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At least 379 records · Page 21Linked to original sources
PubMed2003

Strain and strain rate parametric imaging. A new method for post processing to 3-/4-dimensional images from three standard apical planes. Preliminary data on feasibility, artefact and regional dyssynergy visualisation.

BACKGROUND: We describe a method for 3-/4D reconstruction of tissue Doppler data from three standard apical planes, post processing to derived data of strain rate/strain and parametric colour imaging of the data. The data can be displayed as M-mode arrays from all six walls, Bull's eye projection and a 3D surface figure that can be scrolled and rotated. Numerical data and waveforms can be re-extracted. METHODS: Feasibility was tested by Strain Rate Imaging in 6 normal subjects and 6 patients with acute myocardial infarction. Reverberation artefacts and dyssynergy was identified by colour images. End systolic strain, peak systolic and mid systolic strain rate were measured. RESULTS: Infarcts were visualised in all patients by colour imaging of mid systolic strain rate, end systolic strain and post systolic shortening by strain rate. Reverberation artefacts were visible in 3 of 6 normals, and 2 of 6 patients, and were identified both on bull's eye and M-mode display, but influenced quantitative measurement. Peak systolic strain rate was in controls minimum -1.11, maximum -0.89 and in patients minimum -1.66, maximum 0.02 (p = 0.04). Mid systolic strain rate and end systolic strain did not separate the groups significantly. CONCLUSION: 3-/4D reconstruction and colour display is feasible, allowing quick visual identification of infarcts and artefacts, as well as extension of area of post systolic shortening. Strain rate is better suited to colour parametric display than strain.

Algorithms↗
PubMedDate not supplied

An algorithm for three-dimensional visualization of radiation therapy beams.

A computer algorithm to display radiation beams superimposed on three-dimensional (3-D) views of patient anatomy has been developed. It may be implemented as a postprocessing step to existing software for 3-D presentation and display. The algorithm takes as input a shaded 3-D view (reconstructed, for example, from computed tomography scans), together with the associated depth map, and generates as output an enhanced 3-D view highlighting in color the visible points which lie within the projected beam outlines. The algorithm is independent of the method used to generate the 3-D view (surface or volume rendering techniques may be used) and is independent of beam shape (beams may be modified with shielding blocks). It is not restricted to external surfaces and will correctly show radiation beams projected onto cut-away views of internal organs. The method is illustrated by application to a tangential pair for breast malignancy, using 3-D views generated with volume rendering software.

Algorithms↗
PubMed1990

The operational realities and lessons learned in setting up a functional medical unit, self-contained transportable operating room to support a fixed facility.

Routine surgical care at Cutler Army Community Hospital (CACH), Fort Devens, Massachusetts was interrupted for almost 2 months while the operating room floors of the hospital were renovated. Surgical capabilities were maintained utilizing the field resources of the 46th Combat Support Hospital (CSH). This initiative required the exceedingly close coordination and combined efforts of both medical commands superimposed on a matrix of finite installation support and community acceptance, fostered by a proactive, highly visible public relations program. The joint venture was an unequivocal success in terms of maintaining the continuity of operations, demonstrating the real-life capabilities of surgical field equipment, and providing invaluable first-hand "do's and don'ts" training experience to the soldiers involved in the project. A "lessons learned perspective" of the planning and implementation phases is presented that provides beneficial real-life reference information and resource data.

Attitude of Health Personnel↗
PubMed1981

[Horizontal beam external total 3/4 projection of the foot during weight-bearing (author's transl)].

A method for radiological examination of the supporting areas of the anterior part of the foot employs a horizontal beam external total 3/4 projection as a complement to clinical and podoscopic investigations. This radiograph, which cannot effectively assess the condition of the talometatarsal joint, more clearly visualized on a Guntz film, can however provide more precise information on the state of the plantar pad and the level of the anterior bone pillars. These are normally disposed at an equal distance of approximately 10 mm from the ground. In cases with localised anomalies in the supporting areas, either from increased or decreased pressure, the corresponding modifications in the metatarsal heads are apparently more clearly visible in the Guntz film. The projection proposed enables study of anterior supporting areas when dorsal extension of the toes is impossible (hallux rigidus, metatarsophalyngeal arthrodesis). Finally, study of these films supplies data on the posterior bone pillars, the calcaneum, and styloid of the 5th metatarsal, which, together with the anterior supports, form the seven bone pillars of the foot. For the internal arch and the crown of the astralgus vault, the film shows the head of the astralgus, the tarsal sinus, and the posterior subastralgus joint.

Adult↗
PubMedDate not supplied

Reliability of Enderlein's darkfield analysis of live blood.

CONTEXT: In 1925, the German zoologist Günther Enderlein, PhD, published a concept of microbial life cycles. His observations of live blood using darkfield microscopy revealed structures and phenomena that had not yet been described. Although very little research has been conducted to explain the phenomena Dr. Enderlein observed, the diagnostic test is still used in complementary and alternative medicine. OBJECTIVE: To test the interobserver reliability and test-retest reliability of 2 experienced darkfield specialists who had undergone comparable training in Enderlein blood analysis. SETTING: Inpatient clinic for internal medicine and geriatrics. METHODS: Both observers assessed 48 capillary blood samples from 24 patients with diabetes. The observers were mutually blind and assessed their findings according to a specific item randomization list that allowed observers to specify whether Enderlein structures were visible or not. RESULTS: The interobserver reliability for the visibility of various structures was kappa = .35 (95% CI: .27-.43), the test-retest reliability was kappa = .44 (95% CI: .36-.53). CONCLUSIONS: This pilot study indicates that Enderlein darkfield analysis is very difficult to standardize and that the reliability of the diagnostic test is low.

Adult↗
PubMedDate not supplied

[Laser in gynecology. Palliative laser treatment in genital and breast cancers].

Local, so-called incurable, recurrences of breast or genital cancers were as therapeutic challenge in the past. The authors undertook a pilot trial of laser treatment in 45 patients, as a palliative measure, in view of the serious psychological and physical problems experienced by these women constantly confronted by the presence of painful, visible and often ulcerated tumor lesions. CO2 and Nd:YAG lasers were used for tumor vaporisation and coagulation, the combined use of these two wavelengths providing the new study concept which emerged from this pilot trial.

Adult↗
PubMed2005

Unusual imaging appearances of pancreatic serous cystadenoma: correlation with surgery and pathologic analysis.

BACKGROUND: We describe imaging and pathologic features of serous cystadenoma of the pancreas on multislice helical computed tomography CT (MS-CT) and surgical resection. METHODS: Radiologic and pathologic features were analyzed in five patients. All patients underwent MS-CT and digital subtraction angiography (DSA), and four patients underwent magnetic resonance (MR) imaging. Preoperatively, three cases showed radiologic evidence of mainly solid appearance on MS-CT, and the suspected diagnoses were solid pancreatic tumors (patients 1-3). The other two cases showed radiologic evidence of macrocystic tumor of the pancreas, and the suspected diagnoses were mucinous cystic tumors (cases 4 and 5). All patients underwent surgery, and the diagnosis of serous cystadenoma was confirmed on pathologic examination. RESULTS: In three cases that showed a solid appearance on MS-CT, a microcystic appearance was identified on microscopic examination, and the tumors were found to be hypervascular lesions on multiphasic contrast-enhanced CT and DSA. In cases 1 and 2, the lesions showed high intensity with internal septation on T2-weighted MR images. In two cases, the tumors were classified as a macrocystic variant of serous cystadenoma, and no mural nodules, papillary projections, or calcifications were seen in the tumors. CONCLUSION: Imaging appearance of serous cystadenoma on MS-CT is various and sometimes indistinguishable from that of solid tumor or mucinous cystic tumors of the pancreas. Imaging findings of hypervascularity and a well-marginated high-intensity lesion with internal septation on T2-weighted MR imaging may be crucial to identify serous cystadenoma that contains no visible cystic compartments on MS-CT.

Adult↗
PubMed1993

On the confounding effects of phosphor persistence in oscilloscopic displays.

Phosphor persistence has been a source of confounding in studies of temporal integration in vision. We examined the confounding by assessing the effects of the persistence of two commonly-used phosphors (P15 and P31) on performance of a temporal-integration task. In one experiment we eliminated the visibility of phosphor persistence by closing two mechanical shutters upon display termination. In a second experiment we estimated the duration of phosphor persistence by displaying the image behind closed shutters which opened upon display termination. No detectable persistence was every produced by P15 phosphor. By contrast, P31 phosphor produced persistence that lasted several hundred milliseconds even when a veiling light was projected on the screen. We ascribe the earlier instances of confounding to inadequate interpretation of the technical data on phosphor decay.

Humans↗
PubMed1993

Three-dimensional vascular imaging--an additional diagnostic tool.

Angiography is still the standard for imaging of vascular structures. However, since the number of projections is limited, complex pathoanatomy may not be sufficiently visible. This study presents two patients in whom 3D reconstruction from Spiral CT data revealed combined vascular lesions undisclosed by angiography. In one case the combination of coarctation and chronic dissection type B, in another the combination of two aneurysms of the celiac trunk in series was disclosed. We conclude that 3D reconstruction can be a valuable asset in the diagnosis of complex vascular pathoanatomy.

Adult↗
PubMed2001

Determining indirect caregivers' contribution to patient care.

It is critical to measure contributions of staff who are not direct caregivers so that organizations can continually maximize resource. Understanding the consumer's perceptions is necessary to identify activities that contribute to the perception of an effective CNE. An awareness of the values placed by consumers on education services helps the educators to focus their efforts on those activities with the greatest perceived value. If educators put their efforts toward valued activities, their services would be frequently used and the staff would be more willing to accept the information, thereby benefiting from the educator's expertise. Learning how a role directly benefits patient care helps nurses in leadership positions meet institutional objectives. It allows nurse leaders to ensure that the role is, in fact, contributing to care, and it is doing so to the fullest extent. This builds institutional support and value for the role. The process of evaluating the benefit also allows the educators to gain support and credibility among consumers and other individuals within the institution. This perpetuates the increased utilization and benefit of the role. Results of this project can be used as a guide in evaluating various roles. Understanding activities that are valued by consumers enables staff in the roles that are being evaluated to determine how and where they should focus their efforts. This is especially critical as staff is being asked to do more work with less time and must establish priorities in their ongoing workload. Finally, it is vital to identify ways of turning the invisible work that indirect caregivers provide into visible work.

Attitude of Health Personnel↗
PubMed2003

Preliminary evaluation of image reconstruction by ordered-subset expectation maximization in thallium-201 lung scintigraphy.

OBJECTIVES: We observed whether clearer tumor delineation and greater tumor to non-tumor (T/N) count ratios could be obtained using an iterative ordered-subsets expectation maximization (OSEM) algorithm than conventional filtered-back projection algorithm (FBP) in the image reconstruction of thallium-201 (201Tl) lung scintigraphy. METHODS: In 29 patients with lung cancer and phantom studies, tomograms were reconstructed using FBP and OSEM algorithms, with and without a prefilter (Butterworth filter: BW), whose cut-off frequencies were 0.10 cycles/pixel for FBP and 0.10 and 0.17 cycles/pixel for OSEM. Visual interpretation and tumor to non-tumor (T/N) count ratios were obtained and compared. RESULTS: Without a prefilter, T/N ratios from OSEM and FBP were 1.89 +/- 0.31 (early) and 2.00 +/- 0.54 (late) for OSEM, 1.90 +/- 0.33 (early) and 2.05 +/- 0.59 (late) for FBP, respectively. The OSEM reconstruction without prefiltering showed clearer tumor contours than FBP without a prefilter. Incorporation of BW showed visually low-noised images but decreased T/N ratios in both reconstructions with BW (0.10 cycles/pixel). No greater T/N ratios were obtained by OSEM than FBP, with or without prefiltering. With BW with a cut-off frequency of 0.17 cycles/pixel, the same T/N ratios as those without BW were obtained. The tumor model sized 0.9 cm in the phantom study was invisible in both OSEM and FBP reconstructions without a prefilter, but visible with a prefilter. The influence of prefiltering on T/N ratios was also observed in phantom studies. CONCLUSIONS: Visually improved tumor delineation could be obtained in OSEM reconstruction without a prefilter as compared to FBP reconstruction without a prefilter for tumors greater than 2 cm. Prefiltering should be incorporated into OSEM reconstruction in diagnosing small tumors. However, the influence of prefilter (BW) setting on semi-quantitative interpretation needs further discussion.

Adult↗
PubMed2000

Evaluating clinical supervision in community homes and teams serving adults with learning disabilities.

Evaluating clinical supervision in community homes and teams serving adults with learning disabilities This paper provides a discussion of some of the professional and policy outcomes associated with implementing clinical supervision within a community service for adults with learning disabilities. It is based upon a small qualitative study whose aim was to examine how clinical supervision was operating, its strengths, its weaknesses and where improvements might be made. The study followed the introduction of clinical supervision 9 months earlier for nurses and carers employed in three community homes and one community multiprofessional team. The method consisted of direct observation of individual and group supervision and staff completing critical incident questionnaires, followed by semi-structured, audio-taped interviews with seven registered nurses and four community team members, including a social worker, psychologist and physiotherapist. Outcomes were expressed in two ways: in terms of the benefits of clinical supervision or of its ambivalence. The range of matters brought for discussion, or resolution, in supervision reflected some of the difficulties or dilemmas staff faced working in this area, for example promoting empowerment and assisting clients to make choices, and dealing with clients' challenging and inappropriate behaviours. As for the role of supervisor there was some evidence of nurses expressing apprehension or unpreparedness, also a perceived general concern over the relatively low status of clinical supervision, thought to be due to absence of visible management approval or failure to articulate properly the objective of supervision. A limitation of the study was its small subject sample although considerable data were gathered in each of the units through relatively long-term contact.

Adult↗
PubMed2003

[Report on the ECR2003 (European Congress of Radiology): non-contrast intracranial MR venography with 3D-phase contrast imaging: optimization of presaturation pulse and velocity encoding].

BACKGROUND: Intracranial MR venography is useful for the diagnosis of dural sinus thrombosis and the preoperative assessment of sinus patency encased by tumors. Recently, contrast-enhanced MR venography has been applied for suspected dural sinus occlusion in a shorter time. However, it has some disadvantage for the evaluation of hypervascularized enhancing thrombus mimicking flow in chronic sinus thrombosis. So far, we have evaluated optimal imaging technique and slice orientation and have shown that sagittal three-dimensional (3D) -phase contrast (PC) imaging is the most suitable for the non-contrast intracranial MR venography. PURPOSE: To assess the optimal presaturation pulse (SAT) and velocity encoding (VENC) for the non-contrast intracranial 3D-PC MR venography. METHODS AND MATERIALS: Firstly, we performed phantom experiment to assess the best SAT thickness using arterial presaturation. Second, MR imaging was performed in 7 healthy volunteers to measure the dural sinus flow velocity using a 1.5 T MR. Third, 3D-PC MR venography was performed with a VENC settings at 10, 15, 20 and 30 cm/sec for healthy volunteers. All data were displayed as maximum intensity projection images and three neuroradiologists assessed the visibility of the dural sinuses and the cortical vein. RESULTS: The mean flow velocity of the dural sinuses was 6.3 cm/sec. The thickness of the best SAT was 100 mm. In the assessment of the visibility of the 3D-PC images, dural sinuses were adequately visualized at a VENC of 15 cm/sec. CONCLUSIONS: Non-contrast intracranial 3D-PC MR venography was optimized at 100mm thickness of SAT and a VENC of 15 cm/sec.

Blood Flow Velocity↗
PubMed1997

[Outcome of Van der Meulen columellar extension in bilateral lip-jaw-palate clefts].

A total of 42 patients were operated on for secondary columellar elongation at the Department for Cranio-maxillofacial Surgery in Essen, Germany, from 1990 to 1996. The procedures were carried out because of nasal deformity in bilateral cleft lips (n = 35) or unilateral cleft lips (n = 7). The well-established drawbacks of Millard's forked flap technique, especially the resulting unfavourable scars at the lip columellar angle and the unpredictable, more conspicuous scar formations within the upper lip gave rise to an intensive search for an alternative surgical technique in our clinic. Since 1995 we have undertaken 14 secondary columellar elongations by means of Van der Meulen's three dimensional Z-plasty at the alar rim. Avoiding reopening of the lip we were able to lengthen the columella and project the nasal tip forward between 3 mm and 8 mm in all patients without introducing additional visible scars. The procedure led to an improved contour of the nasal tip, the alar rims and the nostrils. Nevertheless, we observed secondary broadening and shortening of the elongated columella in two children. This complication could subsequently be avoided by postoperative application of a nostril splint. The results confirm the effectiveness of the described technique for moderate columellar lengthening. The postoperative application of nostril splints is mandatory.

Adolescent↗
PubMed1996

Potential health hazards from lead shielding.

Uncoated metallic lead is widely used as radiation shielding in research and development, nuclear medicine and radiology, and various manufacturing processes. The common use of lead shielding, however, may present an insidious health hazard due to lead dust. Field and laboratory measurements were collected to evaluate the distribution and removal of lead from radiation shielding material as well as to measure airborne exposures during large shielding emplacement projects. The data indicate that lead is readily dispersed from visibly oxidized as well as freshly-cleaned shielding, but that a single coating of polyurethane can reduce lead removal by nearly three orders of magnitude. Although 8-hour time-weighted average exposures for workers constructing lead shielding structures were nearly all below the Occupational Safety and Health Administration's action level of 30 micrograms/m3 (due to short work periods), the distribution of airborne lead concentrations during this kind of work demonstrates a potential for overexposure.

Air Pollutants, Occupational↗
PubMedDate not supplied

Geometry of liver system functioning: from a helix to a trajectory on curved space.

Autoisodiasostasis of the liver, i.e., its self-maintenance without change over the course of time, is characterized by a bistable equilibrium between two extreme states called homopoiesis (during which the liver system repairs its worn structures and replicates its cells) and homoerhesis (during which it satisfies the needs of the body). Retinol binding protein traffic within the hepatocyte, made visible by means of immunohistology, has been used as a prototype for studying the competition processes and dynamics of autoisodiasostasis. An account is given of the oscillation of autoisodiasostasis between homopoiesis and homeorhesis through intermediate phases. The phase cycle of autoisodiasostasis is illustrated in the form of bi-dimensional and tri-dimensional diagrams. The temporal behaviour of the systems is represented as a helix trajectory obtained by projecting homopoiesis-homeorhesis phase cycles onto a time series. A unified topological representation of the uncoupled but combined processes of competition and autoisodiasostasis is proposed.

Humans↗
PubMed2003

Is esophageal capsule endoscopy feasible? Results of a pilot.

BACKGROUND AND STUDY AIMS: Capsule endoscopy (CE) has been shown to be accurate in the evaluation of small-bowel bleeding and possibly also other small-bowel disorders. It is commonly believed that other organs are not suitable for CE. We report here on our experience in studying the distal esophagus using CE under various conditions. PATIENTS AND METHODS: A prospective evaluation of CE was carried out in three groups: evaluation of the distal esophagus in routine patients (n = 58) mostly examined for suspected small-intestinal bleeding (group 1); in eight patients with signs of grade I - II reflux esophagitis on upper gastrointestinal endoscopy, who were examined in a supine position for esophageal passage (group 2); and in four volunteers who swallowed the capsule attached to a string (group 3). RESULTS: In 62 routine patients initially included in group 1, the median CE exposure time was 2 s (range 0 - 217 s; median of four pictures, range 0 - 434), excluding four patients with extremely delayed esophageal transit (esophageal times: 45 - 226 min); at least one image of the Z line was obtained in 24.1 % of cases, but adequate assessment of 50 % and 100 % of the circumference of the distal esophagus was possible in only 10.4 % and 0 % of these cases, respectively. In group 2, the values were better (adequate visibility rates of 50 % and 100 % in 12.5 % and 37.5 % of the eight patients, respectively), but the correct diagnosis of reflux lesions was obtained in only three of the eight. In group 3, the visibility of the Z line was good, but all four volunteers experienced the procedure with the attached string as being quite unpleasant. CONCLUSIONS: Distal esophageal assessment by CE with the aim of providing an easy screening method for reflux lesions is not at present feasible. Technical developments will be necessary to achieve this.

Adolescent↗
PubMed1996

Where have all the American celiacs gone?

Celiac disease is a common cause of malabsorption in western countries, with significant geographic variation in incidence. Recent epidemiological studies using serology tests, however, suggest that the disease is more common than previously realized and homogeneously distributed in Europe. These studies have also demonstrated that the clinical presentation of the disease may greatly vary even between neighboring countries. Celiac disease remains a rare diagnosis in the United States. Whether the disease is underdiagnosed or is truly rare remains to be established. We have conducted preliminary studies, both on pediatric patients and adult blood donors, that seem to suggest that the prevalence of positive screening tests for celiac disease in the USA is equivalent to that reported in similar screening studies conducted in Europe. These data also suggest that the dimensions of the American celiac disease iceberg seem to be similar to those of the European one. The visible tip of the American iceberg, however, appears to be much smaller, since most of it still remains submerged. The reasons for these divergences remain unknown and may only be partially related to the limited attention to the disease by the American scientific community. Large, multicenter serological screening studies are needed to define the true prevalence of celiac disease in the United States.

Adult↗