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Biomedical subjects

M Riemer

Publications and source records attributed to M Riemer.

At least 19 recordsLinked to original sources
PubMed2007

[Obligatory informed consent on the risks to the accommodation ability of the eye after the implantation of an artificial lens].

The article reports a medical malpractice claim in Germany against an ophthalmologist who implanted an artificial lens without informing the patient about the risk of losing the eye's accommodation ability before undertaking surgery. As informed consent was not obtained, in spite of the obligation to so, the court ruled that the physician should pay compensation for medical malpractice. The author shows how similar malpractice cases can be prevented in future.

Germany↗
PubMed2006

A novel interactive anatomic atlas of the hand.

Classical anatomic atlases cannot provide the spectrum of views and the detail required in modern diagnostic and surgical techniques. Computer modeling opens the possibility to choose any view from one single model. A computerized model of the hand is presented, which has been obtained by segmentation and graphic modeling of the Visible Human dataset. In addition to being able to choose arbitrary viewpoints, it allows interrogation of the chosen views by mouse click. We believe the functions of these new kinds of atlases are superior to the classical ones.

Anatomy, Artistic↗
PubMed2006

[UV Protection Law. Enhancing the protection of minors against health risks from solaria].

The article reports on a petition to the German Bundestag in the field of UV protection for persons under the age of 18 against the dangers of artificial sunbed tanning for cosmetic purposes. On 16 March 2006 the Parliament agreed to adopt the proposal of the author, after the Ministry of Environment announced it is working on a UV Protection Law for Germany. Furthermore the committee recommended the petition to the government and the parliamentary parties. The UV Protection Law is still in progress, and no draft has yet been published. Therefore, the author explains the difficulties in creating such law from a legal and a public health perspective, pointing out that the split of competence between the federation and the states poses difficulties. He concludes that the German Constitution would allow a sunbed prohibition for minors in public studios and explains why a complete prohibition for the adult population would be disproportionate and unconstitutional.

Adolescent↗
PubMed2001

Creating a high-resolution spatial/symbolic model of the inner organs based on the Visible Human.

Computerized three-dimensional models of the human body, based on the Visible Human Project of the National Library of Medicine, so far do not reflect the rich anatomical detail of the original cross-sectional images. In this paper, a spatial/symbolic model of the inner organs is developed, which is based on more than 1000 cryosections and congruent fresh and frozen CT images of the male Visible Human. The spatial description is created using color-space segmentation, graphic modeling, and a matched volume visualization with subvoxel resolution. It is linked to a symbolic knowledge base, providing an ontology of anatomical terms. With over 650 three-dimensional anatomical constituents, this model offers an unsurpassed photorealistic presentation and level of detail. A three-dimensional atlas of anatomy and radiology based on this model is available as a PC-based program.

Anatomy, Cross-Sectional↗
PubMed2001

A realistic model of human structure from the visible human data.

The computer-based 3D models of the human body reported to date suffer from poor spatial resolution. The Visible Human project has delivered high resolution cross-sectional images that are suited for generation of high-quality models. Yet none of the 3D models described to date reflect the quality of the original images. We present a method of segmentation and visualization which provides a new quality of realism and detail. Using the example of a 3D model of the inner organs, we demonstrate that such models, especially when combined with a knowledge base, open new possibilities for scientific, educational, and clinical work.

Anatomy, Cross-Sectional↗
PubMed2000

[Ventricular fibrillation in intra-atrial cardioversion of atrial fibrillation].

Recently intra-atrial defibrillation has become an interesting alternative to external defibrillation and drug therapy for the treatment of atrial fibrillation. Low-energy intra-atrial defibrillation can be used to restore sinus rhythm f.ex. after a failed external cardioversion or during an electrophysiologic study when the administration of antiarrhythmic drugs should be avoided. Additionally this new technique has led to the development of implantable atrial defibrillators for the treatment of selected patients suffering from chronic atrial fibrillation. Intra-atrial defibrillation seems to be a highly effective and safe method, but little experience exists concerning the outcome so far. Especially the potential risk of inducing ventricular pro-arrhythmia is subject of current controversy. We report the case of a 79-year-old patient suffering from WPW syndrome with a concealed bypass tract who was subject to an intra-atrial defibrillation during an electrophysiologic study. At the beginning of the study atrial fibrillation could be converted to sinus rhythm by a single low-energy atrial defibrillation (3 J.). After a short period of time a second intra-atrial defibrillation had to be performed in the same way because of recurrent atrial fibrillation. By this atrial shock ventricular fibrillation was induced, so that high energy external defibrillation became necessary. Analyzing the ECG a correct R-wave synchronization was found, but a rather short preceding RR interval (252 ms). In conclusion, low energy atrial defibrillation is gaining importance as a highly effective new technique to restore sinus rhythm in patients suffering from atrial fibrillation resistant to conventional therapies. Nevertheless potential risks have to be considered such as the induction of ventricular pro-arrhythmia. Therefore, a correct R-wave synchronization is obligatory and shock delivery should be withheld after short RR intervals. Future prospective randomized studies will have to show whether this new technique is really safe enough and superior to the conventional methods for restoring sinus rhythm in patients suffering from atrial fibrillation.

Aged↗
PubMed1999

Interactive volume visualization using "intelligent movies".

High quality visualization of medical volume models as performed by the VOXEL-MAN and similar systems is still too time consuming and the interaction complicated when sophisticated tools like dissection are used. We hence developed a new paradigm allowing to create simpler derivatives of the model, called "intelligent movies". These are in QuickTime or QuickTime VR format which allow interactive exploration with two degrees of freedom. As a decisive novelty, we extended it by a pixelwise link to the knowledge base which may be queried in the image context. Thus scenes emphasizing a selected aspect of the volume model may be created as intelligent movies, which a user (referring physician, student) can explore largely with the functionality of VOXEL-MAN, but in real time--on any standard PC--and also via a JAVA applet within web browsers. This is shown with the example of 3D interactive anatomical atlases and clinical cases.

Anatomy, Cross-Sectional↗
PubMed1995

[New kinds of 3-dimensional atlases of the anatomy and function of the human body].

It is a drawback of classical multimedia programs for the visualization of spatial knowledge, that they are based on a limited number of predefined views. This paper describes a model that combines pictorial and symbolic knowledge about spatial structures in a way that allows arbitrary views of the scene and the interrogation of the model in the context of the actual view. The style of the pictorial presentation only depends on the objective and the phantasy of the user. The functionality of the approach is demonstrated with the example of the human head. It is furthermore shown that the model potentially allows the simulation or generation of all classical visual teaching aids for anatomy.

Anatomy, Artistic↗
PubMed1994

A new method for practicing exploration, dissection, and simulation with a complete computerized three-dimensional model of the brain and skull.

In current practice, anatomical atlases are based on a collection of planar images presented in a book or, recently, stored on digital media. We present a new kind of interactive true three-dimensional (3D) anatomical atlases based on a volume model derived from MRI and CT. The model has a two-layer structure. The lower level is a volume model with a set of semantic attributes connected to each voxel. The semantic attributes are assigned by an anatomist using a volume editor. THe upper level represents a set of relations between these attributes. Interactive visualization tools such as multiple surface display, preparation of transparent material and cutting are provided. It is shown that the combination of this model with advanced tools for volume visualization provides the 'look and feel' of real dissection. The system therefore represents a bridge between real dissection of a cadaver and textbooks and classical atlases of anatomy. First tests have shown that the atlas system may be used successfully for teaching anatomy, but also as a reference for radiologists or surgeons. The powerful underlying data structure potentially includes all classical visual teaching aids. As a replacement of classical atlases, however, spatial resolution has still to be improved.

Anatomy↗
PubMed1992

Visualization of 3-D treatment plans with fast neutrons.

The treatment planning for radiotherapy with fast neutrons requires modifications of the planning systems used for photons. The neutron- and photon-component of the treatment fields must be determined and can then be used for separate calculations. The corrections for inhomogeneities are performed by use of attenuation coefficients and the corresponding corrections for changes in the kerma. The treatment planning system MEVAPLAN (Siemens) was modified to follow these requirements. Thus treatment planning for 14 MeV DT-neutrons could be performed. The multiplanar option is used to calculate 3D-dose distributions based on up to 40 serial CT slices. The generated three-dimensional dose matrix and the CT data are transferred via magnetic tape to the visualization system VOXEL-MAN developed at the University Hospital of Hamburg. This system uses a ray casting algorithm based on the generalized Voxel-model to display detailed 3D-images of human anatomy together with the calculated dose distribution. Different treatment plans for neutrons and photons are calculated and visualized. Various manipulations of the data-sets are displayed to improve the critical examination of the simulated dose distribution and to discern the quality of treatment techniques.

Fast Neutrons↗