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Biomedical subjects

R Loose

Publications and source records attributed to R Loose.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Radiologic medical desktop conferences--clinical evaluation of the KAMEDIN teleradiology system in routine practice of a radiologic institute].

KAMEDIN is a teleradiology project of "Deutsche Telekom". ISDN based image transfer, visualisation and online-presentation of digital radiological images is performed. In this study the suitability of the KAMEDIN-system has been tested in a clinical environment. The software has been adapted to the requirements of radiological image visualisation. During 6 months over 50 conferences took place with an average of 36 CT-slices per patient. The amount of time was approximately 10 min for conference preparation, 20 min for image transfer and 8 min for conferencing. Software problems occurred and were solved. Image quality on the monitor as well as online presentation including "simultaneous cursors" showed high performance and achieved high acceptance by the clinicians. Thus KAMEDIN is a useful teleradiology system, especially if the system is adapted to the requirements of radiology departments.

Computer Systems↗
PubMed1995

Intramural hemorrhage of the thoracic aorta. Diagnostic and therapeutic implications.

BACKGROUND: Intramural hemorrhage (IMH) was recently identified at necropsy and anecdotally in vivo as a unique aortic syndrome (without entry and with no flap-like intraluminal component, such as overt aortic dissection). However, little is known about diagnosis, prognosis, and outcome of IMH. METHODS AND RESULTS: Between 1983 and 1993, 360 patients from two medical centers with clinical indications of aortic dissection were prospectively evaluated; they presented to the emergency department a median of 3.5 hours after onset of back or chest pain or other suggestive symptoms. Among 195 patients with aortic syndromes, 25 patients (12.8%) were diagnosed to have IMH of the thoracic aorta with no evidence of a primary intimal tear, flap, or overt dissection by multiple noninvasive imaging modalities, including magnetic resonance imaging (n = 12), contrast-enhanced computed tomography (n = 14), and transesophageal echocardiography (n = 3) in random order. There were 16 men and 9 women with a median age of 56 +/- 13 years (range, 15 to 80 years). Arterial hypertension was present in the majority (84%), and Marfan's syndrome was present in 3 patients (12%). IMH was diagnosed within 4 days of hospital admission (median, 2.5 hours). IMH involved the ascending aorta (type A) in 12 cases (48%), the aortic arch in 2 (8%), and the descending aorta (type B) in 11 cases (44%); imaging results were validated by crossmatching with intraoperative, pathomorphological, and/or angiographic findings. IMH was 8.5 +/- 5 cm in length and 2.0 +/- 1.2 cm in aortic wall thickness. Aortic regurgitation and pericardial and mediastinal effusion were present in 5 of 12 patients (42%) with type A IMH and 2 of 11 patients (18%) with type B IMH. IMH progression to overt dissection, rupture, and/or acute tamponade occurred in 8 of 25 patients (32%) within 24 to 72 hours, indicating the need for urgent intervention. The 30-day mortality rate of IMH afflicting the ascending aorta was 80% (4 of 5 cases) with medical treatment (sedation and blood pressure control) versus no mortality in 7 cases with early surgical repair (P < .01); after 1 year, 71.4% of surgically treated patients were alive versus 20% in the medical group (P < .05). IMH of the aortic arch resulted in an early mortality of 50% (1 of 2 patients) with medical treatment. In IMH confined to the descending thoracic aorta, survival with medical treatment was not different from surgical therapy; there was 1 early death among 6 patients with medical therapy and none out of 5 patients with surgery (P = NS). At 1-year follow-up, medical and surgical therapy groups had survival rates of 80% and 83%, respectively (P = NS). CONCLUSIONS: IMH is associated with a clinical profile and prognosis similar to classic dissection and may be considered an ominous precursor of overt aortic dissection. Tomographic noninvasive imaging ensures rapid, nontraumatic diagnosis of IMH. The outcome of IMH of the ascending aorta appears favorable only with immediate surgical repair.

Adolescent↗
PubMed1995

Processing of visual motion direction in the fronto-parallel plane in the stationary or moving observer.

To examine the effect of concurrent self-motion on the perception of the direction of object-motion, random-dot kinematograms were employed in which the strength of the directional signal was manipulated by varying the percentage of coherently moving pixels. The subject's task was to indicate the motion direction of briefly presented displays while undergoing whole body rotations with angular accelerations of 0, 5, 15, or 45 degrees/s2. The perception of the direction of visual motion in the horizontal plane was impaired only when visual and vestibular motion directions were incongruous. The impairment increases with both increasing angular acceleration and decreasing percentage of coherently moving pixels. For object-motion in the vertical plane, an impairment was found for both congruous and incongruous combination of visual and vestibular stimulation, although not as pronounced for the latter (i.e., visual upward, vestibular downward stimulation, and vice versa). These results are discussed in terms of postnatal development and neurophysiological optimization processes resulting from intersensory 'updating' through every-day experience of object-motion during self-motion.

Acceleration↗
PubMed1995

Investigations into the mechanism of toxicity of lipopolysaccharide (LPS) in bovine aortic endothelial cells.

The cytotoxic effect of lipopolysaccharide (LPS) was examined on bovine aortic endothelial cell proliferation in vitro. These LPS-induced cytotoxicity (IC50 = 20 ng/ml) was not inhibitable by substances regulating the formation of nitric oxide (NO). e.g. by NG-monomethyl-L-arginine (L-NMMA), an inhibitor of NO synthesis, and by the glucocorticoid dexamethasone, an inhibitor of the induction of NO synthase. Also other substances which inhibit the generation or action of oxygen radicals, as glutathion and the xanthine oxidase inhibitor allopurinol did not prevent the cytotoxic effect of LPS. Only tyrphostin B46, an inhibitor of tyrosine kinase, attenuated the toxic LPS effect, suggesting that the LPS-induced cytotoxicity in bovine aortic endothelial cell cultures is mediated by a specific tyrosine kinase, and not by NO or oxygen radicals.

Animals↗
PubMed1995

[Neurofunctional MRI imaging of higher cognitive performance of the human brain].

Functional magnetic resonance imaging (fMRI) offers a powerful experimental tool for mapping activated cortical regions in man. Thereby, the paramagnetic deoxyhemoglobin in the red blood cells acts as an endogenous susceptibility contrast agent, which allows the noninvasive detection of stimulus-induced transient changes in regional cerebral blood flow and volume. Fifteen normal subjects were examined on a conventional 1.5-T MR system to visualize cortical activation during the performance of high-level cognitive tasks. A computer-controlled videoprojector was employed to present psychometrically optimized activation paradigms. Reaction times and error rates of the volunteers were acquired online during stimulus presentation. The time course of cortical activation was measured in a series of strongly T2*-weighted gradient-echo images from three or four adjacent slices. For anatomical correlation, picture elements showing a stimulus-related significant signal increase were color-coded and superimposed on T1-weighted spin-echo images. Analysis of the fMRI data revealed a subtle (range 2-5%), but statistically significant (P < 0.05) increase in signal intensity during the periods of induced cortical activation. Judgment of semantic relatedness of word pairs, for example, activated selectively cortical areas in left frontal and left temporal brain regions. The strength of cortex activation in the semantic task decreased significantly in the course of stimulus presentation and was paralleled by a decrease in the corresponding reaction times. With its move into the area of cognitive neuroscience, fMRI calls both for the careful design of activation schemes and for the acquisition of behavioral data. For example, brain regions involved in language processing could only be identified clearly when psychometrically matched activation paradigms were employed. The reaction time data correlated well with selective learning and thus helped to facilitate interpretation of the fMRI data sets.

Arousal↗
PubMed1995

[Intramural hemorrhage of the thoracic aorta as a precursor of dissection].

Aortic dissection without entry and blood-flow in a false lumen was recently identified at necropsy and in vivo as intramural hemorrhage in the aortic wall (IMH). It was the purpose of the study to elucidate clinical signs and prognosis in this rare and poorly understood condition. Among 360 prospectively evaluated patients with clinical suspicion of aortic dissection, 195 patients presented with evidence of aortic disease. Of these, 25 patients (13.2%) had IMH of the thoracic aorta with no primary intimal tear, flap or overt dissection as shown by MRI (n = 12), contrast enhanced CT (n = 14) and TEE (n = 3). IMH was confirmed intraoperatively or at necropsy. There were 16 men and 9 women of ages 56 +/- 13 years; arterial hypertension was associated in 84% and Marfan's syndrome in 12%. IMH involved the ascending aorta in 12 (48%), the arch in 2 (8%), and the descending aorta in 11 cases (44%). IMH occupied 8.5 +/- 5 cm in length and 2.0 +/- 1.2 cm in aortic wall thickness. Both aortic regurgitation and pericardial/mediastinal effusion was present in 42% of type A and in 18% of type B IMH. IMH progression to overt dissection, rupture and/or acute tamponade occurred in 8/25 cases (32%) within 24 to 72 h, indicating the need for urgent surgical repair. The 30-day mortality of IMH inflicting the ascending aorta was 80% (4 of 5) with medical treatment in contrast to none (of 7) with early surgical treatment (p < 0.01). One-year survival was 71% in surgically treated patients and 20% with medical treatment (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Endoscopic transthoracic sympathectomy in a paraneoplastic Raynaud's syndrome].

Six months after nephrectomy for renal-cell carcinoma and during treatment with interferon-alpha and vinblastin, a 70-year-old patient developed necrotizing Raynaud's phenomenon in both hands (at first: pain, livid skin and hyperhidrosis; later: painful acral ulcers; finally: trophic changes plus almost complete impairment of mobility and fine movements in both hands). These changes persisted even after the end of chemotherapy and despite several months on aspirin, naftidrofuryl, nitrates and glucocorticoids, so that the patient's general health was seriously affected. Because repeated sympathetic blocks were efficacious for brief periods, bilateral transthoracic endoscopic sympathectomy (TES) was performed. The patient became free of pain at once, the acral ulcers healed within a few weeks and he could again use his hands. Until his death from advanced metastases 10 months later the Raynaud's phenomenon did not recur. This case suggests that sympathetic vasoconstriction is apparently involved in the maintenance and progression of malignant neoplasm-associated Raynaud's phenomenon. TES is recommended as a reasonable palliative measure in patients with limited life expectancy, as long as preceding sympathetic blockage has indicated likely success and the procedure is performed under intraoperative monitoring of acral and facial skin temperature.

Aged↗
PubMed1994

[Locus of control in chronic schizophrenia. Empirical data in an ambulatory group of patients].

In the present study loci of control as cognitive attitudes are investigated by repeated examinations in an out-patient therapy group of patients suffering from chronic schizophrenia. Loci of control are expressions of subjective intellectual evaluations to give an opinion of individual results of action. Present study data agree with first results in literature which show an external orientation of investigated patients and the constant markedness of cognitive attitudes in time. Furthermore study results about the connection of cognitive attitudes and psychopathological self ratings and ratings by the investigator as well as statements about changes of experience and behaviour are shown and discussed in the end. It is started out that knowledges of these cognitions can support long term out-patient care of patients with chronic schizophrenia. The consideration of cognitive attitudes is part of a concept of therapeutic interventions, which improve personal skills by finding a model of illness.

Adult↗
PubMed1994

[Nuclear magnetic resonance tomography as a functional diagnostic method. New approaches to non-invasive quantification of cerebral blood volume and blood flow].

This paper presents a brief introduction to the current status of cerebral blood volume and blood flow imaging with magnetic resonance imaging (MRI) techniques. A new method for the quantitative assessment of regional cerebral blood volume (rCBV) and regional cerebral blood flow (rCBF) on the basis of the indicator dilution theory is described and preliminary quantitative results from healthy volunteers are presented. The mean values for the rCBV are 8.27 +/- 1.85 ml/100 g for grey matter and 3.78 +/- 1.34 ml/100 g for white matter. The mean values for the rCBF are 44.8 +/- 11.29 ml/min/100 g for the grey matter and 20.88 +/- 8.42 ml/min/100 g for the white matter. These results are in good agreement with PET results from the literature.

Adolescent↗
PubMed1993

[New imaging methods in thoracic diagnosis. A study to evaluate digital storage screen radiography, the slit technique ("AMBER"), asymmetric ("InSight") and conventional film-screen techniques].

New methods have been introduced in recent years in chest imaging to achieve high image quality simultaneously in the mediastinum and in the lung field. In this study the clinical value is assessed for four techniques: digital storage phosphor radiography, slit-technique ("AMBER"), asymmetrical film/screen ("InSight") and conventional film/screen. 43 patients were examined with these techniques within one day. Seven readers of four universities graded the image quality according to ten criteria of the mediastinum and the lung field. The slit-technique ("AMBER") showed the best image quality in both areas. Compared to conventional film/screen, storage phosphor radiography and asymmetrical film/screen ("InSight") yield better image quality only in the mediastinum.

Adult↗
PubMed1993

Time course of dimension and function of the autologous pulmonary root in the aortic position.

Although the autologous, fully vital, and compatible pulmonary root theoretically offers the prospect of an ideal aortic valve substitute, this type of replacement is performed in only a few centers. Major concern relates to the fate of root dimension and function in the systemic circulation and is largely unknown. To investigate the fate of the aortic root, we conducted echocardiographic examinations of eight freestanding pulmonary roots used for aortic valve replacement in adults. The studies were performed at discharge from the hospital and up to 21 months (mean 12.5 +/- 6.6 months) after the operation, as well as in 26 matched control subjects. There were no significant differences between the first and second postoperative studies regarding the root diameter (mean 26.6 +/- 2.1 mm and 27.6 +/- 2.6 mm, respectively), which was within control limits, the maximum transvalvular pressure gradient (mean 4.6 +/- 1.2 mm Hg and 6.6 +/- 2.1 mm Hg, respectively), the maximum leaflet separation (mean 22.1 +/- 1.4 mm and 22.1 +/- 1.8 mm, respectively), and the degree of insufficiency. At the first study, grade I aortic regurgitation was found in four patients and grade I-II in one patient. Regurgitation increased slightly in one patient with an abnormal leaflet. In three patients primary grade I regurgitation disappeared. These data suggest that the pulmonary root in the aortic position can withstand systemic circulation without changes in dimension and function for up to 21 months. Furthermore, some evidence is provided to indicate that in certain cases the viable autograft may adapt to systemic pressure, as indicated by the disappearance of primary regurgitation.

Aortic Valve Insufficiency↗
PubMed1992

Bovine early pregnancy factor (EPF) activity dependent on a 67-kDa polypeptide.

Maternal bovine EPF activity can be reduced to one single polypeptide enriched and identified from serum of cows in early pregnancy. The relative molecular weight of this active polypeptide was estimated at 67 kDa. This bovine EPF was labelled by 125I and peroxidase. In parallel investigations of non-pregnant animals a 67-kDa polypeptide was additionally identified in the last purification step, but without EPF activity in the rosette inhibition test. This indicated occurrence of an inactive pre-compound (or carrier protein) of the EPF in the non-pregnant state. On pre-incubation of lymphocytes with EPF analogues (inactive polypeptide from nonpregnancy serum) EPF retained its optimal activity, its lymphocyte receptors being unaffected. Monoclonal antibodies produced against HPLC-enriched EPF were reactive to the 67-kDa polypeptide in pregnancy material as well as in nonpregnancy material and were not able to differentiate between 'pregnant' and 'nonpregnant'. A mouse anti-EPF serum produced against highly purified EPF isolated from SDS PAGE showed reactivity only against the 67-kDa polypeptide of pregnancy serum but not against that of non-pregnancy serum. This is the first evidence for a difference in antigenic determinants of the two 67-kDa proteins found in pregnancy and non-pregnancy serum. Furthermore, a second higher molecular weight protein could be identified by this antiserum in pregnancy and non-pregnancy serum.

Animals↗
PubMed1992

[MR tomographic studies of the cerebral circulation: the methodological principles and initial clinical experiences with T2*-weighted gradient-echo sequences and CM administration as a bolus].

Paramagnetic contrast agents produce local magnetic field inhomogeneity when they pass through the cerebrovascular system. This effect can be monitored with T2*-weighted gradient echo images, which show transient signal loss, while a bolus of GdDTPA is passing through the brain tissue. This signal loss is correlated to the local cerebral tissue perfusion and the local cerebral blood volume. In a prospective study 10 volunteers and 14 patients with cerebral infarcts and brain tumours were examined. After bolus application of GdDTPA a dynamic series of rapid T2*-weighted gradient echo images were recorded, and the local dynamics of contrast flow in brain tissue was examined. From the series of images, local changes in signal intensity were calculated pixel by pixel and presented as parameter images. By this method, infarcted areas and brain tumours can be distinguished from normal tissue by their contrast flow dynamics. The abnormal contrast dynamics depend on changes in local tissue perfusion and alterations in local blood volume. The separation of the influence of both parameters however is still an unsolved problem.

Adolescent↗
PubMed1988

Effects of long-term treatment with 120 mg of sustained-release isosorbide dinitrate and 60 mg of sustained-release nifedipine on myocardial perfusion.

Forty patients with coronary artery disease and scintigraphically proven myocardial ischemia were randomized into 2 groups receiving 4 weeks of treatment with either 120 mg of isosorbide dinitrate (ISDN) release or 60 mg of nifedipine release. Control exercise testing and myocardial scintigraphy were continued until anginal pains occurred, and repeated at identical individual workloads at the end of the 4 weeks of drug therapy. Myocardial scintigrams were evaluated by quantitative recording of counts in 60 segments/frame. Twenty patients in the ISDN group (group I) exhibited 47 significantly ischemic areas. The remaining 20 patients (group II), treated with nifedipine, had 50 ischemic areas before therapy. In the ischemic areas in group I, there was a mean difference of 30.9% between counts at rest and during exercise in the pretreatment period, and a difference of 18.1% after therapy (39.0%). In group II, the pretreatment difference was 28.8%, decreasing to 20.6% after therapy (17.8%). Both groups of patients were subsequently subdivided into 3 subsets: (1) significantly improved perfusion, (2) significant worsening, and (3) unchanged myocardial perfusion. Group I had 59.5% of areas with significant improvement and 10.6% of areas with significant worsening. In 29.7% of the areas, the findings were unchanged. Group II had improvement in 40% of areas, of significantly worsened areas in 6%, and unchanged areas in 54%, in both groups myocardial ischemia was reduced by therapy, but ISDN improved myocardial perfusion to a considerably greater extent than did nifedipine.

Adult↗
PubMed1988

[Documentation of digital image information--video or laser imager?].

The quality of hardcopies produced by a video- or laser imager was compared. Laser printing could be performed after analogue or digital data transmission, whereas the video imager allowed only analogue data transfer. Evaluation of CT-, MR-, DSA- and radiographic images showed no difference in diagnostic information between video and laser-produced hardcopies. For large formats (35 X 35 cm.), laser images produced by digital transmission were considerably superior to video signals and analogue transmission. There were advantages and disadvantages of both types of imaging, depending on the size of the matrix, the type of image produced, ease of use and capital cost.

Copying Processes↗