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At least 127 records · Page 7Linked to original sources
PubMed1995

Laser tissue welding: a comprehensive review of current and future clinical applications.

Laser techniques for joining tissue, in combination with other surgical technologies, will be a hallmark of surgery in the next century. At present, there are many clinical applications of tissue welding and soldering which are beginning to achieve wide spread acceptance. These exciting clinical developments are the result of many advances which have been made in the past few years in our understanding of the mechanism of laser tissue welding. Also contributing to this progress are many important technical refinements such as tissue solders and feedback control of the laser device. In this article, we describe in depth the history and development of laser tissue welding including key theoretical concepts as well as crucial experiments which have added to our insight into this phenomenon. We also review the evolving concepts of its clinical application and indicate clinical applications which are likely to become more important in the future.

Equipment Design↗
PubMed1982

[Pharmacokinetic one-compartment model using neocarzinostain as a prototype drug and its clinical application to chemotherapy for brain tumor. Part II. A clinical trial with selected protocol].

Neocarzinostatin as previously reported, appeared to exhibit an intense cytotoxicity to the glioblastoma cells and some other malignant brain tumor cells, such as pineal germinoma or medulloblastoma, which are notoriously known to disseminate into the cerebrospinal fluid space. In vitro study, the minimum susceptibility of glioblastoma cells to neocarzinostatin was found to be below 0.005 microgram/ml, whereas normal glia cells were not affected at 0.3 microgram/ml. This study indicated that neocarzinostatin was extremely effective in the treatment of malignant brain tumor without affecting normal neural tissue. Pharmacokinetic study was performed in order to establish intermittent intrathecal perfusion therapy and to prevent subarachnoid dissemination of the brain tumor cells. Experimental results were applied to the treatment of 12 patients with brain tumor, who had shown positive cytology of the cerebrospinal fluid. Follow-up investigation showed quite a favorable result and it was considered that prophylactic irradiation to the entire spinal column could be replaced with intrathecal administration of neocarzinostatin. During clinical application no noticeable side effect was encountered and active stimulation of macrophages, which were mobilized into the CSF space, was another unexpected advantage of this treatment.

Adolescent↗
PubMed2003

Basic studies on the clinical applications of platelet-rich plasma.

Platelets, which contain many growth factors such as platelet-derived growth factor (PDGF) and transforming growth factor-beta (TGF-beta), are being used in clinical applications as platelet-rich plasma (PRP). Only a few studies, however, have been conducted on the growth factors present in PRP and on the clinical applications using the drug delivery system (DDS). For the purpose of clinical application, we first modified the PRP preparation method and assessed the amounts of growth factors contained in the human platelet concentrates. Furthermore, we assessed fibrin glue as a DDS of platelet concentrates. Platelet precipitations were made by twice centrifuging human whole blood. The precipitated platelet was resuspended to yield the platelet concentrates. The growth factor concentrations were measured. Fibrin glue sheets containing this platelet concentrate were implanted in rabbit pinna and samples were obtained for immunostaining (anti-PDGF antibody) to assess the use of PRP over time using the fibrin glue as the DDS. The mean concentration of growth factors present in the platelet concentrates was three times or greater than that of conventional PRP. Furthermore, the results indicated that when the platelet concentrate was used with fibrin glue as a carrier, the contents were released over a period of about 1 week. This raises the possibility that this system may be useful in clinical applications.

Adult↗
PubMed1999

Diffusion-weighted MR imaging in acute stroke: theoretic considerations and clinical applications.

The major clinical use of diffusion-weighted imaging to date has been in evaluation of cerebral infarction, at which it excels. However, diffusion-weighted imaging has also shown promise for other applications, ranging from quantitative analysis of biologic changes that are not apparent from simple visual inspection of images (but are detectable after using regions of interest on apparent diffusion coefficient maps) to better characterization of other intracranial abnormalities (e.g., abscess and tumor). Both the clinical and research applications of diffusion-weighted imaging can be expected to increase, providing fresh insights into physiologic characteristics of both normal and abnormal tissue.

Acute Disease↗
PubMed2005

Assessment of left ventricular diastolic function by early diastolic mitral annulus peak acceleration rate: experimental studies and clinical application.

We sought to examine the hemodynamic determinants and clinical application of the peak acceleration rate of early (Ea) diastolic velocity of the mitral annulus by tissue Doppler. Simultaneous left atrial and left ventricular (LV) catheterization and Doppler echocardiography were performed in 10 dogs. Preload was altered using volume infusion and caval occlusion, whereas myocardial lusitropic state was altered with dobutamine and esmolol. The clinical application was examined in 190 consecutive patients (55 control, 41 impaired relaxation, 46 pseudonormal, and 48 restrictive LV filling). In addition, in 60 consecutive patients, we examined the relation between it and mean wedge pressure with simultaneous Doppler echocardiography and right heart catheterization. In canine studies, a significant positive relation was present between peak acceleration rate of Ea and transmitral pressure gradient only in the stages with normal or enhanced LV relaxation, but with no relation in the stages where the time constant of LV relaxation (tau) was > or =50 ms. Its hemodynamic determinants were tau, LV minimal pressure, and transmitral pressure gradient. In clinical studies, peak acceleration rate of Ea was significantly lower in patients with impaired LV relaxation irrespective of filling pressures (P < 0.001) and with similar accuracy to peak Ea velocity (area under the curve for septal and lateral peak acceleration rates: both 0.78) in identifying these patients. No significant relation was observed between peak acceleration rate and mean wedge pressure. Peak acceleration rate of Ea appears to be a useful index of LV relaxation but not of filling pressures and can be applied to identify patients with impaired LV relaxation irrespective of their filling pressures.

Animals↗
PubMed2001

[MR hydrography of the abdomen: technical consideration of data acquisition and future prospects for clinical applications].

Recent advances in MR hydrography have enabled various clinical applications in the areas of abdominal and pelvic disorders, for example, MR cholangiopancreatography (MRCP), MR urography(MRU), and MR hydrography of the fetus. Although the two-dimensional(2D) single-slice method provides excellent information as to the global relationship between lesions and various anatomical structures, small lesions or detailed anatomical characteristics may not be visualized owing to the partial volume effect. Source images of the 2D multislice method are most suitable for the detection of small lesions and detailed evaluation of anatomical structures as "tomographic imaging", while the three-dimensional(3D) method is useful in obtaining data sets for 3D imaging. MR hydrography is a promising method for the noninvasive evaluation of various abdominal disorders, and it has the potential to play new roles in various anatomical regions. However, knowledge of the proper indications is essential for successful clinical application.

Abdomen↗
PubMed2002

Clinical application of positron emission tomography for diagnosis of dementia.

Clinical applications of PET studies for dementia are reviewed in this paper. At the mild and moderate stages of Alzheimer's disease (AD), glucose metabolism is reduced not only in the parietotemporal region but also in the posterior cingulate and precuneus. At the advanced stage of AD, there is also a metabolic reduction in the frontal region. In AD patients, glucose metabolism is relatively preserved in the pons, sensorimotor cortices, primary visual cortices, basal ganglia, thalamus and cerebellum. In patients with dementia with Lewy bodies, glucose metabolism in the primary visual cortices is reduced, and this reduction appears to be associated with the reduction pattern in AD patients. In patients with frontotemporal dementia, reduced metabolism in the frontotemporal region is the main feature of this disease, but reduced metabolism in the basal ganglia, and/or parietal metabolic reduction can be associated with the frontotemporal reduction. When corticobasal degeneration is associated with dementia, the reduction pattern of dementia is similar to the reduction pattern in AD and the hallmarks of diagnosing corticobasal degeneration associated with dementia are a reduced metabolism in the primary sensorimotor region and/or basal ganglia and an asymmetric reduction in the two hemispheres. FDG-PET is a very useful tool for the diagnosis of early AD and for the differential diagnosis of dementia. I also describe clinical applications of PET for the diagnosis of dementia in Japan.

Alzheimer Disease↗
PubMed2000

Analysis of urea nitrogen and creatinine kinetics in hemodialysis: comparison of a variable-volume two-compartment model with a regional blood flow model and investigation of an appropriate solute kinetics model for clinical application.

To investigate an appropriate solute kinetics model for clinical application, we analyzed urea nitrogen (UN) and creatinine (Cr) kinetics by a variable-volume two-compartmental model (2CM) and a regional blood flow model (RBF) in 44 hemodialysis patients with varying proportions of first compartmental volume and regional volume (p(1)). Solute kinetics could not be solved in some of the patients with higher p(1) values, and there were more solution failures by the RBF than by the 2CM. The solute generation rate (g) and solute distribution volume in the dry state (V(D)) increased with increases in p(1) in both models, but there were some differences between the two models. When g was normalized by V(D), it became relatively constant, irrespective of the p(1) value or model used (0.133 +/- 0.029 mg/min/l by the 2CM and 0.132 +/- 0.029 mg/min/l by the RBF for UN; 0.0200 +/- 0.0049 mg/min/l by the 2CM and 0.0198 +/- 0.0048 mg/min/l by the RBF for Cr). The intercompartmental mass transfer coefficient (K(c); liters/min) calculated by the 2CM decreased as p(1) increased (K(c) = -1.77.p(1) + 1.16, p < 0.0001, R = 0.999 for UN; K(c) = -0.847.p(1) + 0.556, p < 0.0001, R = 1.000 for Cr). The systemic blood flow (Q(sys); liters/min) calculated by the RBF also decreased as p(1) increased (Q(sys) = -11.1.p(1) + 6.21, p < 0.0005, R = 1.000 for UN; Q(sys) = -5.22.p(1) + 2.90, p < 0.001, R = 0.999 for Cr). Since the RBF more frequently failed to solve the solute kinetics and since there was a difference in its Q(sys) values for UN and Cr, the 2CM was considered to be a superior model. When p(1) was extremely low, the 2CM could be transformed into a modified variable-volume one-compartment model (1CM) which presented a similar g/V(D) (0.133 +/- 0.029 for UN; 0.0200 +/- 0.0048 for Cr). This modified 1CM was considered to satisfy appropriate conditions for clinical application, since it is simpler than the 2CM and provides useful information on the dialysis dose.

Aged↗
PubMed2001

Clinical applications of infant lung function testing: does it contribute to clinical decision making?

Infant lung function testing is important in clinical research and recent standardisation efforts have enabled measurements to be made in infants in different laboratories throughout the world. Thus, the theoretical conditions are now fulfilled for use of these techniques in clinical practice. This review discusses the usefulness of various infant lung function techniques in a clinical setting and their potential present or future clinical application. It will focus on the role of infant lung function in the clinical management of infants with respiratory disease.

Age Factors↗
PubMed1994

Platelet activation by thrombin can be directly measured in whole blood through the use of the peptide GPRP and flow cytometry: methods and clinical applications.

The role of platelet activation in clinical settings is controversial, partly because the methods used to detect platelet activation (e.g. platelet aggregation and radioimmunoassays of plasma beta-thromboglobulin and platelet factor 4) are plagued by major methodological problems. Clinical studies that utilize flow cytometric assays of washed platelets are also susceptible to artefactual in vitro platelet activation. Whole blood flow cytometry circumvents many of these methodological problems. However, a major limitation in previously described whole blood flow cytometric assays is their inability to study the effect on platelet activation of thrombin, the most important platelet agonist in vivo. This article reviews the method and clinical applications of a new flow cytometric assay in which platelet activation by thrombin is directly measured in whole blood through the use of the peptide Gly-Pro-Arg-Pro (GPRP). GPRP inhibits thrombin-induced fibrin clot formation and platelet aggregation, but not thrombin-induced platelet activation. The presently described assay of platelet activation by thrombin in the physiological milieu of whole blood should be widely applicable to the many clinical settings (e.g. arterial thrombosis) in which platelet activation by thrombin is postulated to play an important role.

Amino Acid Sequence↗
PubMed2002

Clinical application of 3-dimensional echocardiography.

Three-dimensional echocardiography has emerged as a novel non-invasive imaging modality enabling the registration and analysis of volumetric datasets containing information on cardiac structure. This review describes the principles of the method, different acquisition modes and the display options in perspective of clinical applications. Emerging clinical applications are discussed, including improved quantification of cardiac volumes and the ability of more complete, versatile and intuitional display of cardiac pathology. According to the available literature, the most probable fields for practical use of three-dimensional echocardiography are cardiac interventions in such conditions as valvular disease, congenital pathology (septal defects) or cardiac tumors. The most expected development is the introduction of fast, user-friendly systems allowing real-time data acquisition and data processing.

Cardiac Volume↗
PubMed1990

[A study on the nurse's response for the clinical application of nursing diagnosis].

Although the usefulness and importance of clinical application of nursing diagnosis are well recognized by the academic circle, it is not yet generally practiced. In order to provide data for establishing a policy for clinical nursing diagnosis; a study was made at a seminar, sponsored by the Department of nursing, Severance Hospital, with participation of 190 nurses from 33 hospitals. The objective of the study was to find out: 1) if the nurses agree with the academic community in recognizing the benefits and problems of clinical application of nursing diagnosis; 2) how the nurses evaluate their ability to carry out nursing diagnosis; and 3) if educational programs would help enhance ability of nursing diagnosis among nurses. The summary of findings by the study is as follows: 1. While all nurses responded positively on the question of benefits improving science and quality of nursing, thus elevating credibility and position of nurses, some expressed concern on the practicality of the system in setting up nursing objectiveness, confirming the nursing problems and utilizing patient information. For the 20 questions and the scale of 1-5, the lowest average score was 3.223 and the highest 4.066. 2. The study attempted to find out the opinion of the nurses on the problems that would make difficult to adopt the nursing diagnosis in clinics. The result of the study indicates the nurses believe the major problems are the fact that the subject of nursing diagnosis are not well defined and that the form sheets do not match with the ones that are currently being used. However, comparing it with the result of the previous study on the same question (inadequate manpower and insufficient time allocated for the job were two major problems pointed out then). It can be said that the opinion of the nurses studied this time was much more positive and it suggests that they believe the system can be adopted without increasing manpower and only by giving additional training and by adjusting the format of nursing record sheets. It suggests that the future for adopting a clinical nursing diagnosis is very bright. 3. As the most urgent problem to be solved for adopting clinical nursing diagnosis, 38. 5% responded that it was "education of nurses", and 34.2% responded that it was "staffing adequate number of nurses". 4. For the 10 questions asked for self-evaluation of ability to adopt the system, with the scale of 1-5, average score was lower than 3.(ABSTRACT TRUNCATED AT 400 WORDS)

Education, Nursing, Continuing↗
PubMed1997

[Electrogastrography. Evolution and clinical applications].

Electrogastrography (EGG) is a non invasive technique of recording gastric myoelectrical activity by cutaneous electrodes. Although first reported about 70 years ago, the development of this methodology has been very slow, mainly because of several shortcomings in data acquisition, interpretation of EGG data and poor correlation with the antral contractile activity. Recently, EGG has received increasing interest and technical improvements. The better quality of the signal obtained and the applications with automated signal processing, have improved the interpretation of the EGG. For this reasons, the number of EGG applications, both experimental and clinical, has rapidly increased. However, the lack of invasivity of this methodology has suggested some clinical applications which probably exceeded the specific possibility of the EGG. We aimed in this study at analysing several parameters, whose clinical relevance is not clearly understood, obtained by the automatic analysis, to identify patients with gastric electrical abnormalities between 10 patients with abnormal gastric emptying and 10 healthy controls. The best separation between these two groups was obtained by combining both mean dominant frequency and power.

English Abstract↗
PubMed2003

Clinical database. Structure, development strategies and expected clinical applications.

The paper provides the description of a data-base developed to include in a quite structured format most clinical data used for patient management in a hospital setting. The system was aimed at achieving a reasonable compromise between the significant but complex solutions the research offers and the real needs of medical practice. First of all, the paper defines the requirements for designing a computerized clinical database according to a patient-centered clinical approach. Then, it describes the structure of a prototype aimed at classifying clinical data as a hierachy and describing them according to a structural approach. Next, problems related to the management and upgrading of the system are identified and possible solutions described, with a particular emphasis or knowledge acquisition, refinement and specialization, and on problems related to the functional aspects required for clinical applications. Finally, some meaningful clinical applications are outlined, which use the computerized clinical database as the standard for knowledge organization and data sharing.

Database Management Systems↗
PubMed1999

Clinical applications of transpulmonary contrast echocardiography.

BACKGROUND: The recent development of new fluorocarbon-based echocardiographic contrast agents that are capable of opacification of the left-sided cardiac chambers after intravenous injection is a major new advance in diagnostic cardiac imaging. METHODS AND RESULTS: This is a review article focusing on these novel contrast agents, new echocardiographic imaging techniques to optimize their efficacy, and their clinical applications. Specific clinical applications of these agents are (1) enhancement of endocardial border definition to improve assessment of regional and global left ventricular function, (2) myocardial perfusion imaging by intravenous contrast echocardiography, (3) augmentation of spectral and color flow Doppler images, and (4) tissue-specific targeting of microbubbles for delivery of therapeutic agents. CONCLUSIONS: New intravenous contrast agents offer the possibility to assess myocardial perfusion echocardiographically. It is also possible to use these agents for delivery of therapeutic agents, including gene therapy.

Albumins↗
PubMed1987

Gonadotrophin-releasing hormone--diversity of functions and clinical applications.

Gonadotrophin-releasing hormone (GnRH) plays a pivotal role in the regulation of the reproductive system. Chemically synthesised GnRH and analogues have found wide application in clinical medicine. Pulsatile administration of GnRH is used in the treatment of infertility and cryptorchidism. GnRH agonists inhibit gonadotrophin by pituitary desensitisation while antagonists compete out the effects of endogenous GnRH. These agents find application in contraception, the treatment of hormone-dependent neoplasms, precocious puberty, endometriosis, porphyria and disturbances of the menstrual cycle. It is now apparent that GnRH has been co-opted during evolution for functions other than the stimulation of gonadotrophins. GnRH has paracrine (local) effects in the gonads and placenta, acts as a neurotransmitter in the central nervous system, and has autocrine regulatory effects in some tumour cells. Evolutionary studies in non-mammalian vertebrates show that the GnRH gene has been duplicated to produce different molecular forms of unknown function. In addition to producing GnRH, the GnRH precursor is cleaved to produce peptides with novel activities, including prolactin inhibition.

Animals↗
PubMed2003

[Preparation of high-purity and safe autologous plasmin and its clinical application].

PURPOSE: To report an improved preparation of safer and highly-purified autologous plasmin and to demonstrate its clinical applications. METHODS: Prior to clinical application, animal experiments were carried out. In addition, the activity of plasmin in the vitreous cavity after injection was measured serially. In preparation for clinical use, the proteinase inhibitors aprotinin and benzamidine were used for suppression of protein denaturation. The samples were incubated for 48 hours to check for contamination. The preparation was applied to patients with idiopathic macular hole and diabetic macular edema. RESULTS: The plasmin detached the vitreous body from the inner limiting membrane of the retina without any ill effects in animal experiments. The specific activity reached a peak in 5-10 minutes and decreased rapidly thereafter. By adding a suppressor of protein denaturation in the purification process, 0.2 IU (0.1 ml) of high-purity plasmin could be prepared from each patient. No bacterial contamination was noted. Complete vitreous detachment could be induced in two clinical cases. Urokinase was used instead of streptokinase to activate plasminogen. CONCLUSIONS: Vitreous detachment is considered to be induced safely and consistently by injection of plasmin prepared using a protein denaturation suppressor and activated with urokinase. This method is expected to be of clinical value.

Animals↗
PubMed1994

[The advantages of spatial, three-dimensional ultrasound imaging in clinical application].

Following the first three-dimensional (3D) ultrasound imaging of organs using 3D ringstructures, which we developed in 1986, the method had to be improved and refined because of sources of error resulting from the ring structure. The newly developed 3D method enades its application in clinical routine. By rotating the sectional plane around a horizontal axis using an especially constructed 3D probe, in 5 s 60 ultrasound sections of the examined tissue are registered. These 60 sections are calculated transparently and than compiled into a transparent spatially reconstructed image. In spite of the enormous information, the 3D picture is projected on the screen after a very short time. There is no loss in information. The spatially reconstructed body can be cut along any imaginable plane so that planes can be demonstrated which normally are inaccessible to conventional sonography. This new method presents possibilities which were formerly confined to CT and MRI. We tested this method mainly in prenatal and tumor diagnoses. It has been shown that the dignity of tumors can be differentiated in many cases already by means of the 3D-image. An indistinct image is characteristic for a malign tumor, and a sharply defined image represents a benign lesion. The diagnosis of fetal malformations can profit from this new method. Exact localizations and volume determinations are now sonographically possible. New diagnostic possibilities by means of ultrasound are forthcoming. But this needs further technical investigations. Both the presentation with a closed surface and the transparent presentation will have indications in the future. Our goal is a free applicability of the probe.

Breast Neoplasms↗