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At least 19 recordsLinked to original sources
PubMed1989

A CT-compatible version of the Fletcher system intracavitary applicator: clinical application and 3-dimensional treatment planning.

A new acrylic version of the familiar Fletcher intracavitary applicator, the Ann Arbor (AA) applicator, has been developed. This new device eliminates the problem of "streak" artifacts on CT images, but unlike other plastic applicators the ability to shield portions of the bladder and rectum is retained through the use of tungsten alloy shields which are afterloaded with the radioactive sources. To minimize changes in placement geometry and to take advantage of the wide clinical experience with the Fletcher system, the new applicator nearly duplicates the physical dimensions of the Fletcher applicator. With the Ann Arbor applicator in place, dummy sources are easier to locate on standard radiographic simulations. CT scans are free of artifact and provide clear, detailed visualizations of cross-sectional anatomy. The new applicator thus allows CT images to be used to their potential in evaluating crucial anatomic relationships and in performing 3-D dosimetry with dose volume analysis. Using a treatment planning system with 3-D capabilities, solid surface graphic display of applicator, cervix, rectum, bladder, and treatment isodose volume has been performed. In addition, dose volume histograms can be generated to obtain precise measurements of the volume of cervix, rectum, or bladder receiving specified doses.

Brachytherapy↗
PubMed1990

Biplanar transesophageal echocardiography: anatomic correlations, image orientation, and clinical applications.

Clinical transesophageal echocardiography is a rapidly expanding diagnostic procedure. Conventional transesophageal endoscopes allow imaging from a single array mounted in the horizontal plane. This article introduces the clinical application of biplanar imaging, which incorporates a second orthogonal longitudinal plane. Our clinical experience with 291 patients who underwent biplanar transesophageal echocardiography is presented. The examination, technique, and resultant anatomic correlations unique to this new examination are discussed and illustrated. The anatomy is displayed in a familiar format comparable to the precordial examination. Biplanar imaging adds substantially to the comprehensive anatomic delineation of certain cardiac structures.

Adolescent↗
PubMedDate not supplied

Peptide hormone analogues and novel clinical applications.

Clinical application of peptide hormone analogues is rapidly expanding. Peculiar aminoacid residues, conformational turns and the degree of molecular flexibility may represent critical keys for differential interaction with the receptor sites, hence for specific biological effects. Broadly different biological responses may be elicited as a function of dose and timing of administration. The clinical use of the heptadecapeptide analogue ACTH 1-17 (Synchrodyn 1-17) has provided new diagnostic information about subtle alterations of the adrenal function and has been valuable to presenting the rhythmic ordering of several functions, especially of those which are more dependent on the glucocorticoid modulation. In this sense, the use of a synthetic hormone analogue presenting a wide range of programmable effects appears essential for a better medicine. A large body of evidence indicates that the same concept applies to most actions of the gonadotropin-releasing hormone (LH-RH) related analogues. The availability of small computerized instruments for data collection and analysis of the endogenous rhythmicities, on the one hand, and for programmable administration of the analogues, on the other hand, is already providing new approaches to heretofore unsuccessful therapies.

Adrenocorticotropic Hormone↗
PubMed1990

[Experimental complex partial seizure and its possible clinical application].

Clinical applications of experimental models of complex partial seizure were studied using kainic acid-induced limbic seizures and amygdaloid kindling models. The following experiments were done aiming to study the basic approach for the treatment of the intractable complex partial seizures. 1) Degenerative focal lesions were made in bilateral substantia nigra and substantia innominata by a local microinjection of the ibotenic acid and influences upon limbic seizures were studied. Substantia innominata has a facilitatory effect upon secondary generalization of the limbic seizure while substantia nigra has an inhibitory influence. Degenerative lesions of the bilateral hippocampus inhibited development process as well as establishment of the kindling. 2) Resection of the primary epileptic focus in a limbic seizure status resulted in seizure control in cats with a single focus but not in another with multiple foci. 3) An autoradiography was done during limbic seizure status induced by kainic acid microinjection, and local cerebral glucose utilization (LCGU) and local cerebral blood flow were studied in order to study the relationship between cerebral metabolism and cerebral blood flow during limbic seizures. In the pyramidal cell of the hippocampus, an increased ratio of LCGU (x 4.1) is larger than that of LCBF (x 1.6). This uncoupling may be one reason of the neuronal cell damage during the limbic seizure status. 4) Autoradiography of the calcium suggested that one of the causes of hippocampal degeneration in intractable complex partial seizures should be a consequence of calcium influx into pyramidal cells during repeated limbic seizures.

Animals↗
PubMed1988

An improved tungsten-178/tantalum-178 generator system for high volume clinical applications.

Clinical utilization of the multiwire gamma camera (MWGC) requires low-energy radionuclides. The short-lived (9.3 min) tantalum-178 (178Ta) is ideally suited for the MWGC and can be produced from long-lived (21.7 day) tungsten-178 (178W) by a previously reported 178W/178Ta generator. This generator, however, is limited by sharp increase in breakthrough after elution of only 30-60 column-volumes. To optimize the 178W/178Ta generator for clinical use, varying eluant acid concentrations were evaluated. A reduced (from 0.1 to 0.03N) HCI concentration in the eluant, coupled with low operating temperatures (3 to 5 degrees C) allowed high (40 to 60%) 178Ta yield. Minimal 178W breakthrough (less than .01%) resulted, even after elution of more than 200 column-volumes. Each of six tested generators provided sterile, high activity (up to 100 mCi) 178Ta elutions for more than 30 days. Radiation dosimetry was estimated utilizing both human and animal biodistribution data. The whole body (critical organ) dose in adults and neonates were 1/20 (1/21) and 1/19 (1/50) respectively relative to that of technetium-99m (99mTc) as sodium pertechnetate. The optimized 178W/178Ta generator provides a commercially practical, safe source of low-energy radioisotope for the MWGC with substantial dosimetry advantages over 99mTc.

Animals↗
PubMed1977

[Experimental studies on clinical application of 13N-ammonia; clinical application of the functional image].

1) Clinical application: Dynamic scintigraphy of liver and heart of a patient having liver cirrhosis after intrasigmoidal administration of 13N-ammonia (pH 8.1) were performed. Simultaneously, continuous measurments of radioactivity at the left side abdomen and the left temporal region were done by using a scintillation detector for renography. Successive measurement of radioactivity of blood was also carried out. 2) Comstruction of functional images of liver and heart: By using digital radioisotope image of liver and heart of the patient after intrasigmoidal administration of 13N-ammonia, the maps with respect to parameters described in the pervious paper were constructed.

Ammonia↗
PubMed1991

[Clinical application of clinical laboratory tests].

Recent advances in clinical laboratory tests have made it possible to study and clarify the pathogenesis of various diseases from various aspects. Such major advances can be very useful for the treatment and prophylaxis of diseases. Better tests can clarify the mutual relationships among diseases. Unfortunately, however, many clinical tests are not used effectively because they are not adequately understood. On this occasion, we are being given the opportunity to learn about the most recent clinical tests related to blood coagulation and fibrinolysis. These tests offer us the means of elucidating the pathogenesis of diseases. By applying the knowledge gained at this workshop in our clinical practice, we will be able to repay, in a small way, Dr. Matsuo, the chairman, for his efforts in the planning of this workshop.

Blood Coagulation↗
PubMed1987

Who still prefers aggressive surgery for breast cancer? Implications for the clinical applications of clinical trials.

Conservative breast surgery and modified radical mastectomy may, according to recent reports, yield equivalent survival. Analysis of a 1985 Canada-wide study (N = 228) compared surgeons and oncologists still recommending modified radical mastectomy (30%) with those recommending less aggressive surgery (69%) for a hypothetical stage I patient. The groups did not differ significantly in most physician characteristics, estimated survival and cure probabilities, importance of most treatment goals, uncertainty about treatment choice, or most attitudinal responses. Although equally involved with and cognizant of the value of clinical trials, the modified radical group expressed more skepticism about the ability of trial results to be transferred to practice and to take sufficient account of patient uniqueness, indicating greater focus on variation than mean results. Trial results might be more readily adopted if they are reported in accessible data-bases, incorporating patient characteristics potentially relevant to treatment choice. This would allow clinicians to individualize treatment by analyzing patient subsets of their own choosing.

Attitude of Health Personnel↗
PubMed1990

Home urinary luteinizing hormone immunoassays: clinical applications.

Home ovulation prediction kits represent a valuable advance in monoclonal antibody technology and offer patients a quick, reliable, and relatively inexpensive means to predict the day of ovulation. These kits are used widely by patients trying to conceive and are commonly recommended by physicians involved in the care of infertile couples. They provide a more accurate and practical means to prospectively predict the time of ovulation than do BBT graphs or cervical mucus exams, and can be used as presumptive evidence of ovulation. Whereas ovulation prediction kits appear to be most useful for couples in timing sexual intercourse, other possible uses exist, including timing of AI, the PCT, and the endometrial biopsy for luteal phase evaluation. Despite multiple potential applications, clinical studies which support the use of urinary LH immunoassays in the evaluation and treatment of the infertile couple are quite limited. More well-designed studies to define the clinical value of ovulation prediction kits need to be undertaken.

Female↗