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Value of a structured report for the interpretation of parathyroid scintigraphy in primary essential hyperthyroidism].

The aim of the study was to evaluate whether a four-stage report scheme increases the diagnostic accuracy of dual phase Tc-99 m sestamibi scintigraphy (MIBI-scintigraphy) in patients with primary hyperparathyroidism (pHPT). We analysed the scans of 35 patients with primary hyperparathyroidism referred for Tc-99 m sestamibi scintigraphy and compared them with the sonographic and surgical findings. All scans were interpreted following a four-stage report scheme: Group A--typical scintigraphic findings of a single gland disease, group B--scan consistent with single gland disease, group C--multiple gland disease, group D--non diagnostic scan. Twenty-three scans were ranked in group A. In all these patients, scintigraphy diagnosed both the side and the localization of the adenoma correctly. Sonography made the correct diagnosis in 21/23 individuals and showed false-positive results in 2/23 cases. Group B included 10 scans. In 7/10 individuals, both the side and the localization of the adenoma were diagnosed correctly, whereas in 2/10 patients only the side was diagnosed. The scan of a single patient with hyperplasia of all 4 parathyroid glands was falsely interpreted as "consistent with a left caudal single gland disease". Sonography made the correct diagnosis in 8/10 cases, two individuals were diagnosed as false positive and false negative, respectively. No scan was interpreted as multiple gland disease (group C) and two scans were non diagnostic (group D). Both patients of the last group were correctly diagnosed by sonography. These findings suggest that in case of typical scintigraphic findings of single gland disease, scintigraphy but not sonography should be the primary localization technique for minimally invasive parathyroidectomy.

Adenoma↗
PubMed2002

Dental CT evaluation of mandibular first premolar root configurations and canal variations.

OBJECTIVES: Routine dental CT scans were used to describe mandibular first premolar root configurations and canal variations. STUDY DESIGN: One hundred twenty dental CT examinations were evaluated for mandibular first premolar root configurations and canal variations regarding shape of root and root canal, incidence of multiple canals, and level of bifurcation. RESULTS: A total of 17 teeth in 12 patients showed mesial invagination of the root of the mandibular first premolar. One root displayed 3 canals with 3 apical foramina. In 2 teeth, a single canal divided into 2 canals, but merged into 1 apical foramen. One root showing 2 root canals finally divided into 2 roots near the apex. Thirteen roots had 2 canals and 2 apical foramina. The distance from the cementoenamel junction to the level of bifurcation was between 4 and 13 mm (mean, 7.4 mm). CONCLUSION: The occurrence of incidentally found mandibular first premolar root variations should be an important component of dental CT reports.

Bicuspid↗
PubMed2001

Minimally invasive open parathyroidectomy in an endemic goiter area: a prospective study.

HYPOTHESIS: Single-gland disease identified by preoperative localization studies in combination with rapid intraoperative parathyroid hormone monitoring seems to allow a limited exploration of the neck in sporadic primary hyperparathyroidism. Minimally invasive open parathyroidectomy by lateral approach (oMIP) in sporadic primary hyperparathyroidism seems feasible in an endemic goiter region. DESIGN: One hundred consecutive patients with sporadic primary hyperparathyroidism underwent preoperative double-phase technetium Tc 99m sestamibi scanning with single-photon emission computed tomography and high-resolution ultrasonography with color Doppler imaging of the cervical region. All patients were operated on with the use of quick parathyroid hormone assay to confirm the surgical success "on-line." Patients with localized single-gland disease, irrespective of additional ipsilateral thyroid disease requiring surgery, were selected for oMIP. Success of the preoperative localization studies, postoperative (at least 6 months) serum calcium levels, and operating time were analyzed. SETTING: University hospital, section of endocrine surgery. RESULTS: Of 100 patients, 83 (83%) were considered suitable for oMIP. In 69 patients, oMIP was finished successfully. Nine of these had had previous neck surgery, and another 24 underwent additional ipsilateral thyroid resection. Permanent normocalcemia was achieved in 67 (97.1%) of 69 patients and 98 (98%) of 100 patients. CONCLUSION: The oMIP in combination with quick parathyroid hormone assay may become the treatment of choice for sporadic primary hyperparathyroidism in an endemic goiter region in centers with high experience in thyroid and parathyroid surgery. It allows treatment of concomitant ipsilateral thyroid disease and is feasible in reoperations.

Adolescent↗
PubMed2001

[Ductus arteriosus apertus as the cause of recurrent nerve paralysis. A case report].

There are various reasons for paralysis of the vocal folds, which consequently imposes great demands on differential diagnostics. Angiocardiopathies are regarded as very rare cases of etiopathogenesis. In the present case, a persistent arterial duct could be identified as the reason for the paralysis of the left recurrent nerve of a 59-year-old female patient. The necessity of interdisciplinary diagnostics going beyond the field of otorhinolaryngology is emphasized, especially in cases of a paralysis of the recurrent nerve.

Diagnosis, Differential↗
PubMed2001

[Non-neoplastic arthropathies of the temporomandibular joint].

The pathologic conditions that involve the TMJ are similar to those conditions that involve other joints in the body. Therefore, many of the radiologic characteristics are also similar. Nevertheless, because of the complex structure and function of this small joint, it is essential to know the variety of diseases that can involve the temporomandibular joint. It is also important to understand that functionally both TMJ's act as a single unit and that any alteration in function caused by a pathologic process on one side may lead to dysfunction on the contralateral side. It is essential that the radiologist is familiar with the principles of TMJ function as well as TMJ pathology.

Diagnosis, Differential↗
PubMed2001

CT and MR imaging of acquired abnormalities of the inner ear and cerebellopontine angle.

INTRODUCTION: Several entities of acquired lesions may affect the inner ear and cerebellopontine angle. The imaging of these lesions depends on the clinical history, and should be adapted to the lesion searched for and suspected by the otolaryngologist. In this paper, the modality of CT and MR imaging which is suited to delineate the acquired lesions of this region will be presented. MATERIALS AND METHODS: CT and/or MR imaging of the inner ear and cerebellopontine angle was performed in all cases in which an acquired lesion of this region was suspected by the otolaryngologist. CT was performed in the axial and coronal plane with the use of a high-resolution bone-window-level-setting. MRI was performed in the axial plane using high-resolution 3D T2-weighted fast spin echo sequences and 3D T1-weighted gradient echo sequences before and after the i.v. application of gadopentate dimeglumine. The obtained images were evaluated for the depiction of the acquired lesions. RESULTS: CT best depicted osseous lesions such as traumatic affections or lesions leading to ossification of the inner ear. Tumorous lesions were delineated in those cases in which they yielded to bony changes. Inflammatory or tumorous lesions not yielding to bony changes or intralabyrintine calicifications were not depicted. MRI delineated very well all lesions leading to soft tissue changes, and moderately depicted traumatic changes yielding to less severe fractures affecting the investigated region. CONCLUSION: CT and MR imaging are suited differently to delineate the acquired lesions of the inner ear and cerebellopontine angle. CT is excellently suited to depict osseous lesions, while MRI is excellently suited to delineate lesions affecting the soft tissue structures. These two imaging modalities should be used depending on the clinical question, and are supposed to be complementary methods.

Cerebellar Diseases↗
PubMed2001

A computer-based method for calculation of orbital floor fractures from coronal computed tomography scans.

PURPOSE: A computer program recently developed for the calculation of the orbital floor and fracture areas from coronal computed tomography (CT) scans was used in a study to evaluate the accuracy and ability of this new method. MATERIAL AND METHODS: The size of orbital floors and fabricated fractures in 14 dried, anatomic specimens were measured in coronal CT scans by 3 independent observers. Based on this data set, the orbital floor and fracture regions were calculated with the newly developed computer program. These calculated regions were then compared with a direct measurement of the specimens that had been obtained by digital photography. The accuracy of the computer-based calculations was assessed using Lin's concordance correlation coefficient. RESULTS: The size of the orbital floor (mean +/- SD) was found to be 5.21 +/- 0.39 cm(2) by direct measurement of the specimens and 5.30 +/- 0.52 cm(2) by calculation with the computer program. The region of the fracture (mean +/- SD) was 1.05 +/- 0.64 cm(2) by direct measurement and 1.01 +/- 0.62 cm(2) by computer calculation. The between-method mean difference (direct measurement minus computer based calculation) was -0.09 cm(2) (or 1.7% of mean orbital floor region) for orbital floor region and 0.04 cm(2) (or 3.8% of mean fracture region) for fracture region. CONCLUSIONS: This accurate and time-saving method is practicable for determining the size and location of orbital floor fractures. This calculation program can be advantageously applied in the clinical management of blowout fractures of the orbit.

Algorithms↗
PubMed2001

[Magnetic resonance imaging and magnetic resonance arthrography of the acetabular labrum: comparison with surgical findings].

AIM OF THE STUDY: To evaluate the accuracy of magnetic resonance imaging (MRI) and magnetic resonance (MR) arthrography in detecting acetabular labral lesions in correlation to surgical findings. PATIENTS AND METHODS: Forty patients (40 hips) with chronic hip pain and a strong clinical suspicion of labral lesions were examined with MRI in the coronal and axial plane by obtaining T1 weighted and proton density-weighted spin echo sequences. Additionally, MR arthrography of the hip joint in the coronal oblique and sagittal oblique plane was performed by obtaining T1-weighted three-dimensional gradientecho sequences after the intraarticular injection of gadopentate dimeglumine. The labra were prospectively evaluated on the basis of morphology, signal intensity, the presence or absence of a tear, and their attachment to the acetabulum. All patients underwent surgery, and the MRI findings and MR arthrography findings were compared with the surgical results. RESULTS: Surgically, 34 labral lesions, and 6 normal labra were detected. MRI correctly depicted labral lesions in 24 patients and two normal labra, and MR arthrography correctly depicted labral lesions in 30 patients and 5 normal labra compared with the surgical results. The sensitivity of MRI was 80%, the accuracy of MRI was 65%, the sensitivity of MR arthrography was 95%, and the accuracy of MR arthrography was 88%. CONCLUSIONS: MR arthrography enables considerably more accurate detection of acetabular labral lesions than MRI. MR arthrography should be the method of choice for the diagnosis of the presence or absence of acetabular labral lesions in patients with chronic hip pain and a strong clinical suspicion of labral lesions.

Acetabulum↗
PubMed2001

Clinical application of magnetic resonance imaging in 30 cochlear implant patients.

OBJECTIVE: The goal of this investigation was to provide evidence that magnetic resonance imaging (MRI) can be performed safely and effectively on cochlear implant patients who require diagnosis of additional diseases. STUDY DESIGN: A retrospective study was performed over 5 years. In a total of 300 patients with cochlear implants at the authors' center, MRI was performed whenever it was medically indicated. SETTING: All patients underwent scanning in a Philips Gyroscan T10-NT MRI machine, using commercially available Powertrac 3000 software. PATIENTS: All patients with cochlear implants for whom MRI was indicated (n = 30) were included in this study. They had a wide variety of conditions necessitating MRI, including cervical discus prolapse, hypophyseal adenoma, epipharynx carcinoma, knee degeneration, parotid tumor, and preoperative evaluation for reimplantation and bilateral implantation. RESULTS: No adverse effects from the MRI were reported by any of the patients. The cochlear implants all retained their function. All images were of diagnostic value. Because of the MRI, the patients did not need to undergo additional, more invasive and expensive diagnostic procedures. Examples of MRI images from 5 patients are shown. CONCLUSIONS: MRI on cochlear implant patients, using the Med El Combi 40 and Nucleus mini 22 series at 1 Tesla, can be a safe procedure. Removal of any magnet is not necessary.

Calcinosis↗
PubMed2001

Chemotherapy-related hemolytic-uremic syndrome following treatment of a carcinoma of the nasopharynx.

OBJECTIVE: A cisplatin-containing regimen followed by radiation therapy is the recommended treatment for patients with advanced nasopharyngeal carcinoma. We report a case of a 58-year-old woman with hemolytic-uremic syndrome (HUS) who received induction chemotherapy for undifferentiated squamous cell carcinoma of the nasopharynx. PATIENTS AND METHODS: During the 2nd course of chemotherapy (consisting of bleomycin, cisplatin and epirubicin), the patient developed hemolytic anemia, thrombocytopenia, and acute renal failure. After HUS had been diagnosed, the patient was transferred to the intensive care unit. RESULTS: Twice daily therapeutic plasma exchange (TPE) with fresh-frozen plasma, hemodialysis and high-dose cortisone was performed. Two weeks after the start of plasma exchange, thrombocytes and renal function began to normalize. Low-dose cortisone was continued until the patient recovered from hemolytic anemia. Six weeks after the administration of the second course of chemotherapy, the patient had fully recovered from HUS, and radiation therapy was carried out as planned. The patient responded well to treatment, but died 9 months after the diagnosis due to liver metastases. CONCLUSION: We demonstrated that early TPE with fresh-frozen plasma and high-dose cortisone is a potentially successful treatment modality for the usually fatal, fulminant form of chemotherapy-induced HUS.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2000

[Intracochlear position of cochlear implant electrodes].

The insertion of cochlear implant electrodes in human temporal bones may be associated with the destruction of structures within the cochlea. The aim of this study was to measure such insertional trauma by means of histologic processing of implanted human temporal bones following implantation of a Combi 40/40+ electrode array (Med-El, Innsbruck). We implanted 6 human temporal bones with original electrodes (3 with Combi 40 and 3 with Combi 40+). In 4 bones Healon was used for electrode insertion. The histological investigation was performed after radiographic evaluation of the position of the electrode. For the histological procedure we used a technique which keeps the electrodes in position within the cochlea. In these slides we could clearly identify the electrodes in the tympanic scale. When inserted properly (point of first resistance) no trauma occurred in the basal portion of the cochlea and minimal trauma in the middle portion of the cochlea.

Cochlea↗
PubMed2000

[Preoperative imaging of the inner ear prior to the implantation of a multichannel cochlear implant using computed and MR technology].

CT and MRT are now standard examinations prior to insertion of a cochlear implant. Both methods have advantages and disadvantages in terms of discovering potentially pathological structures in the inner ear. The aim of this study was to evaluate the pros and cons of using CT and MRT before cochlear implantation. CT is usually performed using axial planigraphic planes. Like MRT, bone-specific CT is helpful in the diagnosis of congenital and acquired changes within the inner ear. Congenital defects in the meatus acusticus internus, the endolymphatic duct and sac, the cochlea and the vestibulum can be diagnosed and also quantified. Infectious morphologic changes can be seen on CT images in their terminal residual state (sclerotic tissue). However, acute inflammation and fibrotic tissue is not visible on CT. T2-specific MRT images are very fluid sensitive and play a major role in preoperative cochlear implant diagnosis. This examination demonstrates fluid within the peri- and enolymphatic cave and permits the diagnostician to determine whether congenital or acquired diseases have destroyed such fluid-filled cavities. In order to demonstrate pathological changes in the temporal bone and neural structures in the inner ear, MRT is the preferred method. Displaying the modiolus and the cochlear nerve is extremely important because, in their absence, a cochlear implantation may be contra-indicated. MRT also demonstrates other neural structures such as the facial nerve. This information may be important for the surgeon, e.g. the state of the pneumatic system in the mastoid cavity (which is best visualised by bone-specific CT).

Cochlear Implantation↗
PubMed2000

[Preoperative diagnostic procedures before cochlear implantation].

About 200 patients are considered each year for cochlear implant recipiency. Only 1/4 of these candidates actually receive an implant. The aim of the study is to discuss the preoperative procedure we use, which is aimed to exclude patients who would not benefit from an implant. A cochlear implant is an example of very expensive high-profile medical therapy, a single implant costing about 280,000 Austrian schillings. The aim of the preoperative diagnostic procedure is to select the right patients, with a view to providing the best audiologic outcome. During the past 20 years, important parameters have been identified to determine suitable patients. Candidates for a cochlear implant are infants and children (independent of the etiology of deafness or high-grade hearing loss), as well as postlingual deaf adults. Congenitally deaf adults or teenagers are considered unsuitable to receive an implant.

Acoustic Impedance Tests↗
PubMed2000

[Postoperative imaging and evaluation of the electrode position and depth of insertion of multichannel cochlear implants by means of high-resolution computed tomography and conventional X-rays].

Following cochlear implantation, postoperative imaging of the electrode is very important in order to measure the depth of insertion and the position of the electrode, so that kinking and incorrect electrode placement can be clearly identified. The aim of this study was to outline the diagnostic value of CT and conventional X-ray for these parameters. For this purpose we obtained radiographs of patients who had received a cochlear implant. Computed tomography was performed by obtaining axial sections. For conventional X-ray we used digital imaging, utilising a modified Chausse III projection. The images were then rated according to electrode position, insertion depth and possible complications. We also measured the radiation dose using a dummy and evaluated the cost of each examination. Both examinations permit excellent identification of electrode position and insertion depth. However, the depth of insertion can be measured much more accurately by means of digital X-ray. The radiation dose of CT was 230 times higher than that of conventional X-ray and the cost of CT 5 times that of digital X-ray.

Austria↗
PubMed2000

[Clinical utilization of magnetic resonance imaging for patients with cochlear implants].

To date, MR imaging is absolutely contraindicated in cochlear-implanted patients. The aim of this study is to document the potential value of MR imaging in such patients, without injurious or side effects and without technical device failure. After in vitro experimental testing, 25 cochlear implanted patients underwent MRI. Radiological evaluation was also possible. The use of 1-Tesla fast spin echo sequences minimised artifacts. All cochlear implants are still in working order; no changes in fitting data or a reduction in speech understanding were observed. MR helped to avoid other invasive medical procedures.

Austria↗
PubMed2000

Variations in ILMA external diameters: another cause of device failure.

PURPOSE: To report failure of insertion of #5 and #4 intubating laryngeal mask airways (ILMAs) in a patient with a mouth opening of just under 25 mm, and the variances among same-size ILMAs. CLINICAL FEATURES: A 53-yr-old man with obstructive sleep apnea underwent elective ENT surgical repair. His mouth opening was just under 25 mm. Ventilation by mask was easy. Direct laryngoscopy failed after induction of anesthesia and neuromuscular block. Neither a #5 nor a #4 ILMA could be passed between the patient's teeth, despite different twisting maneuvres. A #4 LMA was thus prepared as a conduit for fibreoptic intubation. Placement of the LMA was easy, as was fibreoptic-guided intubation. The LMA was removed over the tracheal tube (TT) to enable ENT surgery, and the further course was uneventful. Manual examination showed that, unlike others of the same type, the failed ILMAs were not sufficiently compressible either to allow insertion in this patient or to the 20 mm reported as the maximal outer dimension of the device. Radiological examination revealed that, at the point of the device where it is intended to be compressible, the silicone layer was thicker in the failed devices than in stock compressible ILMAs, and the end of the steel tube was not so sharply beveled. CONCLUSION: Our inability to insert an ILMA in a patient with an interdental distance of just under 25 mm was because the device was not sufficiently compressible although the manufacturer states the maximal outer dimension to be 20 mm.

Anesthesia↗
PubMed2000

[The pharynx. The imaging of its normal anatomy].

BACKGROUND: The pharynx, being part of the digestive as well as the respiratory system, is embedded in the complex spatial anatomy of the neck and, due to its function and location, represents a very sophisticated region. DIAGNOSIS: Cross-sectional imaging with CT and MR imaging plays an indispensable complementary role to clinical work-up, as far as submucosal and deep cervical spaces are concerned. However, as dysphagia is a common symptom in clinical practice, interpretation of double contrast studies and videofluoroscopic investigations are also on frequent demand in the daily routine. CONCLUSION: Close interdisciplinary co-operation and the radiologist's familiarity with the anatomy of the region are required in order to use the diagnostic tools in an optimal fashion.

Cineradiography↗