Biomedical subjects
Publications and source records attributed to M Osteaux.
Benign osteoblastoma is a rare tumor; the majority of lesions occur in the spine, femur, and tibia. Osteoblastoma in the patella is so rare that it seems not to have been reported previously in more than one case. A 29-year-old man with a sports injury, who failed to respond to conservative treatment over a prolonged period of time, was later found to have an osteoblastoma of the patella.
The authors present a short overview on the state of the art of detection, diagnosis, operative staging and post-operative follow-up of colorectal carcinoma by barium studies, echography, CT and MR. Current concepts about these matters are briefly described and discussed according to the author's experience.
Bilateral congenital defects in the pedicles of the second cervical vertebra were noted on conventional X-rays and tomography of a 42-year-old male. He had been assaulted after which he suffered upper neck and occipital pain. Subsequent CT scanning demonstrated the incomplete nature of the axis defects. This is felt to be important in prognosticating the likelihood of spondylolisthesis formation and counselling the patient with regard to acceptable future physical activity. The role of CT examination for this purpose has not been stressed before. The importance of differentiation from old trauma is emphasized.
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Cardiac amyloidosis is an uncommon cause of heart failure. Based on an observation of immunocytic cardiac amyloidosis with a fatal course, the diagnostic modalities are reviewed with special emphasis on echocardiographic findings. The possible role of magnetic resonance imaging is discussed.
The validity of reference values for vertebral bone mineral density (BMD) reported in the literature has frequently been questioned. The introduction of dual-energy methods, new calibration systems, and automated image evaluation algorithms, has also made it necessary for us to re-evaluate BMD values in a normal population. We present patient selection criteria, CT measurement and evaluation protocols and results of single energy (SEQCT) and dual energy quantitative CT (DEQCT) for trabecular (tBMD) and cortical (cBMD) bone density in 135 males and 139 females. For SEQCT, tBMD loss rates of 1.7 and 1.8 mg/ml per year for males and females, respectively, were determined by linear regression. The respective DEQCT data show smaller decrements with age. Different statistical models for tBMD in females were tested; models based on a multiphase variation of tBMD yielded an improvement of the fit. For cBMD the percent rate of loss with age is much smaller than for tBMD; females showed a significantly higher loss rate than males, however. A comparison of our results with published data is included.
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The safety and success rate of chemonucleolysis are largely dependent on correct needle insertion. The neurological complications of chemonucleolysis are related to inadvertent puncture of the dura, nerve root and/or spinal nerve. To avoid this complication, a puncture angle of 50 degrees to 60 degrees above the sagittal plane is widely recommended (1). Our CT study of the location of the spinal nerve L4-L5 and L5-S1 demonstrates a great variability of this location and also explains some of the possible hazards of 50 degrees to 60 degrees puncture (2). The CT-evaluation of the relationship between the nerve root, spinal nerve and apophyseal joint with respect to the puncture angle is suitable. In our experience, this method is helpful for fast, safe and easy insertion of the needle.
Intrasubject reproducibility with repeated determination of vertebral mineral density from a given set of CT images was investigated. The region of interest (ROI) in 10 patient scans was selected by four independent operators either manually or with an automated procedure separating cortical and spongeous bone, the operators being requested to interact in ROI selection. The mean intrasubject variation was found to be much lower with the automated process (0.3 to 0.6%) than with the conventional method (2.5 to 5.2%). In a second study, 10 patients were examined twice to determine the reproducibility of CT slice selection by the operator. The errors were of the same order of magnitude as in ROI selection.
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A method for simultaneous acquisition of information on cytochemical and microangiographic characteristics of tissue after perfusion with contrast medium was developed. The technique is based on the use of hydrosoluble resin as embedding material and is illustrated by the demonstration of gamma-glutamyltranspeptidase activity and of the microcirculation in rat liver during chemically induced hepatocarcinogenesis and experimental metastasis. The method is applicable to investigations aimed at correlating microangiographic and cytochemical characteristics of normal or altered tissues.
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