BACKGROUND: We investigated whether color-coded Doppler sonography combined with an ultrasound contrast medium would improve the assessment of liver-supplying vessels after orthotopic liver transplantation. METHODS: Forty-seven patients after orthotopic liver transplantation participated. Examinations were done without and then with the ultrasound contrast medium Levovist. Visualization of the liver-supplying vessels was assessed with a scoring system. RESULTS: Visualization of the portal vein was similar without and with contrast medium. Hepatic arteries were visualized in 39 patients without contrast medium and 46 patients with contrast medium. The remaining patient showed hepatic artery thrombosis, which was confirmed angiographically. With the use of Levovist, the examination took 3.7 min rather than the usual 6.4 min. CONCLUSION: Imaging of hepatic arteries after liver transplantation improved significantly with the use of ultrasound contrast medium. These findings are important because the early detection of blood flow through the liver after transplantation affects prognosis.

Adult↗

PubMedDate not supplied

Changes in hepatic hemodynamics after orthotopic liver transplantation: color Doppler sonography.

BACKGROUND: Liver perfusion has an influence on therapy results in patients undergoing orthotopic liver transplantation (OLT). The objective of the present study was to investigate changes in hepatic hemodynamics in patients after OLT with color-coded Doppler sonography (CCDS). METHODS: Forty-five consecutive patients were included. The examinations were done before, on postoperative day 1, and then weekly until the patients were discharged. Mean velocity of the portal (PV-V) and splenic (SV-V) veins and the maximum velocity and resistance index of the hepatic artery were determined. RESULTS: After OLT a significant increase in PV-V and SV-V was observed. Twenty-five patients had normal perfusion of the hepatic artery, whereas 16 patients had abnormal flow patterns. In these patients prostaglandin I(2) was used until flow rates normalized. In four patients, CCDS could not detect perfusion of the hepatic artery. CONCLUSIONS: CCDS is a suitable method for evaluating hepatic hemodynamics before and after OLT. Changes in blood flow velocities in the liver-supplying vessels are detectable, but perfusion of the hepatic artery is seldom detectable. These observations are of special interest after OLT, where liver circulation has an influence on therapy results.

Adult↗

PubMedDate not supplied

MR of hemorrhagic acoustic neuromas.

The magnetic resonance (MR) appearance of hemorrhagic acoustic neuromas has not previously been reported. Four patients with surgically proven acoustic neuromas containing spontaneous hemorrhage were preoperatively evaluated with MR imaging. All patients presented with new onset of symptoms and three had subarachnoid hemorrhage. Signal changes on T1- and T2-weighted spin echo sequences were characteristic for acute, subacute and chronic intraparenchymal hemorrhage. Recognition of hemorrhagic changes on MR is important since more rapid surgical intervention is required in this patient subgroup.

Adult↗

PubMedDate not supplied

[Incidence and start of inpatient treatment of pediatric hip dislocations in West Germany].

A national report of hospitalized children with cdh (up to the 6th year of age) (treated in 1983) is presented. 196 (63.1%) of all university hospitals and orthopaedic departments took part in this statistic. The number of all collected children was 1172,888 of them had a hip dislocation. Hospital treatment of children with a dislocated hip started on the average in the age of 9 months, that means much to late. Only 4.1% of the children showed neurological symptoms. The patents are reported in detail. The presented data lead to the conclusion, that the actually performed legal examination of children is insufficient for early detection of cdh. A general orthopaedic clinical and ultrasound examination in the first week of life should be introduced.

Acetabulum↗

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[An objective sign of the presence of a dislocation of the peroneal tendon?].

If being necessary to diagnose a rupture of the external ligaments of the ankle joint one must produce special "forced" X-rays of both ankle joints in the ap-direction in the apperature of "Scheuba". In these X-rays we found a sign , typical for the luxation of the peronaeus tendons: The rims of the ankle joint are not dislarged in the external areas but they show a significant dislargement of the distance between the malleolus externus and the processus subfibularis tali on the hurt side - the range is always more than 10 mm and in significant difference to the sane side, were we found this difference never more than 10 mm. The new objektive significant sign for the luxation of the peronaeus tendons is described and a comparison to X-rays of some persons is demonstrated.

Adolescent↗

PubMedDate not supplied

[Rupture of the juvenile tibial tuberosity--classification and therapy recommendations based on a case history].

The tear-off or the large fractureee of the tuberositas tibiae with participation of the platform of the knee-joint is a special form of fracture of the lower extremity. Primarily it appears in the puberty. The explanation of these facts bases on the knowledge of the evolution of this ununitary region. The report explains this evolution and the arise of this special fractur. Also it explains the fundamental classifications of this fractur and it's therapy.

Adolescent↗

PubMedDate not supplied

Guidelines for selecting a conceptual model of nursing: focus on the individual patient.

How do conceptual models help you in clinical practice? How can you select the best model to guide successful interventions for your critical care patients? These authors present three guidelines for selection of a conceptual model for your patient situation. Six case studies of patients requiring critical care nursing demonstrate the fit of the patient's problems and goals for care with particular conceptual models of nursing.

Adult↗

PubMedDate not supplied

Cellular and vascular reactions in the liver to radio-frequency thermo-ablation with wet needle applicators. Study on juvenile domestic pigs.

UNLABELLED: The aim of this animal experiment was to investigate the cellular and vascular reactions in the liver of juvenile domestic pigs produced by a radio-frequency thermoablation (RFTA) applicator perfused with saline solution. METHODS: A total of 13 coagulation necroses were produced in the liver of 3 anesthetized domestic pigs using RFTA. The pigs were dissected and the coagulations examined. RESULTS: The mean macroscopical length and width of the coagulation zones with a hemorrhagic marginal zone after a 5-minute application time were 34.1 +/- 8 mm (22-46 mm) and 20.8 +/- 4 mm (12 +/- 28 mm) respectively. The sonographically determined diameters correlated significantly (r(length) = 0.741 and r(width) = 0.923). Three areas in the coagulation zones could be histologically distinguished: (1) central necrosis zone, (2) hemorrhagic marginal zone, (3) sublethal damage zone. Large vessels did not show any substantial changes after RFTA. Venous vessels less than 1 mm were completely thermally denatured or destroyed. CONCLUSIONS: Tumors in close proximity to large blood vessels can be treated by RFTA with 'wet electrodes'.

Animals↗

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Psychological distress around menopause.

The authors sought to identify a subgroup of women who are likely to experience psychological distress in the period around menopause. A sample of 189 women (mean age=49.49) was selected from the general population and rated for menopausal status, menopausal symptoms, depression, anxiety, perceived control, body image, and sex role. Menopausal symptoms were not found to discriminate between pre-, peri-, and postmenopausal women. Factor analysis of the symptoms yielded a specific somatic factor that correlated with menopausal status but not with psychological variables and a nonspecific psychosomatic factor that correlated with psychological variables but not with menopausal status. This suggests that psychological distress during the menopausal transition may indicate a personal psychological or physiological vulnerability rather than a specific reaction to the menopausal events.

Anxiety↗

PubMedDate not supplied

Measurement and modification of the accuracy of determinations of urine glucose concentration.

Studies were designed to assess the accuracy of urine glucose testing in a sample of juvenile diabetic subjects, and to determine the effects of a visual discrimination training procedure on the accuracy. In the first study, each of 81 juvenile-diabetic children was presented three prepared glucose solutions and asked to determine the glucose concentration using the 2-Drop Clinitest method. Results showed errors in 54.3% of the judgments, with greatest difficulty occurring with 1-g/dl concentrations. The majority of errors were false negatives. Study II involved similar testing accuracy on a sample of 10 nurses and 2 research technicians, before and after a visual discrimination training procedure. Results showed that the subjects were incorrect on 39% of the trials initially, with a reduction in the error rate to less than 19% after training.

Adolescent↗