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At least 415 records · Page 23Linked to original sources
PubMed1991

Basic principles of magnetic resonance contrast agents.

The use of contrast agents in MRI is well established as a means to improve diagnosis. MRI differs from other imaging modalities because signal and contrast are multiparametric in both the properties of the tissue and the method of measurement. Contrast depends on differences in proton-spin density, magnetic susceptibility, molecular diffusion and perfusion, and T1 and T2 relaxation times. Relaxivity contrast agents, those that focus on shortening relaxation times, are most commonly employed in the form of paramagnetic chelates and depend on a variety of mechanisms, including concentration, number of ion-coordination sites, spin quantum number, magnetic moment, ion-to-proton distance, and correlation time constants characteristic of the chemical and molecular structure. A sound understanding of the principles of general contrast mechanisms, contrast agent design, and MRI techniques used in conjunction with contrast agents is vital to ensure proper enhancement and optimal diagnostic results.

Contrast Media↗
PubMed1990

Genetic counselling and prenatal diagnosis of cystic fibrosis in Debrecen (Hungary)--prenatal diagnosis by microvillar enzyme assay from amniotic fluid.

Amniotic fluid intestinal alkaline phosphatase, gammaglutamyltransferase and trehalase activity were quantitated to assess their reliability for the prenatal diagnosis of cystic fibrosis. To obtain optimal diagnostic discrimination, the three enzyme values obtained for each sample were combined into a single linear discriminant function that proved to be a more accurate indicator of the outcome of the pregnancy. From the cases studied here, it appears that this method can be expected to give a correct prediction in 92.0% of all high risk pregnancies.

Amniotic Fluid↗
PubMed1990

[Preliminary study of pelvic CT with air enema].

In pelvic CT, several techniques (appropriate preparations) have been reported for the optimal diagnostic imagings. We demonstrated the usefulness and limitations of "Air Enema", which is one of preparations for hollow viscera in pelvic CT examination. From Oct. 1986 to Mar. 1987, 38 patients with gynecological abnormalities were evaluated by consecutive pre and post "Air Enema" CT. The patients aged 26-75 years with mean of 44.6 years. All patients were examined in prone position with 100 ml of 2% iopamidol in the urinary bladder and medical tampon in the vagina. Two consecutive scans were performed from the level of pubic symphysis to the 5th lumbar vertebra at 10 mm-15 mm intervals. The first scan was pre "Air Enema" CT, in which the rectum, entire colon and terminal ileum were not distended. The second scan was post "Air Enema" CT, in which the hollow viscera was distended by 1000 ml-1500 ml of air. Two images, each from pre and post "Air Enema" CT were evaluated on the efficacy for imaging diagnosis. In "Air Enema" CT, main useful effect was "replacement effect", which was that intrapelvic masses and/or intrapelvic paravascular spaces were clearly delineated by distended bowels. Detection and location of intrapelvic masses were correctly diagnosed when the masses were relatively small (5.3 cm in average diameter), but there were no advantages in cases in which the pelvic masses were large enough to occupy the pelvic cavity (12.7 cm in average diameter). Abdominal pain was the most common adverse reaction to this technique. But complaints usually disappeared in few hours after examination. Thus, "Air Enema" seems to be useful preparation for pelvic CT examination to detect relatively small intrapelvic masses and abnormalities.

Adult↗
PubMed1990

[Possibilities of ultrasonic dopplerography and multi-level manometry in the evaluation of lesions of the arteries of the lower limbs].

Dopplerographic and manometric examination was conducted in 429 patients with obliterating lesions of the lower limb arteries in order to find optimal diagnostic combinations. The data of noninvasive diagnosis were verified in 119 cases. The data obtained bore evidence that coincidence of the findings of ultrasonic dopplerography and multilayer manometry is indicative, with a high degree of probability, of the presence or absence of lesions of the lower limbs. The findings of ultrasonic dopplerography are the main criteria in appraising affections of the aortoiliac segment and those of multilayer manometry--in appraising affections of the femoropopliteal segment. The findings of both methods are of equal significance in appraising the tibial segment. Multilayer manometry allows indirect appraisal of the condition of arteries in the channel of the deep femoral artery.

Adult↗
PubMed1990

[A comparative study of the karyotypes of fetuses of spontaneous early abortions obtained by direct method and by long-term culture].

The direct method of chromosomal preparations on chorionic villi biopsies has been applied to the cytogenetic study of 34 early spontaneous abortion products. These results were compared with those obtained through long term cultures performed simultaneously from the same samples. The success rate obtained through the direct method (86.2%) is superior to that of the long term culture (76.4%). However, the combined use of both techniques further improves the success rate (94.1%) and the reliability of the results. Among the 32 informative cases, 15 chromosomal aberrations (46.8%) have been detected. These data demonstrate the value of the direct method of karyotyping chorionic villi from spontaneous abortion products. However, considering the specific advantages of either method respectively, the authors recommend that both be used simultaneously for optimal diagnostic efficiency.

Abortion, Spontaneous↗
PubMed1989

Hypertension--an overview.

The contributions in this symposium address the causes of both essential and secondary hypertension, optimal diagnostic techniques, treatment regimens, and long-term management of the hypertensive patient through a continued-care program. The intended emphasis is on issues that will have practical use in patient assessment and evaluation of therapeutic options. In particular, our goal was to provide current information that could enhance the care of the hypertensive patient.

Antihypertensive Agents↗
PubMed1989

Preoperative staging techniques for soft-tissue neoplasms.

Preoperative staging studies need not be limited to one of the techniques discussed since each has its own specific advantages and disadvantages in the overall evaluation of soft-tissue neoplasms. Among orthopaedic oncologists, however, it is apparent that MRI is becoming the preoperative staging study of choice. It is by the careful, judicial use of one or all of these techniques that optimal diagnostic information is obtained and the patient given the best treatment alternatives.

Angiography↗
PubMed1989

Magnetic resonance imaging of the kidneys and adrenal glands.

A simple renal cyst will have low signal intensity on T1-weighted SE images with short TE and short TR because of the long T1 values of the cyst fluid. With increasing TE and TR, cysts demonstrate increased signal intensity due to the long T2 values of the cyst fluid. On T1-weighted images a complicated cyst will have higher signal intensity than a simple cyst; it may not be possible to differentiate these complicated cysts from solid masses. MRI seems to be useful in identifying simple cyst fluid and, therefore, has potential in characterization of cystic lesions considered complex by CT or ultrasound. Unfortunately, imaging techniques have not yet been optimized, diagnostic criteria are somewhat vague, and accuracy has not been established in a representative patient population. Solid masses often can be identified and differentiated from simple, uncomplicated cysts on MR images. The inability to differentiate among various types of solid tumors or to separate these from complicated cysts or inflammatory masses remains a limitation. Most lesions are more readily seen on contrast-enhanced CT than on MR images and therefore the role of MRI in the detection and diagnosis of renal cell carcinoma remains limited. Although the high detection rate of renal cell carcinoma is encouraging, CT is still more sensitive than MR in demonstrating solid lesions less than 3 cm in diameter. MRI cannot be used as a screening modality for renal tumors. MRI seems quite helpful in the staging of renal cell carcinoma. Macroscopic extension into the perinephric fat, tumor extension into the renal vein and the inferior vena cava, and macroscopic metastases to other organs are readily seen. Furthermore, differentiation between enlarged nodes and vessels is possible with MRI. Some authors recommended the use of MRI to stage renal cell carcinoma in patients with known contraindication to contrast, prior suboptimal bolus contrast enhanced CT scan, and equivocal CT findings. MRI can replace the inferior vena cavagram in the staging work-up and MR may be superior to CT for planning the surgical approach in Stage IIIA lesions by determining the upper extent of tumor thrombus within the inferior vena cava or the right atrium.(ABSTRACT TRUNCATED AT 400 WORDS)

Adrenal Gland Diseases↗
PubMed1989

[Neurinoma of the acoustic nerve diagnosed at the otoneurologic laboratory of the Regional Hospital with Polyclinic in Ostrava].

In 1977-1987 at the otoneurological laboratories of the Regional Hospital with Policlinic in Ostrava 41 neurinomas of the acoustic nerve were diagnosed. The incidence of the disease in the catchment area was 1:125,555 per year. Women were affected more frequently than men, the mean ratio being 5:3. 12% of the tumours were under 1 cm in size and 30% under 2 cm. In women and youth as a rule larger tumours were found than in men. Women had also on average a shorter case-history--by 1.5 years. Acute unilateral hypacusia, as the initial symptom of the disease was recorded in 17% of the patients, again more frequently in women (23%) than in men (6.5%). In the majority of patients the diagnosis was late through the fault of the attending physician who for long considered the patient's complaints trivial and did not indicate an adequate examination. The thus lost time reduces the patient's chances. Even the most perfectly equipped otoneurological laboratory with optimal diagnostics cannot reverse the patient's sad fate.

Adolescent↗
PubMed1987

Analysis of fetal intestinal enzymes in amniotic fluid for the prenatal diagnosis of cystic fibrosis.

Amniotic-fluid intestinal alkaline phosphatase activity, gamma-glutamyltranspeptidase activity, and leucine-aminopeptidase activity were quantitated to assess their reliability for the prenatal diagnosis of cystic fibrosis. The results indicate that for each of these enzymes an arbitrary cutoff point could be chosen that would enable one to correctly predict the outcome for the majority of at-risk pregnancies. However, some false positives and false negatives occurred with each enzyme. To obtain optimal diagnostic discrimination, the three enzyme values obtained for each sample were combined into a single linear discriminant function that proved to be a more accurate indicator of the outcome of the pregnancy. This was especially important for those cases in which the predicted outcome as based on the individual enzyme results was in disagreement. From the cases studied here, it appears that this method can be expected to give a correct prediction in approximately 96.5% of all 25%-at-risk pregnancies. False positives can be expected in approximately 1.4% of the pregnancies and false negatives in approximately 2.2%.

Alkaline Phosphatase↗
PubMed1988

Diagnosis and treatment of chronic postoperative bacterial endophthalmitis.

Chronic postoperative bacterial endophthalmitis has recently assumed a prominent role in differential diagnosis of inflammation following extracapsular cataract extraction with posterior chamber intraocular lens implantation. The optimal diagnostic and therapeutic approach to this entity has not yet been clearly defined. We present a case of chronic postoperative Propionibacterium acnes endophthalmitis in which the diagnosis was made by anterior chamber paracentesis, and topical, periocular, and systemic antibiotic therapy resolved the inflammation. Anterior chamber paracentesis for aerobic and anaerobic cultures may be an appropriate initial diagnostic step in suspected cases. While successful treatment may require surgical intervention in some cases, others may respond to antibiotic therapy alone.

Bacterial Infections↗
PubMedDate not supplied

Profiles of progesterone in milk and clinical ovarian findings in postpartum cows with ovarian dysfunctions.

Milk progesterone profiles, based on twice or once weekly sampling, were constructed for postpartum dairy cows. The cows were simultaneously examined by rectal palpation and clinical ovarian findings were related to the progesterone profiles. The combination of progesterone analysis and clinical examination may be used to optimize diagnostic accuracy and a number of practical recommendations are given on the basis of the results from this study.

Animals↗
PubMed1986

Radiologic diagnosis of nonsquamous tumors of the head and neck.

Nonsquamous cell tumors of the head and neck can be reliably identified and often accurately diagnosed by proper state of the art radiologic assessment. For optimal diagnostic and preoperative work-up of head and neck lesions, complete radiologic analysis is now essential.

Head and Neck Neoplasms↗
PubMed1985

[Early diagnosis of myocardial infarct: value of the combined use of creatine kinase and MB isoenzyme determinations].

To define the optimal diagnostic strategy for acute myocardial infarction, 225 patients with suspected myocardial infarction were studied by serial (3 hour intervals) sampling for CK and CK-MB enzyme activity. In 12 patients the diagnosis of myocardial infarction was rejected. In the remaining 213 the myocardial infarction was transmural in 183 (anterior in 79, postero-inferior in 95, anterior and inferior in 9), non transmural in 30. In these patients the mean increase of enzyme activity, the time to pick activity and the infarct size (Sobel method) were measured. The best diagnostic sensitivity in the early phases of myocardial infarction was obtained by the combined use of CK and CK-MB determinations (95.9% of the diagnosis at 9 hours after the acute event). However the percent of positivity of CK & CK-MB values occurred significantly (p less than 0.01) later in non transmural (4.3% at 3, 34.7% at 6 and 86.9% at 9 hours after the onset of the chest pain) than in transmural myocardial infarction (25.2% at 3, 54.4% at 6 and 97.6% at 9 hours) and among these in inferior as compared to anterior (18.7% vs 32.2% at 3 hours, 46.8% vs 62.7% at 6 hours and 96.8% vs 98.3% at 9 hours). The CK/CK-MB ratio was of limited diagnostic value because it was increased (greater than 8) in most of the patients, either with normal or abnormal enzymes activities. Early kinetics differed in the different anatomo-clinical types of infarction. In all locations of myocardial infarction the mean enzyme activity increase was significantly correlated with the calculated enzymatic infarct size.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Enzyme Tests↗
PubMedDate not supplied

[Contribution of thoracoscopic brushing to the diagnosis of pleural diseases].

Pleural brushing can be performed under thoracoscopic examination. The combined use of all three methods of diagnosis (macroscopy, biopsy, cytology) achieved optimal diagnostic results. From September 1980 to October 1981 we have performed 150 thoracoscopies for pleural effusions, while the results of conventional pleural cytology and biopsy were negative. In 108 cases pleural brushing and biopsy were both performed. The diagnosis was in 37 cases non malignant diseases states associated with effusions and in 71 cases tumoral effusions. Among the 37 cases of non malignant diseases states associated with effusions were: 6 mechanical effusions, 27 inflammatory processes, 4 infectious processes. Among the 71 cases of tumoral effusions were 3 benign pleural lipomas, 50 metastatic carcinomas, 18 carcinomatous mesotheliomas. We studied the diagnostic accuracy of pleural brushing: in non malignant diseases, pleural brushing show the non tumoral features of the process, in metastatic tumours, biopsy was positive in 80% of the cases; pleural brushing in 78% of cases; taken together they allowed the diagnosis in 86% of the cases, in carcinomatous mesotheliomas biopsy was positive in 82,3%, pleural brushing in 78%; taken together they allowed the diagnosis in 89% of the cases. Pleural brushing allows a rapid cytological diagnosis, enhances the histological results and may also be used to get cellular material in areas dangerous to biopsy.

Adenocarcinoma↗
PubMed1984

[Exploratory strategy for hydrocephalus in adults].

Decision theory can be useful for the determination of an optimal diagnostic and/or therapeutic strategy. Of course, the physician remains the only decision-maker, but these methods, quite simple, introduce a scientific background to medical decisions by the quantitative evaluation of the consequences of the choices. We will present the use of such a methodology in the treatment of adults presenting hydrocephalus.

Adult↗
PubMed1983

Osteomyelitis of the foot.

A favorable outcome was obtained in the case of an infected diabetic ulcer that resulted from neglect. The importance of appropriate antibiotic therapy and the advantage of a newer generation cephalosporin, cefamandole nafate (Mandol), is discussed. Optimal diagnostic information relative to the presence of osteomyelitis may be obtained by concomitant use of conventional radiographic technique and bone scanning. The most complete information concerning the status of diabetic control is gained by evaluation of standard blood glucose levels in conjunction with glycosylated hemoglobin A1C.

Cephalosporins↗
PubMed1982

[Actual germ spectrum in wound surgery].

Under aerobic conditions Staph. aureus was isolated in 40%, grampositive germs were as frequent as gramnegative bacteria. Bacteroides fragilis was the predominant germ from material suspicious of an anaerobic infection. For its isolation the material should be sent as soon as possible to the laboratory to be investigated under anaerobic conditions. The author stresses the close cooperation between the clinician and the microbiologist to receive optimal diagnostic results as the basis of an effective chemotherapy.

Aerobiosis↗