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PubMed1996

[Development of a clinical-radiological CD-ROM database for focal lesions of the liver].

PURPOSE: The development of a CD-ROM database for continuous acquisition and archiving of interesting radiologic cases is described. As a pilot study radiologic images of focal lesions of the liver were collected. METHODS: The database runs on a PC (80486 DX2, 66 MHz, 16 MB RAM), which is connected to the clinic network, a high quality x-ray scanner and a CD-ROM writer. Radiologic images can be inserted into the database either by scanner or by image transfer via network. The database is designed using Access 2.0. Well documented cases were chosen retrospectively, manipulated and archived. RESULTS: 308 images of 12 focal lesions with a capacity of 802 MB were stored on CD-ROM. Per case a storage capacity of 40-75 MB is necessary for image raw material, 15-25 MB are necessary for the postprocessed data. Spatial resolution is 190 dpi (3000 pixel/40 cm). Clinical data, radiological diagnosis coded by modified ACR index and a compressed icon of the images are stored on PC, the image data are stored on CD-ROM. 2.5 hours per case are needed for the complete acquisition, manipulation and archiving procedure, but improved hardware configuration can reduce the time significantly. CONCLUSION: The described database allows continuous archiving of interesting radiologic cases on PC. ACR index is suited for a quick search of a specific combination of radiologic images and diagnosis from different modalities.

Angiography↗
PubMed2006

The relative contributions of compression and hypoxia to development of muscle tissue damage: an in vitro study.

Deep pressure ulcers develop in tissues subjected to sustained mechanical loading. Though it has been hypothesized that this damage mechanism results from local tissue ischemia, it has recently been shown with a cell model that sustained compression can cause cell deformation, leading to tissue breakdown. The present study focuses on the assessment of cell viability during compression and ischemia in an in vitro muscle model to determine their relative contributions to damage development. A model system was developed consisting of engineered skeletal muscle produced from the culture of murine muscle cells in a collagen gel. The tissue was subjected to 0, 20, or 40% compression under hypoxic or normoxic conditions. Experiments were performed on the stage of a microscope and cell viability was monitored using fluorescent markers for apoptotic and necrotic cell death. Hypoxia did not lead to significant cell death over a 22 h period. By contrast, compression led to immediate cell death that increased with time. No additional effect of hypoxia on cell death was observed. These data show that contrary to existing theories, compression can cause development of muscle damage and that hypoxia does not contribute to cell death development within 22 h in engineered muscle.

Animals↗
PubMed1979

Experimental acute balloon compression of the spinal cord. Factors affecting disappearance and return of the spinal evoked response.

Acute balloon compression of the thoracic spinal cord for 15, 7, 5, 3, and 1 minute in monkeys caused immediate disappearance of the spinal evoked response and complete focal ischemia of the compressed segment in all animals. Only the animals in the 1-minute group, however, demonstrated return of the evoked response. These data, coupled with data from previous experiments of slow balloon compression of the spinal cord and spinal cord ischemia, suggest that the major pathological substrate for neural dysfunction after balloon compression of the spinal cord, be it acute or slow, is physical injury of the neural membrane, irrespective of blood flow changes. These findings also suggest that the ability of that membrane to recover is related to rapidity and length of time of compression. Focal changes in blood flow do not appear to be significant in this mechanism.

Acute Disease↗
PubMed1996

Experimental acute dorsal compression of cat spinal cord: correlation of magnetic resonance signal intensity with spinal cord evoked potentials and morphology.

STUDY DESIGN: Acute dorsal compression of the spinal cord was applied to adult cats, and magnetic resonance signal intensity, spinal cord evoked potentials, and morphologic changes of the spinal cord were examined after 5 hours. OBJECTIVES: The present study investigated the correlation of magnetic resonance signal intensity with spinal cord evoked potentials and spinal cord morphology after 5 hours of spinal cord compression in cats. SUMMARY OF BACKGROUND DATA: Neurologic prognosis of the injury might be predicted by an analysis of magnetic resonance signal intensity pattern. Little information is available on relationships between magnetic resonance images and functional or morphologic damage of spinal cord in acute animal experiments. METHODS: Acute dorsal compression of the spinal cord was performed in 24 anesthetized cats. After laminectomy, the L2 segment was compressed for 5 hours. Spinal cord evoked potentials were recorded by electrodes placed in the epidural space at L4, and the spinal cord was stimulated at T12. The animals were divided into four groups based on changes in the amplitude of spinal cord evoked potentials. Immediately after compression for 5 hours, magnetic resonance images were obtained. Signal intensity of the spinal cord was measured on sagittal midline images. Morphologic changes were assessed. RESULTS: Spinal compression significantly increased the signal intensity of the L1, L2, and L3 segments on T2-weighted and proton density-weighted images. The increase in signal intensity was remarkable in the animals whose spinal cord evoked potentials were reduced greatly (< 40% of the control group). Histologically, edema was present in the high intensity area on T2-weighted and proton density-weighted images. CONCLUSIONS: In summary, the present study documents that spinal compression causes tissue edema, which produces high signal intensity on magnetic resonance imaging. The magnetic resonance signal intensity is correlated closely with decreased amplitude of spinal cord evoked potentials.

Acute Disease↗
PubMed1993

Anatomical and morphological evaluation of pacemaker lead compression.

In recent years, pacemaker lead failure due to compressive damage has been reported with increasing frequency. To document the mechanism of this failure, we evaluated explanted mechanically damaged leads with electrical testing, optical microscopy, and in some cases, scanning electron microscopy (SEM). In addition, we performed an autopsy study to measure the compressive loads on catheters placed percutaneously through the costoclavicular angle, as well as by cephalic cutdown. Of the 49 explanted compression damaged leads with enough clinical data for analysis, all had been placed by percutaneous subclavian puncture. Our autopsy data confirmed the significant increase in pressures generated in the costoclavicular angle for medial percutaneous subclavian catheterization (126 +/- 26 mmHg) compared to a more lateral percutaneous subclavian puncture (63 +/- 15 mmHg) or a cephalic cutdown (38 +/- 13 mmHg) (P < 0.01). In vivo coil compression testing documented loads up to 100 pounds per linear inch of coil and a compressive morphology by SEM identical to that seen in the clinical explants. Pacemaker leads appear to be susceptible to compression damage when placed by subclavian venipuncture. When possible, leads should be placed such that they avoid the tight costoclavicular angle.

Bloodletting↗
PubMed1994

Cyclic compression-flexion loading of the human lumbar spine.

STUDY DESIGN: The present study was designed to investigate the biomechanical behavior of the lumbar spine under controlled complex physiologic situations with chronic input. OBJECTIVE: The objective was to determine the response of the human cadaver lumbar spinal column under repetitive compression-flexion forces. SUMMARY OF BACKGROUND DATA: Studies have been conducted in the past to determine the biomechanical response of the spine under uniaxial or pure forces. There is no methodology that can be used to apply and continuously quantify the fatigue response of the lumbar spinal column under controlled combined complex loading vectors (e.g., compression flexion). METHODS: Intact cadaver lumbar columns (L1-L5) were mounted with the superior end in contact with a ball-transfer mount, inducing a flexion load to the spine while allowing multiple degrees of freedom. The distal portion of the specimen was attached to a six-axis load cell to quantify the force sustained by the specimen during the entire loading cycle. The applied load and piston deformation and the generalized six-axis force histories were gathered as a function of time using a digital data acquisition system. RESULTS: The stiffness versus number of cycles (K-N) response exhibited nonlinear characteristics. The stiffness increased initially and then stabilized after 1,000-2,000 cycles of loading, delineating the viscoelastic characteristics of the spine. The initial stiffness increase before stabilization was found to be significantly different (P < 0.025) compared to the stiffness beyond 2,000 cycles. CONCLUSIONS: The data suggest that the fatigue response can be understood by cyclically loading the ligamentous lumbar spine preparation to approximately 2,000 cycles.

Aged↗
PubMed1995

The evaluation of a biexponential model for description of intercompartmental fluid shifts in compressed oedematous tissue.

A parametric model was fitted to force curve data gained by a non-invasive impression method that measures force and fluid translocation during mechanical compression of the skin. The ability of the model parameters to estimate high- and low-viscosity fluid flow in compressed areas were evaluated in a silicone rubber model and in six patients with chronic pitting oedema. Different softnesses of silicone rubber gave significantly different parameter values. The flow properties of the silicone model could be analysed in detail with the suggested model. Parameter analysis showed a higher fraction of low-viscosity fluid for oedema than for reference sites. The model parameters could be interpreted in softness value according to an international standard for consistency (ISO 2137). The suggested parametric model gave reliable and detailed information about high- and low-viscosity fluid flow and can be used to estimate intercompartmental fluid shifts in oedematous tissue.

Aged↗
PubMed1997

Upper plexus thoracic outlet syndrome: optimal therapy.

BACKGROUND: Previously, transaxillary first rib resection alone was not considered adequate therapy for "upper plexus" (median nerve) thoracic outlet syndrome. It was thought that the "combined" approach with upper plexus dissection through a supraclavicular incision in addition to the transaxillary approach was necessary. However, with better understanding of anatomy--that the median nerve receives fibers from C8 and T1 as well as the upper plexus and that muscles that compress the upper plexus attach to the first rib--it is now recognized that first rib removal alone will relieve upper plexus compression. METHODS: Assessment of 2,210 operations for thoracic outlet syndrome revealed 250 patients (11%) had symptoms and nerve conduction velocity slowing of the median nerve only (upper plexus), whereas 452 (20%) patients had both median and ulnar nerve compression (upper and lower), and 1,508 patients exhibited compression symptoms and nerve conduction velocity slowing of the ulnar nerve alone (lower plexus). RESULTS: Transaxillary first rib resection relieved symptoms of median nerve (upper plexus) compression as well as it did for ulnar nerve (lower plexus) compression. Treatment outcome comparisons of patients with median and ulnar compression show no significant differences. CONCLUSIONS: These data refute the need for supraclavicular or combined supraclavicular and transaxillary approaches to treat patients with upper plexus (median) thoracic outlet syndrome compression as previously recommended. The transaxillary approach alone is satisfactory.

Adolescent↗
PubMed2006

Effect of a stiff lifting belt on spine compression during lifting.

STUDY DESIGN: An in vivo study on weightlifters. OBJECTIVES: To determine if and how a stiff back belt affects spinal compression forces in weightlifting. SUMMARY OF BACKGROUND DATA: In weightlifting, a back belt has been reported to enhance intraabdominal pressure (IAP) and to reduce back muscle EMG and spinal compression forces. METHODS: Nine experienced weightlifters lifted barbells up to 75% body weight while inhaling and wearing a belt, inhaling and not wearing a belt, and exhaling and wearing a belt. IAP, trunk muscle EMG, ground reaction forces, and kinematics were measured. An EMG-assisted trunk model, including IAP effects, was used to calculate spinal compression and shear forces and to reveal the contribution of back muscles, abdominal muscles, and IAP to moment generation. RESULTS: The belt reduced compression forces by about 10%, but only when inhaling before lifting. The moment generated by IAP increased when wearing a belt and inhaling, but this moment was small and the increase was largely negated by the flexing moment generated by abdominal muscles. CONCLUSIONS: Wearing a tight and stiff back belt while inhaling before lifting reduces spine loading. This is caused by a moment generated by the belt rather than by the IAP.

Abdominal Muscles↗
PubMed2005

Real-time plaque characterization and visualization with spectral analysis of intravascular ultrasound data.

Coronary artery disease is the number one cause of death in the United States and the Western world, and approximately 250,000 affected people die per year without ever being admitted to a hospital. One of the main reasons of such a high death-rate without any diagnosis is that more than 50 or heart-attacks) occur in patients with no prior history of known heart disease or symptoms. Coronary artery disease leads to the occlusion of arteries that are vital in providing nutrients to the heart muscles. The disease develops by progressive accumulation or formation of "plaque" within an artery. Certain types of plaques could occlude blood flow and yet might be "stable". These plaques usually have a high fibrous content, and are known as hard plaques. On the other hand, "unstable" or "soft" plaques might not cause much occlusion but could be vulnerable to rupture. Rupture of such plaques could lead to total or partial occlusion in arteries resulting in sudden cardiac death or heart-attack. In fact, 68 coronary arteries are less than 50.Intravascular ultrasound (IVUS) is a minimally invasive imaging modality that provides cross-section images of arteries in real-time, allowing visualization of atherosclerotic plaques in vivo. In standard IVUS gray-scale images, calcified regions of plaque and dense fibrous components generally reflect ultrasound energy well and thus appear bright and homogeneous on IVUS images. Conversely, regions of low echo reflectance in IVUS images are usually labeled "soft" or "mixed" plaque. However, this visual interpretation has been demonstrated to be very inconsistent in accurately determining plaque composition and does not allow real-time assessment of quantitative plaque constituents.Spectral analysis of the backscattered radiofrequency (RF) ultrasound signals allows detailed assessment of plaque composition. Advanced mathematical techniques can be employed to extract spectral information from these RF data to determine composition. The spectral content or signature of RF data reflected from tissue depends on density, compressibility, concentration, size, etc. A combination of spectral parameters were used to develop statistical classification schemes for analysis of in vivo IVUS data in real-time. The clinical data acquisition system is ECG gated and the analysis software developed by our group reconstructs IVUS gray-scale images from the acquired RF data. A combination of spectral parameters and active contour models is used for real-time 3D plaque segmentation followed by computation of color-coded tissue maps for each image cross-section and longitudinal views of the entire vessel. The "fly-through" mode allows one to visualize the complete length of the artery internally with the histology components at the lumen surface. In addition, vessel and plaque metrics such as areas and volumes of individual plaque components (collagen, fibro-lipid, calcium, lipid-core) are also available.

Coronary Artery Disease↗
PubMed1997

Atlantoaxial fusion and retrodental pannus in rheumatoid arthritis.

STUDY DESIGN: This study analyzed the influence of atlantoaxial fusion in rheumatoid arthritis patients on inflammatory retrodental pannus. OBJECTIVES: To determine the value of fusion on the magnitude of pannus as a compressive structure on the spinal cord. SUMMARY OF BACKGROUND DATA: Transverse and vertical instability may lead to neurologic deficits from spinal cord compression. Increased size of the retrodental pannus can exacerbate the neurologic deterioration. Anterior removal of dens and pannus followed by posterior fusion has been proposed in such situations as a method to relieve spinal cord compression. METHODS: Twenty-two patients with atlantoaxial instability and verified pannus on magnetic resonance imaging underwent posterior fusion of the upper cervical spine. These patients were followed 12 to 75 months after surgery by clinical, radiologic, and magnetic resonance imaging evaluations. The size of the pannus was compared before and after surgery. RESULTS: In all patients, the retrodental pannus had significantly decreased or disappeared postoperatively. CONCLUSIONS: Pannus reduction occurred even in patients whose disease was active or progressing, supporting the hypothesis that the pannus is more a reactive fibrous tissue resulting from instability rather than a direct consequence of the inflammatory process itself.

Adult↗
PubMed1985

Ender rod versus compression screw fixation of hip fractures.

Eighty-seven matched pairs of patients with extracapsular hip fractures were treated with either Ender rod or compression screw and plate fixation. The data obtained both perioperatively and from one to 39 months postoperatively showed no significant differences with respect to infection rate, mortality, length of stay, or ultimate functional status. In the Ender rod group, 66.7% of the patients experienced technical problems, compared with 10.3% of patients in the compression screw group. The Ender technique offered few practical advantages and an unacceptably high level of problems, even when patients with only stable fractures were considered.

Adult↗
PubMed2006

Improvement of DCT-based compression algorithms using Poisson's equation.

We propose two new image compression-decompression methods that reproduce images with better visual fidelity, less blocking artifacts, and better PSNR, particularly in low bit rates, than those processed by the JPEG Baseline method at the same bit rates. The additional computational cost is small, i.e., linearly proportional to the number of pixels in an input image. The first method, the "full mode" polyharmonic local cosine transform (PHLCT), modifies the encoder and decoder parts of the JPEG Baseline method. The goal of the full mode PHLCT is to reduce the code size in the encoding part and reduce the blocking artifacts in the decoder part. The second one, the "partial mode" PHLCT (or PPHLCT for short), modifies only the decoder part, and consequently, accepts the JPEG files, yet decompresses them with higher quality with less blocking artifacts. The key idea behind these algorithms is a decomposition of each image block into a polyharmonic component and a residual. The polyharmonic component in this paper is an approximate solution to Poisson's equation with the Neumann boundary condition, which means that it is a smooth predictor of the original image block only using the image gradient information across the block boundary. Thus, the residual--obtained by removing the polyharmonic component from the original image block--has approximately zero gradient across the block boundary, which gives rise to the fast-decaying DCT coefficients, which, in turn, lead to more efficient compression-decompression algorithms for the same bit rates. We show that the polyharmonic component of each block can be estimated solely by the first column and row of the DCT coefficient matrix of that block and those of its adjacent blocks and can predict an original image data better than some of the other AC prediction methods previously proposed. Our numerical experiments objectively and subjectively demonstrate the superiority of PHLCT over the JPEG Baseline method and the improvement of the JPEG-compressed images when decompressed by PPHLCT.

Algorithms↗
PubMed1997

Ultrasound-guided pseudoaneurysm compression: efficacy after coronary stenting and angioplasty.

PURPOSE: Ultrasound-guided compression of femoral pseudoaneurysms has often obviated the need for open operative repair. Increasing use of percutaneous interventional cardiac procedures has created pseudoaneurysms with a large-caliber arterial defect, often in patients who are placed immediately on anticoagulation therapy. This report describes the prospectively collected information from our vascular laboratory regarding ultrasound-guided compression of these pseudoaneurysms after cardiac procedures, both interventional and diagnostic. METHODS: Since March 1994 prospective data collection for patients who have undergone pseudoaneurysm compression in our vascular laboratory has recorded information including cardiac procedure, size of catheter or sheath, coagulation parameters, pseudoaneurysm size and location, and time to compression. Forty-one patients underwent attempted ultrasound-guided pseudoaneurysm compression after cardiac procedures: 19 after cardiac catheterization alone, seven after angioplasty, one after atherectomy, two after insertion and subsequent removal of an intraaortic balloon pump, and 12 after coronary stenting. RESULTS: Compression was successful overall in 88% of the patients (36 of 41). Successful compression of the pseudoaneurysm was seen in 95% after catheterization alone, 100% after angioplasty, 100% after atherectomy, and 100% after intraaortic balloon pumping, as compared with 67% after stenting (eight of 12 vs 28 of 29; p = 0.02). A sheath size of 9F or greater was a significant factor in predicting unsuccessful compression (three of eight vs two of 33; p = 0.04). Abnormal coagulation parameters were present in 20 of the 41 patients and was not significantly different in patients who were successfully or unsuccessfully treated (four of five vs 16 of 36; p = 0.40). CONCLUSIONS: Pseudoaneurysms after cardiac procedures and interventions can often be successfully compressed with an ultrasound-guided technique. The presence of abnormal coagulation parameters was not identified as a risk factor for compression failure and should not dissuade attempted compression. Stent placement was more likely to result in unsuccessful compression, and this appeared to be a result of the larger size of the arterial defect. Even in this setting, compression achieved obliteration of the pseudoaneurysm in more than half of the patients.

Aneurysm↗
PubMed1997

Elastic compression stockings: durability of pressure in daily practice.

BACKGROUND: Elastic compression stockings are valuable tools in the treatment of many phlebological diseases. As to day no data are available about how long these elastic compression stockings continue to exert enough compression for a proper clinical function. PATIENTS AND METHODS: In this study we measured the pressure at the B level of compression class II and III elastic stockings directly after the patients started to use them, after 1 month, and after 3 months. In total 99 below knee stocking were measured with a TNO-tester, which has officially been accepted by the CEN for measurement of elastic compression stockings. RESULTS: Class II flat knitted stockings showed a mean pressure of 29.3 (SD 4.9) mmHg at the start of the study, declining to 27.6 (SD 5.2) mmHg, and 26.5 (SD 4.4) mmHg, at 1 and 3 months respectively. The round knitted class II had comparable results. In class III flat knitted stockings we measured 47.5 mmHg (SD 8.1) at the start, and 44.2 (SD 7.1) mmHg, and 41.3 (SD 6.7) mmHg, at 1 and 3 months respectively. Extrapolation of the results after 1 and 3 months demonstrate that the mean pressure of class II stocking is less than 25 mmHg after 4 to 5 months. Class III stockings were less than 35 mmHg close to 6 months, if evaluated in the same way. Individual regression analysis show that after 6 months 66% of the pressure class II stockings have a pressure of less than 25 mmHg and 45% of the pressure class III less than 35 mmHg. When considering a 10% safety margin the figures are respectively 84% and 63%. CONCLUSIONS: From the results of this study it can be concluded that, especially for the most frequently used compression class II stockings, three new stockings each year are necessary to ensure an effective function of the stocking during the time they are being used by the patient. For compression class III flat knitted stockings two pairs can be considered as sufficient.

Aged↗
PubMed2004

Binding of bovine pancreatic trypsin inhibitor to trypsinogen: spectroscopic and volumetric studies.

We have investigated the binding of bovine pancreatic trypsin inhibitor (BPTI) to bovine trypsinogen by combining ultrasonic velocimetry, high precision densimetry, and fluorescence spectroscopy. We report the changes in volume, adiabatic compressibility, van't Hoff enthalpy, entropy, and free energy that accompany the association of the two proteins at 25 degrees C and pH 8.0. We have used the measured changes in volume and compressibility in conjunction with available structural data to characterize the binding-induced changes in the hydration properties and intrinsic packing of the two proteins. Our estimate reveals that 110 +/- 40 water molecules become released to the bulk from the hydration shells of BPTI and trypsinogen. Furthermore, we find that the intrinsic coefficient of adiabatic compressibility of the two proteins decreases by 14 +/- 2%, which is suggestive of the binding-induced rigidification of the proteins' interior. BPTI-trypsinogen association is an entropy-driven event which proceeds with an unfavorable change in enthalpy. The favorable change in entropy results from partial compensation between two predominant terms. Namely, a large favorable change in hydrational entropy slightly prevails over a close in magnitude but opposite in sign change in configurational entropy. The reduction in configurational entropy and, consequently, protein dynamics is consistent with the observed decrease in intrinsic compressibility. In general, results of this work emphasize the vital role that water plays in modulating protein recognition events.

Animals↗
PubMed1992

[The computer-assisted processing of CT data in planning endosseous implantation interventions].

The success of dental implantologic measures depends considerably on the correct positioning of the endosseous implants. A sufficient amount of bony substance is mandatory to provide overall covering of the implant with at least 1 mm of cortical bone. By the aid of a custom-developed software system, computed tomography image data can be handled on a conventional MS-DOS personal computer. The user is enabled to simulate size and positioning of the implant by interactive graphic animation. Quick and exact presentation is achieved by optimizing the computation algorithms. Storage needs are minimized by a segmentation procedure and additional compression of the image. Integrated patient data management and user friendly self-documenting program surfaces provide easy application.

Computer Graphics↗
PubMedDate not supplied

A comparison of tibiofemoral joint forces and electromyographic activity during open and closed kinetic chain exercises.

We chose to investigate tibiofemoral joint kinetics (compressive force, anteroposterior shear force, and extension torque) and electromyographic activity of the quadriceps, hamstring, and gastrocnemius muscles during open kinetic chain knee extension and closed kinetic chain leg press and squat. Ten uninjured male subjects performed 4 isotonic repetitions with a 12 repetition maximal weight for each exercise. Tibiofemoral forces were calculated using electromyographic, kinematic, and kinetic data. During the squat, the maximal compressive force was 6139 +/- 1708 N, occurring at 91 degrees of knee flexion; whereas the maximal compressive force for the knee extension exercise was 4598 +/- 2546 N (at 90 degrees knee flexion). During the closed kinetic chain exercises, a posterior shear force (posterior cruciate ligament stress) occurred throughout the range of motion, with the peak occurring from 85 degrees to 105 degrees of knee flexion. An anterior shear force (anterior cruciate ligament stress) was noted during open kinetic chain knee extension from 40 degrees to full extension; a peak force of 248 +/- 259 N was noted at 14 degrees of knee flexion. Electromyographic data indicated greater hamstring and quadriceps muscle co-contraction during the squat compared with the other two exercises. During the leg press, the quadriceps muscle electromyographic activity was approximately 39% to 52% of maximal velocity isometric contraction; whereas hamstring muscle activity was minimal (12% maximal velocity isometric contraction). This study demonstrated significant differences in tibiofemoral forces and muscle activity between the two closed kinetic chain exercises, and between the open and closed kinetic chain exercises.

Adult↗