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PubMed1992

[Bronchiolo-alveolar carcinoma in a solitary site. The computed tomographic characteristics].

Bronchioloalveolar carcinoma is a peripheral, well-differentiated neoplasm arising beyond a recognizable bronchus, with a tendency to spread to the peripheral air spaces using the lung structure as stroma. This tumor has better prognosis than other lung neoplasms if it is diagnosed early (stage I). For this reason, the CT scans of 16 patients (all of them asymptomatic, only 2 smokers) were reviewed to assess CT capabilities. The cytologic diagnosis was made with CT-guided fine-needle aspiration biopsy in 4 patients (surgical confirmation followed); the histologic diagnosis was made in 12 patients after surgery. CT findings included the peripheral (14 cases) or subpleural (2 cases; 12.5%) location, irregular margins forming a star-like pattern (2 cases; 12.5%), pseudocavitation (13 cases; 81%), heterogeneous attenuation (11 cases; 69%), pleural tags (14 cases; 87.5%) and air bronchogram (2 cases; 12.5%). These CT findings, if compared with the same number of CT scans in patients with adenocarcinoma and squamous cell carcinoma, are present in 70% of patients (11/16) and, although not highly specific (specificity: 36%), they are typical enough to suggest the diagnosis.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed2002

Intraventricular tuberculoma.

A 38-year-old female presented with headaches, fever, and malaise. Computed tomography showed an intraventricular peripheral ring-enhanced lesion with central necrosis. The lesion was totally excised. Histological examination revealed a tuberculoma. The patient was treated with antituberculous chemotherapy. The patient was asymptomatic at 9 months. Ventricular involvement in neurotuberculosis is rare, but should be considered in the presence of other indicators of tuberculous infection.

Adult↗
PubMed1988

Extracranial and extraspinal nerve sheath tumors: computed tomographic evaluation.

Thirty-five patients with 37 peripheral nerve sheath tumors (NST) (16 schwannomas, 11 neurofibromas, 5 plexiform and 1 diffuse neurofibroma, and 4 malignant NST) were studied respectively. The benign NST usually appeared on CT as well-defined oval, spherical or fusiform masses, centered at the expected anatomic location of a cranial, spinal, autonomic or peripheral nerve with characteristic displacement of adjacent muscles and blood vessels. None of the schwannomas appeared homogeneously hypodense on IV enhanced CT, whereas close to half of neurofibromas and plexiform neurofibromas were so. This fact, which had not been reported in the past, may be related to differences in inherent vascularity and blood-nerve barrier (fenestrated blood vessels) between schwannomas and neurofibromas and may be a useful distinguishing CT feature. The most reliable, though not infallible criterion of malignant NST was poor definition of their margins. Ninety-two per cent of NST (34 out of 37) were diagnosed or included in a limited differential pre-operatively.

Female↗
PubMed2004

[Using AR model to analyze injured nerve with needle EMG signal].

The two main factors to affect the style of the recruitment are temporal recruitment and spatial recruitment. This study sought a new way to analyze the recruitment with the modern spectrum method. The abnormal spatial recruitment and temporal recruitment of varied injury degrees of intramuscular neuron were compared through the AR model. At last, AR coefficients were extracted and passed through BP artificial neuron network to classify different NEMG signals and good result was gained.

Action Potentials↗
PubMed1999

What clinical information resources are available in family physicians' offices?

BACKGROUND: When faced with questions about patient care, family physicians usually turn to books in their personal libraries for the answers. The resources in these libraries have not been adequately characterized. METHODS: We recorded the titles of all medical books in the personal libraries of 103 randomly selected family physicians in eastern Iowa. We also noted all clinical information that was posted on walls, bulletin boards, refrigerators, and so forth. Participants were asked to describe their use of other resources such as computers, MEDLINE, reprint files, and "peripheral brains" (personal notebooks of clinical information). For each physician, we recorded how often the resources were used to answer clinical questions during 2 half-day observation periods. RESULTS: The 103 participants owned a total of 5794 medical books, with 2836 different titles. Each physician kept an average of 56 books in the office. Prescribing references (especially the Physicians' Desk Reference) were most common (owned by 100% of the participants), followed by books on general internal medicine (99%), adult infectious disease (89%), and general pediatrics (83%). Books used to answer clinical questions were more likely to be up to date (copyright date within 5 years) than unused books (74% vs 27%, P <.001). Items posted on walls included drug dosage charts and pediatric immunization schedules. Only 26% of the physicians had computers in their offices. CONCLUSIONS: Drug-prescribing textbooks were the most common type of book in family physicians' offices, followed by books on general internal medicine and adult infectious diseases. Although many books were relatively old, those used to answer clinical questions were generally current.

Adult↗
PubMed1985

Use of the calibrated carotid pulse tracing for calculation of left ventricular pressure and wall stress throughout ejection.

Calibrated carotid pulse tracings have been found previously to provide accurate estimates of end-systolic pressure. This study extends this technique to the estimation of arterial pressure throughout ejection. In twenty patients without aortic stenosis (age range 8 to 67 years), simultaneous recordings were made of the pressure tracing in the ascending aorta, externally recorded carotid pulse tracing, phonocardiogram, left ventricular echocardiogram, and peripheral blood pressure. Data were computer digitized and plots of arterial pressure were derived from the aortic pressure tracing (PA) and from the carotid pulse tracing (Pc). Left ventricular (LV) wall stress was then calculated throughout ejection using PA or Pc. The noninvasive estimation of pressure was excellent, with a maximum difference of 3.4 mm Hg between population means. This occurred within the first third of ejection. The wall stress calculations were similar, with a maximum mean population error of 3.5 gm/cm2 at 20% of ejection. The peak wall stress values had a mean difference of 1.4 gm/cm2; mean wall stress over the LV ejection period was 0.5 gm/cm2 higher when calculated from Pc than from PA. Thus, the carotid pulse tracing provides an accurate reproduction of the morphology of the pressure tracing recorded from the ascending aorta, and when calibrated by peripheral blood pressure measurement, it can be used to calculate LV pressure throughout ejection. These pressure estimates can be used to calculate wall stress throughout ejection with a high degree of accuracy.

Adolescent↗
PubMed1999

[BAL from two different lung segments indicated by high resolution computed tomography (HRCT) in patients with sarcoidosis. II. The role of T gamma delta lymphocytes (T gamma delta)].

The aim of the study was to evaluate the role of lymphocytes T gd in sarcoidosis by estimation of T gd cells in double BAL (2 x 120 ml) from two different lung segments: with the most (s.A) and with the least (s.B.) extensive involvement evaluated by high resolution computed tomography (HRCT) and in peripheral blood. Examined group consisted of 28 sarcoid patients with homogeneous, regular distribution of nodular opacities in conventional chest X-ray (14 F, 14 M aged 19-54). Twelve patients showed homogeneous distribution of HRCT changes (RD) in lung parenchyma and 16 showed nonhomogeneous distribution of HRCT changes (ND) with domination of pathological changes in upper lobes. Eleven healthy volunteers served as controls. Lymphocytes T gd were estimated by flow-cytometry. In peripheral blood of patients with sarcoidosis the mean value of T gd lymphocytes (4.75%) did not differ from control group (5.3%). In all patients the mean values of T gd percentage in BAL from s.A (1.7 + 1.0%) and in BAL from s.B (2.1 + 1.5%) were significantly lower (p < 0.01) than the mean value in peripheral blood (4.75 + 2.4%) and were significantly lower than mean value of T gd cells in BAL from s.B bis (4.2 + 2.7%). Among subgroups ND and RD we did find any significant differences between values of T gd in BAL form s.A and s.B. Our results suggest minimal role of T gd lymphocytes in sarcoid pathogenesis.

Adult↗
PubMed1980

[Computer tomographic and angiographic studies of histologically confirmed intrahepatic masses (author's transl)].

The computer tomographic and angiographic findings in 53 patients with intrahepatic masses were compared. The histological findings show that 17 were due to echinococcus, 12 were due to hepatic carcinoma, ten were metastases, five patients had focal nodular hyperplasia, three an alveolar echinococcus and there were three cases with an haemangioma of the liver and a further three liver abscesses. Computer tomography proved superior in peripherally situated lesions, and in those in the left lobe of the liver. Arteriography was better at demonstrating lesions below 2 cm in size, particularly vascular tumours. As a pre-operative measure, angiography is to be preferred since it is able to demonstrate anatomic anomalies and variations in the blood supply, as well as invasion of the portal vein or of the inferior vena cava.

Angiography↗
PubMed1979

Evidence of CSF enhancement in the spinal subarachnoid space after intravenous contrast medium administration: is intravenous computer assisted myelography possible?

Following intravenous injection of iodinated contrast medium, peripheral enhancement of the area inside the spinal canal, is frequently observed by computed tomography. This may be due, at least in part, to enhancement of the cerebrospinal fluid in the spinal subarachnoid space. Our preliminary observations in human patients and in animal experiments are reported. The goal of intravenous computer assisted myelography is worth pursuing.

Cerebrospinal Fluid↗
PubMed1985

Computed tomography of the heart: evaluation of anatomy and function.

Diseases of the heart and blood vessels represent one of the most challenging problems for advanced diagnostic imaging systems. Computed tomographic scanning is potentially an ideal cardiac imaging modality since it is a cross-sectional imaging method with very high resolution. Currently available computed tomographic scanners have exposure speeds of 1 to 5 seconds, which are inadequate for the majority of cardiovascular imaging applications. Nevertheless, a variety of limited computed tomographic scanning techniques have been successfully performed in selected patient subgroups. These methods require the administration of contrast medium injected or infused into a peripheral vein, combined with either dynamic computed tomographic scanning or some form of electrocardiographic gated computed tomography. The newer conventional computed tomographic scanners can display anatomic structures in the heart and great vessels with considerable fidelity and provide not only cross-sectional displays but also, by means of computer manipulation, any selected reconstructed images in oblique, coronal or sagittal projections. Feasibility studies indicate improved accuracy of computed tomographic measurements of cardiac chamber volumes. Physiologic measurements include estimation of shunt flows and cardiac output and analysis of myocardial wall thickening. The full potential of computed tomography should be reached once fast, multiple slice, computed tomographic scanners using scanning electron beam techniques become available. The prototype CVCT (cine computed tomographic C-100 scanner) designed at the University of California, San Francisco, is now undergoing evaluation. This instrument images up to eight contiguous slices at the rate of 16 to 24 images/s. The computed tomographic scanner specifically designed for cardiac imaging should extend the utility of computed tomography in the evaluation of cardiac diseases and the study of cardiovascular physiology.

Heart↗
PubMed1989

A multichannel FES system for the restoration of motor functions in high spinal cord injury patients: a respiration-controlled system for multijoint upper extremity.

A multichannel functional electrical stimulation (FES) system for the restoration of quadriplegic upper extremity function is described. The system is composed of a personal computer NEC PC-8801mkII, peripheral electronic circuits, CRT display and respiratory sensors for volitional control by the patient, and percutaneous electrodes. A C4 quadriplegic patient could drink canned tea by herself by using this FES system. Distinct features of the system are as follows: 1) Versatile volitional control was realized by controlling the memory allocation of the stored stimulation data by voluntary respiratory signals. 2) Sophisticated fine control of the fingers, wrists, and elbow was realized by creating the multichannel stimulation data from recorded myoelectric activities of normal subjects during movements of the upper limb.

Arm↗
PubMed2003

Delayed-onset pineal abscess following transsphenoidal surgery for pituitary adenoma: a case report.

A 41-year-old woman suffered fever, speech disturbance and confusion four months after transsphenoidal surgery for pituitary macroadenoma. Meanwhile, the patient had been well except for transient asymptomatic postoperative pneumocephalus without cerebrospinal fluid (CSF) rhinorrhoea. Brain computed tomographic scan revealed a peripherally enhancing pineal abscess which superimposed on a preexisting pineal cyst. CSF findings showed elevated leukocyte count and positive bacterial culture. Three weeks of intensive antibiotic therapy and surgical evacuation of the pineal abscess ensued. The patient showed restricted postoperative recovery with moderate hypothalamic dysfunction. A unique case of delayed-onset postoperative pineal abscess which complicates the preexisting asymptomatic pineal cyst is presented and the possible explanation for this is speculated with review of the available literatures.

Abscess↗
PubMed1991

A quick and accurate line-sampling technique to quantify myelinated axons in peripheral nerve cross-sections.

A quick and accurate computer-assisted method of quantifying the number of myelinated axons in normal and experimental or regenerated peripheral nerve cross-sections is described. Using an IBM-PC, quantitation software and a light microscope with a camera lucida attachment, the number of axons in a sciatic nerve can be calculated in fifteen minutes. Nine nerve samples with various nerve diameters and axon densities were used to test the technique. Total counts (actual count) were compared to the number of axons estimated by the line-sampling technique (projected count) and the two groups varied up to 15%. The principle advantage of this method is that it saves time by eliminating photography and performing total counts. The technique can be applied to normal and regenerated peripheral nerve.

Animals↗
PubMed2006

Surgical shunt closure via the lumen of an intrahepatic portal aneurysm.

BACKGROUND/AIMS: A surgical shunt closure via the lumen of an intrahepatic portal aneurysm was successfully performed in a 70-year-old Japanese woman with hepatic encephalopathy due to hyperammonemia. She had a 4-month history of repeated hepatic encephalopathy which persisted after treatment with oral medicine. Color Doppler ultrasonography and computed tomography revealed a cystic peripheral portal aneurysm, 4 cm in diameter, connecting the posterior branch of the portal vein to the short hepatic vein in the right lobe. METHODS: While performing the Pringle maneuver and clamping the inferior vena cava below the liver, the wall of the portal aneurysm was opened, and the site of inflow from the portal vein and the site of outflow to the hepatic vein via the lumen of the portal aneurysm were closed with interrupted sutures. RESULTS: The patient's postoperative course was uneventful, and she was discharged 12 days after surgery. 12 months after surgery, she had no recurrence of hyperammonemia or hepatic encephalopathy. CONCLUSION: Surgical shunt closure via the lumen of a portal aneurysm can be performed safely, easily, and completely with good vision.

Aged↗
PubMed1999

[A case of active pulmonary tuberculosis in the right lower lung field detected by CT].

Many studies have indicated the pitfalls in detecting abnormalities on chest radiography, although radiography of the chest has been used for the screening of peripheral lung cancer. Recently, mass screening with a spiral computed tomography scanner has been performed for the detection of small peripheral lung cancers, and it has been clarified that spiral CT was superior to chest radiography in the screening and detection of peripheral lung cancer. However, there have been only a few reports on pulmonary tuberculosis that was detected by chest CT. We report a case of active pulmonary tuberculosis detected by chest CT, and invisible on plain chest radiography. 39 year old female consulted our hospital, because chest radiography at mass screening for lung cancer showed an abnormal shadow in the left upper lung field. Chest CT revealed a high density nodule with calcification compatible with old tuberculosis. However, there was another 20 mm x 10 mm sized nodule in right S9b that was invisible on plain chest radiography. The nodule had a clear margin with satellite lesion that characterize active pulmonary tuberculosis. Bronchial lavage was performed by bronchofiberscopy, and Mycobacterium tuberculosis was isolated from lavage fluid. The nodular shadow disappeared after the treatment with isoniazid and rifampicin for 9 months.

Adult↗
PubMed1993

Basics of computer hardware and software.

The basics of computer hardware and software are presented. A computer is a general-purpose electronic counting device used in data processing because of its accuracy and high speed. The physical components of a computer system are called the hardware, which includes the central processing unit and peripheral equipment for data input, output, and storage. Computer capacity is measured by the amount of data that can be stored in main memory and by the computer word size. Performance is indicated by the speed with which instructions are executed. Input devices (e.g., keyboard-type terminals) are the components that accept raw data and convert it into electronic form, and output devices (e.g., video display terminals) present the results of data processing in human-readable form. System software is the set of instructions that facilitate hardware use and allow the application software, which solves specific user problems, to run efficiently. System and application software is written by using various machine and symbolic languages. Milestones in software-development techniques include program subroutine use, modular programming, functional decomposition, structured programming, and structured analysis. Objectives in improving software quality are reducing development costs, making maintenance easier, and making development results more predictable. Because software development has lagged behind revolutionary advances in hardware, the full potential of computers has yet to be realized.

Computer Literacy↗
PubMed2005

Clinical validity of a negative computed tomography scan in patients with suspected pulmonary embolism: a systematic review.

CONTEXT: The clinical validity of using computed tomography (CT) to diagnose peripheral pulmonary embolism is uncertain. Insufficient sensitivity for peripheral pulmonary embolism is considered the principal limitation of CT. OBJECTIVE: To review studies that used a CT-based approach to rule out a diagnosis of pulmonary embolism. DATA SOURCES: The medical literature databases of PubMed, MEDLINE, EMBASE, CRISP, metaRegister of Controlled Trials, and Cochrane were searched for articles published in the English language from January 1990 to May 2004. STUDY SELECTION: We included studies that used contrast-enhanced chest CT to rule out the diagnosis of acute pulmonary embolism, had a minimum follow-up of 3 months, and had study populations of more than 30 patients. DATA EXTRACTION: Two reviewers independently abstracted patient demographics, frequency of venous thromboembolic events (VTEs), CT modality (single-slice CT, multidetector-row CT, or electron-beam CT), false-negative results, and deaths attributable to pulmonary embolism. To calculate the overall negative likelihood ratio (NLR) of a VTE after a negative or inconclusive chest CT scan for pulmonary embolism, we included VTEs that were objectively confirmed by an additional imaging test despite a negative or inconclusive CT scan and objectively confirmed VTEs that occurred during clinical follow-up of at least 3 months. DATA SYNTHESIS: Fifteen studies met the inclusion criteria and contained a total of 3500 patients who were evaluated from October 1994 through April 2002. The overall NLR of a VTE after a negative chest CT scan for pulmonary embolism was 0.07 (95% confidence interval [CI], 0.05-0.11); and the negative predictive value (NPV) was 99.1% (95% CI, 98.7%-99.5%). The NLR of a VTE after a negative single-slice spiral CT scan for pulmonary embolism was 0.08 (95% CI, 0.05-0.13); and after a negative multidetector-row CT scan, 0.15 (95% CI, 0.05-0.43). There was no difference in risk of VTEs based on CT modality used (relative risk, 1.66; 95% CI, 0.47-5.94; P = .50). The overall NLR of mortality attributable to pulmonary embolism was 0.01 (95% CI, 0.01-0.02) and the overall NPV was 99.4% (95% CI, 98.7%-99.9%). CONCLUSION: The clinical validity of using a CT scan to rule out pulmonary embolism is similar to that reported for conventional pulmonary angiography.

Humans↗