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Biomedical subjects

H Job

Publications and source records attributed to H Job.

7 recordsLinked to original sources

[Intravenous coronary angiography with synchrotron radiation].

INTRODUCTION: Coronary artery disease still remains the primary cause of death in the western industrialized world. Although the clinical value of selective coronary angiography (SCA) is beyond dispute, the associated risk of an invasive approach, the inherent costs and the necessary hospitalization have lead to the development and investigation of novel non-invasive techniques for coronary imaging. Intravenous coronary angiography (ICA) has been shown to permit non-invasive imaging of the coronary arteries. METHODS: In 66 pts (80% male, age 62 (+/- 8.5 yrs) after interventional therapy/CABG operation, ICA and a SCA were carried out within a time interval of < 6 weeks. After determination of the individual circulation time, contrast media (370 mg iodine/ml, 15 ml/s, 21 ml) was injected via a sheath in the cubital vein while the patient was sitting in an upright position in a specially designed scanning chair. In two different projections 6-8 images/patient were obtained for further image processing and evaluation. 182 target vessels had to be evaluated (LAD 55, Cfx 21, RCA 54, Grafts 52). In 50 target vessels one or more stents were implanted. RESULTS: 182 target vessels were evaluated according to the following criteria: no stenosis, < 70%, > = 70%, occlusion. Evaluation of the ICA and SCA images was performed by two independent investigators. Due to poor image quality, 17 vessels were not evaluated. The ICA findings were compared to that of SCA. For the LAD a sensitivity of 84% (specificity 93%), for the RCA a sensitivity of 85% (specificity 97%), for the Cfx a sensitivity of 67% (specificity 90%), and for grafts a sensitivity of 85% (specificity 97%) was calculated. CONCLUSION: ICA proved to be a feasible and safe technique for follow-up after coronary intervention/CABG operation on an outpatient basis. Evaluation of stents and severe calcification is possible. A good image quality provided, LAD RCA and grafts can be evaluated with an acceptable sensitivity and specificity. Due to superimpositioning the low sensitivity for the Cfx has to be compensated by further image processing.

Aged↗

Complex regional pain syndrome with selective emotional sudomotor failure.

We report a patient with sympathetically maintained pain following a mild limb injury. Only emotional sudomotor failure was found in the painful limb. Thermoregulatory vasomotor function was intact. However, the patient had other target-specific sympathetic lesions, including thermoregulatory vasomotor failure in a different limb, not associated with pain. We hypothesize that the sympathetic failure preceded the symptoms and that the mild injury may have provoked collateral sprouting of emotional sudomotor fibres, coupling them with somatic sensory fibres to cause continuous pain.

Adolescent↗

Improvements in long term phototherapy for patients with Crigler-Najjar syndrome type I.

Patients with Crigler-Najjar syndrome Type I are being treated with long-term blue-light phototherapy into childhood, adolescence and beyond. Phototherapy systems adapted from sunbed-type bases fitted with blue-emitting fluorescent tubes have been described. These systems provided higher irradiances and improved patient compliance compared with overhead therapy systems used in neonatal phototherapy. The acrylic bases of such units are, however, not designed to provide adequate levels of comfort for prolonged treatment in the long term. Previous work has shown that layer(s) of transparent 'bubble-wrap' can be used to address this problem, although the material absorbs light and provides lower levels of comfort for older or larger patients. We have used designs of transparent plastic lilos that provide better cushioning, although tend to puncture, and share with bubble-wrap a low porosity leading to patient discomfort. We have investigated the use of standard mesh and high-transmission fabrics stretched over an adjustable-tension frame. This method in particular combines a high degree of comfort with a clinically effective blue-light irradiance level, and hence appears to provide a satisfactory method of phototherapy delivery. The development of higher transmission materials offers further potential for improvement.

Adolescent↗