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Biomedical subjects

F Terrier

Publications and source records attributed to F Terrier.

At least 91 records · Page 5Linked to original sources

[Sonography of the shoulder].

Sonography is a valuable method for the detection of rotator cuff tears. A high resolution transducer and an experienced examiner are necessary. The rotator cuff is not visible in large tears and has a convex outer border in small tears. Sonography reveals pathology of the subacromial bursa, joint effusions, inflammatory tissue in rheumatoid arthritis and often also bony erosions and tendon calcifications. Arthrography is still indicated in equivocal cases. Arthro-CT is the method of choice for the diagnosis of limbus and capsular pathology, but not for rotator cuff tears. MRI shows promising results in rotator cuff tears, but its role has not been definitively assessed.

Bursa, Synovial↗

Sulfur derivatives of 2-oxopropanal oxime as reactivators of organophosphate-inhibited acetylcholinesterase in vitro: synthesis and structure-reactivity relationships.

We have prepared four new oximes, 1b-e, which conform to the general structure RCH2COCH = NOH where R = CH3S, CH3SO, CH3SO2, and (CH3)2S+, respectively, and have the same E configuration as the parent 2-oxopropanal oxime 1a (R = H, MINA). The pKa values range from 6.54 (1e) to 8.16 (1b), as compared with 8.30 for 1a. Rates of reaction (kappa 1) with 4-nitrophenyl acetate indicate that the oximate anions have a much higher nucleophilicity than common oxyanions of similar basicities: the alpha effects measured for 1a-e are of the order of 200-250. The abilities of 1b-e to reactivate acetylcholinesterase (AChE) inhibited by organophosphates have been evaluated. In vitro experiments reveal a significant reactivation potency of 1b-e against VX-, sarin-, and paraoxon-inhibited immobilized eel AChE. The highly lipophilic methylthio oxime 1b (log P greater than 1) is intrinsically (kappa 2) 3 times more reactive than the more basic MINA (log P less than 1). The sulfonium oxime 1e is a potent reactivator against paraoxon. Interestingly, both 1b and 1e have a low toxicity and they exhibit a significant antidotal effect at a relative low dose against paraoxon in rats.

Acetylcholinesterase↗

[Intravenous digital subtraction angiography of the lower extremities combined with step translation (2-field DSA)].

We evaluated a bolus-chase technique designed to reduce the volume of contrast material and to shorten examination time during intravenous digital subtraction angiography (IV-DSA) of the lower limbs. With this technique, after a single injection of contrast material, two contiguous fields can be sequentially imaged (two-field DSA) using a step translated x-ray tube. 67 patients with peripheral vascular disease were studied. All examinations provided diagnostic information, so that in no instance additional intra-arterial injections were required. With the two-field DSA only 3.49 injections were needed in the average for five fields examined in each patient, resulting in a 30% reduction of contrast agent used.

Adult↗

Rotator cuff tears: correlation of sonographic and surgical findings.

High-resolution, real-time sonography of the rotator cuff was performed in 51 shoulders, and the results were correlated with findings obtained during subsequent surgery. Prospective sensitivity of sonography in detection of a tear was 100%; specificity, 75%; and accuracy, 92%. Retrospective estimation of tear size on sonograms correlated well with the intraoperative measurements for small and moderate lesions. Large lesions were often underestimated sonographically. Retrospectively, partial tears were correctly diagnosed in seven patients, and bursal thickening was recognized in 17 patients. Sonography of the shoulder proved to be an accurate, noninvasive method for the diagnosis of complete rotator cuff tears. It is useful for estimating tear size and location and may be useful in recognizing partial tears.

Adult↗

The Trillat procedure for recurrent anterior instability of the shoulder.

In the Trillat procedure for recurrent anterior instability of the shoulder the coracoid process is osteotomised and tilted downward to act as a bone block, and a screw is used to fix it and the Bankart lesion to the anterior scapular neck. We reviewed 52 cases after a mean follow-up of 69 months. Results in 73% of shoulders were excellent, 10% were good, 7% fair and 10% poor. Dislocation recurred in 4%, but a positive apprehension sign was present in 10 other shoulders. Some degenerative changes were seen in 62% of shoulders, a complication known to be associated with bone-block procedures. The most important reason for loss of lateral rotation was iatrogenic impingement of the coracoid. This frequent and potentially serious complication can also cause posterior subluxation of the humeral head and osteoarthritis.

Adolescent↗

[Clinical applications of magnetic resonance spectroscopy].

In this overview the physics of magnetic resonance spectroscopy (MRS) are briefly discussed. The biochemical pathways which can be investigated by MRS in physiological and pathological states are presented. The potential clinical applications of this method to the musculoskeletal system, heart, brain, liver and kidney are examined.

Brain↗

[Radiologic diagnosis of early complications following kidney transplantation].

Postoperative complications after renal transplantation, such as hematomas, abscesses, urinomas, lymphoceles and obstruction of the ureter, can be diagnosed by means of sonography. Early vascular complications, such as venous thrombosis and arterial occlusion or stenosis, can be recognized by duplex sonography and accurately depicted by angiography to allow planning of surgical intervention. Stenosis of the renal artery is amenable to treatment by percutaneous angioplasty. Parenchymatous complications (acute tubular necrosis, acute rejection, cyclosporin-A-toxicity) can cause changes in the intrarenal flow patterns at duplex sonography, but this examination does not allow accurate diagnosis and differentiation of these changes. Magnetic resonance imaging is a very promising method for the differential diagnosis of parenchymatous complications.

Humans↗

MR in renal disease: importance of cortical-medullary distinction.

The diagnostic value of MR contrast between renal cortex and medulla (CMC) as an indicator of renal disease was retrospectively studied in 51 patients (9 patients with obstructive disease, 7 with inflammatory disease, 12 with various noninfectious parenchymal medical disease, 5 with vascular disease, 2 with diffuse neoplastic disease, 7 with hemosiderosis, and 10 with renal trauma [blunt trauma and 9 postlithotripsy]). Additionally, normal kidneys from 20 control subjects were studied. On T1-weighted spin-echo images (SE 500/30), CMC was visible in all the normal kidneys (19% contrast +/- 2% SD). A decrease in or an absence of CMC on T1-weighted images (SE 500/28) was found to be a sensitive but nonspecific sign in most of the renal diseases studied. CMC was visibly preserved at normal levels in 7 of the 9 kidneys traumatized by lithotripsy and in all 4 kidneys with acute renal obstruction; CMC was above normal in kidneys with hemosiderosis. In conclusion, alteration in CMC is a sensitive but nonspecific indicator of renal disease. Furthermore, normal CMC can be seen in the presence of renal pathology.

Adolescent↗

Edema and the lack of blood perfusion produce opposite effects on the magnetic resonance characteristics of acutely ischemic rat kidneys.

Both kidneys of 28 rats were studied with magnetic resonance imaging (0.35 tesla, double spin-echo technique with echo-delay times [TEs] of 28 and 56 ms and repetition times [TRs] of 0.5 and 2.0 seconds). Kidneys were studied before and up to 4 hours after ligation of the abdominal aorta above the origin of the left renal artery (20 rats) or after ligation of the left renal artery (eight rats). Any changes in the relaxation times of cortex and medulla and in the cortex-to-medulla contrast (CMC) were correlated to histologic data and renal water content. After the first hour following ligation of either the abdominal aorta or the left renal artery, the cortex of the left kidneys showed a 20% shortening of the mean T2 relaxation time (P less than .001), a 16% shortening of the mean T1 relaxation time (P less than .001), a 73% increase in mean CMC on T2-weighted images (P less than .001) and a 42% decrease in mean CMC on T1-weighted images (P less than .001). There were no significant changes either in relaxation times of the medulla of the left kidneys or in relaxation times and CMC of the right kidneys. During the next three hours, relaxation times of cortex and CMC remained unchanged in the rats with ligated abdominal aorta. In the rats with ligated renal artery, relaxation times of cortex and CMC returned to normal values.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

Lactate accumulation in ischemic- and anoxic-isolated rat hearts assessed by H-1 spectroscopy.

Proton magnetic resonance (MR) spectroscopy with homonuclear editing was used to assess lactate accumulation in ischemic and anoxic hearts perfused according to the Langendorff method. An increase in the lactate signal was observed after 5 minutes of ischemia and after 10 to 20 minutes of anoxia. This study demonstrates that proton MR spectroscopy can be used to monitor the time course of MR-visible lactate levels in ischemic and anoxic isolated rat hearts.

Animals↗

Magnetic resonance imaging of experimental renal hemorrhage.

Experimental renal hemorrhage was induced by injecting autologous blood into the left kidney of 13 rats. To investigate the magnetic resonance (MR) characteristics of acute renal hemorrhage and subsequent stages of resolution, repetitive MR images were obtained using a 0.35 Tesla imager during a period of 21 days postinduction. A dual spin-echo imaging (TR 500 and 2,000 msec, TE 28 and 56 msec) was used to calculate the relaxation times and record the intensities in the renal medulla and cortex. Histologic examination (n = 9) indicated that blood was dispersed intrarenally, and no encapsulated hematoma developed. The signal intensity on the T1- and T2-weighted images, as well as the relaxation times in the hemorrhagic renal parenchyma were unchanged during 21 days when compared with intact kidney values. Subcapsular fresh blood had a high signal intensity on T2-weighted images. A marked overlap of the relaxation parameters between intact kidney parenchyma and diffuse intrarenal hemorrhage was observed. Detection of dispersed intrarenal blood using spin echo MR imaging may be difficult.

Animals↗

Posttransplant renal rejection: comparison of quantitative scintigraphy, US, and MR imaging.

Accuracy of ultrasonography (US), quantitative scintigraphy, and magnetic resonance (MR) imaging in diagnosis of acute renal allograft rejection was studied in 46 patients who underwent renal biopsy. Thirty-three patients had acute rejection; six, cyclosporine nephrotoxicity, as shown by biopsy, clinical findings, and follow-up study; two, acute tubular necrosis; and five, normal biopsy findings and renal function. Accuracy in demonstrating rejection was 72% for US and 75% for scintigraphy, indicating no significant difference between the two. MR imaging was significantly more accurate, reaching a level of 98%. However, accuracy of MR in demonstrating acute tubular necrosis in a larger number of patients is not known, and its accuracy in indicating recurrent glomerulopathy or infectious disease has not been addressed. The definitive role of MR in evaluating posttransplant renal failure is currently not established, but because of its high sensitivity in detecting renal abnormality, MR can be used for cases when results of US or scintigraphy are equivocal or contradict clinical impressions or when biopsy cannot be performed for medical reasons.

Adult↗

Patterns of recurrence of esophageal carcinoma after transhiatal esophagectomy and gastric interposition.

Serial barium and CT studies were performed for follow-up of 35 patients who had undergone transhiatal esophagectomy with gastric interposition for esophageal carcinoma. The results were compared with the clinical and pathologic findings. Thirteen patients (37%) were clinically and radiologically free of tumor recurrence after a mean observation period of 18 months. Twenty-one patients (60%) developed recurrent carcinoma within 12 months and one patient (3%) within 14 months. Thirteen patients were clinically asymptomatic when recurrence was detected radiologically. Recurrence was initially confined to the mediastinum in one-half of the patients, whereas the others already had distant metastases when recurrence first became evident. Because most of the recurrent lesions originated outside the interposed stomach, CT was more useful than barium studies in showing early recurrence. Radiologic follow-up including CT allows earlier detection of limited recurrent carcinoma after surgery and, thus, offers the possibility of appropriate additional palliative radiotherapy or chemotherapy.

Adenocarcinoma↗

The subcoracoid space. An anatomic study.

Soft tissue impingement under the coracoid process has recently been identified as a cause of painful shoulder disability. In this study the normal space between the humeral head and the coracoid process in two functional positions of the arm was measured in an attempt to delineate anatomic risk factors predisposing to subcoracoid impingement. Forty-seven normal shoulders were studied by computerized tomography (CT) in adduction, 20 additionally in forward flexion/internal rotation, which is the position most frequently causing subcoracoid impingement. The distance between the humeral head and the coracoid tip averaged 8.7 mm for the adducted arm and 6.8 mm for the flexed arm. Modifications of the coracohumeral relationship were found to affect the subcoracoid clearance roughly 1.5 times more in flexion than with arm at the side. Subcoracoid impingement appeared particularly likely during forward flexion of a shoulder with a coracoid tip close to the scapular neck and projecting far laterally.

Adult↗

Contrast-enhanced MRI of periarticular soft-tissue changes in experimental arthritis of the rat.

This study was to determine if manipulation of magnetic resonance signal intensity by means of an intravenously injected paramagnetic contrast agent is useful for the detection and characterization of periarticular inflammation. Arthritis was induced in 20 rats by means of intradermal injection of Freund's complete adjuvant. MR imaging was performed with a resistive magnet operating at 0.35 T. A double spin-echo technique with TE's of 28 and 56 ms and TR's of 0.5 and 2.0 s was used. The hindpaws of the adjuvant-injected rats were imaged on Day 8, Day 11, or Day 15 following injection of the adjuvant. The images were obtained in the transverse plane before and after intravenous injection of gadolinium-DTPA (0.2 mmol/kg). Because of their long T2 relaxation time, inflammatory lesions were characterized by high MR signal intensity on precontrast images obtained with long TR and long TE (T2-weighted images). On the other hand, because of their long T1 relaxation time, the inflammatory lesions were of relatively low intensity and not easily recognized on precontrast images obtained with short TR and short TE (T1-weighted images). Postcontrast T1-weighted images were also sensitive in detecting periarticular inflammation as a result of T1 shortening by the gadolinium-DTPA. However, in our particular model, the data did not indicate any greater MR sensitivity for detecting arthritis by means of gadolinium-DTPA enhancement.

Animals↗

Ultrasound in postoperative acalculous cholecystitis.

Eleven patients were examined by ultrasound before undergoing cholecystectomy (n = 9) or cholecystostomy (n = 2) for acalculous cholecystitis after abdominal surgery. The ultrasound images were analyzed retrospectively and compared with the surgical and histologic findings. The results indicate several established ultrasound criteria of cholecystitis to be less reliable than usual. Although 10 of 11 patients were on parenteral hyperalimentation, gross distention of the gallbladder was observed in only 3. In 4 of 7 patients, in whom pericholecystic fluid was observed, no gallbladder perforation was found at surgery. However, thickening of the gallbladder wall was displayed in 10 of 11 cases, combined with a sonolucent intramural layer in 6. Furthermore, intraluminal nonshadowing echogenic densities correlated with empyema or hemorrhage in 5 of 8 cases. In conclusion, despite several limitations, ultrasound can be of considerable help when one is deciding to perform repeat laparotomy when acalculous cholecystitis is suspected.

Acute Disease↗