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  • 1
    ISSN: 1432-1459
    Keywords: Three-dimensional magnetic resonance imaging ; Trigeminal nerve neuralgia ; Neurovascular compression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Three-dimensional MR tomography was used to examine the relationship between symptoms of trigeminal neuralgia and neurovascular compression of the nerve in 18 patients. The intensity of neurovascular interaction was classified according to neuroradiological criteria. We found that a radiologically defined compression or dislocation of the nerve by an artery was always associated with symptoms of trigeminal neuralgia. A simple contanct between vessel and nerve, however, was also observed on the asymptomatic sides of 10 out of 18 patients. In 6 of 18 patients, in contrast, trigeminal neuralgia was present in spite of the absence of neurovascular contact. In accordance with a cited study based on autopsy and intraoperative findings, our findings indicate that, in a certain proportion of cases, trigeminal neuralgia may be caused by neurovascular compression alone, whereas in other cases, other pathogenetic factors may be involved to a varying degree or be even exclusively responsible for the development of trigeminal neuralgia. The possible significance of the method for a preoperative estimation of the success of microvascular decompression of the trigeminal nerve is discussed.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-086X
    Keywords: Key words: Embolism, pulmonary—Fragmentation, mechanical—Thrombolysis—Interventional procedures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: To report the results of thrombus fragmentation in combination with local fibrinolysis using recombinant human-tissue plasminogen activator (rtPA) in patients with massive pulmonary embolism. Methods: Five patients with massive pulmonary embolism were treated with thrombus fragmentation followed by intrapulmonary injection of rtPA. Clot fragmentation was performed with a guidewire, angiographic catheter, and balloon catheter. Three patients had undergone recent surgery; one of them received a reduced dosage of rtPA. Results: All patients survived and showed clinical improvement with a resultant significant (p 〈 0.05) decrease in the pulmonary blood pressure (mean systolic pulmonary blood pressure before treatment, 49 mmHg; 4 hr after treatment, 28 mmHg). Angiographic follow-up in three patients revealed a decrease in thrombus material and an increase in pulmonary perfusion. Two patients developed retroperitoneal hematomas requiring transfusion. Conclusion: Clot fragmentation and local fibrinolysis with rtPA was an effective therapy for massive pulmonary embolism. Bleeding at the puncture site was a frequent complication.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-2161
    Keywords: Magnetic resonance imaging ; Gadolinium-DTPA ; Rheumatoid arthritis ; Dynamic magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thirty-four joints (19 knees, 15 wrists) of 31 patients suffering from rheumatoid arthritis and related disorders were examined prior to and following intravenous administration of Gadolinium-DTPA (0.1 mmol/kg body weight). T1-weighted spin-echo sequences and the gradient-echo technique FLASH were applied. FLASH scanning was used for the registration of the time-dependent changes of signal intensity following Gd-DTPA. Synovial proliferations exhibited a rapid and marked increase of signal intensity whereas fatty tissue, bone marrow, muscle and synovial effusion demonstrated only minor changes, causing enhanced contrast between synovial pannus and joint effusion or other neighbouring structures. Within the synovial pannus, ratios (absolute signal increase) of 131.3±53.4% and 122.9±51.1% were found in T1-weighted spin-echo and in FLASH sequences respectively. The average signal increase gradient of pannus (108.2±70.6%/min) was significantly (p〈0.001) different from muscle (13.4±7.8%/min), fatty tissue (10.2±8.4%/min), bone marrow (5.5±7.1%/min), and joint effusion (14.7±7.8%/min).
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-2161
    Keywords: Key words Bones ; infection ; Bones ; radionuclide studies ; MRI ; comparative studies ; Bones ; MRI studies ; MRI ; extremities ; Bones ; immunoscintigraphy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. A retrospective study of the validity of combined bone scintigraphy (BS) and immunoscintigraphy (IS) using 99mTc-labelled murine antigranulocyte antibodies (MAB) and magnetic resonance imaging (MRI) in chronic post- traumatic osteomyelitis. Design and patients. The results of MRI and combined BS/IS of 19 lesions in 18 patients (13 men, 5 women; mean age 45 years, range 27–65 years) were independently evaluated by two radiologists and one nuclear medicine physician with regard to bone infection activity and extent. The patient group was a highly selective collection of clinical cases: the average number of operations conducted because of relapsing infection was eight (range 2–27), the average time interval between the last surgical intervention and the present study was 6.5 years (range 3 months to 39 years), and from the first operation was 14 years (range 1.5–42 years). Interobserver agreement on MRI was measured by kappa statistics. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated for MRI and the nuclear medicine studies. Results. For MRI/nuclear medicine, a sensitivity of 100%/77%, a specificity of 60%/50%, an accuracy of 79%/61%, a PPV of 69%/58% and a NPV of 100%/71% were calculated. Four MR examinations were false positives because of postsurgical granulation tissue. A high degree of interobserver agreement was found on MRI (κ=0.88). A low-grade infection was missed on two scintigrams, while four were false positive because of ectopic haematopoietic bone marrow, and in one examination the anatomical distortion resulted in an inaccurate assignment of the uptake leading to false positive findings. Image analysis was frequently hindered by susceptibility artefacts due to residual abrasions of metallic implants after removal of orthopaedic devices (15/18 patients); this led to limited assessment in 17% (3/18 patients). Conclusion. Acute activity in a chronic osteomyelitis can be excluded with high probability if the MRI findings are negative. In the first postoperative year fibrovascular scar cannot be distinguished accurately from reactivated infection on MRI and scintigraphy may improve the accuracy of diagnosis. MRI is more sensitive in low-grade infection during the later course than combined BS/IS. Scintigraphic errors due to ectopic, peripheral, haematopoietic bone marrow can be corrected by MRI.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-2161
    Keywords: Magnetic resonance imaging ; Threedimensional, gradient-echo sequence ; Chondromalacia ; Knee joint ; FLASH ; FISP
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diagnosis of chondromalacia of the patellofemoral joint using three-dimensional gradient-echo sequences was investigated in 41 patients, with arthroscopic verification in 25 patients. In vitro examinations in human caderveric patellae were performed in order to determine optimal imaging parameters. FLASH (TR=40 ms, TE=10 ms, flip angle=30°) and FISP (TR=40 ms, TE=10 ms, flip angle=40°) were used in clinical studies. Advanced stages of chrondromalacia could be visualized with high sensitivity. The therapeutically relevant differentiation of major and minor degrees of chondromalacia seems to be possible. 30° FLASH-images in the axial plane proved to be the most efficacious technique for the diagnosis of chondromalacia.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Cell & tissue research 48 (1958), S. 24-50 
    ISSN: 1432-0878
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Zusammenfassung 1. Verschiedene Abschnitte des Brust- und Bauchbereiches der V. cava caudalis von Rindern, Schafen, Pferden, Schweinen und Hunden wurden untersucht. 2. Die makroskopisch-anatomische Untersuchung ergab gleiches Aussehen der Venenwand aller Tiere im thorakalen Abschnitt. Im Leberbereich und im restlichen abdominalen Bereich zeigt die Wand der V. cava caudalis analog den histologischen Befunden bei Rind und Schaf ein rhombisch-netzartiges Muster, bei Pferd, Schwein und Hund eine glatte und glänzende Oberfläche. 3. Die mikroskopisch-anatomischen Untersuchungen ergaben: a) Die Wand der hinteren Hohlvene ist bei allen Haussäugetieren im Brustbereich bindegewebig-elastisch strukturiert. Die Adventitia enthält ein Band von dicken, longitudinal verlaufenden elastischen Fasern, welches diesen Venenabschnitt befähigt, sich bei der Atmung zu dehnen und zu verkürzen. Die Media ist fast rein bindegewebig; nur bei Pferd und Hund finden sich zirkulär verlaufende Muskelfasern. b) Im Zwerchfellbereich, am Foramen v. cavae ist die Vene bei allen untersuchten Tieren rein bindegewebig aufgebaut. c) Im Leberbereich der hinteren Hohlvene stellt die Adventitia die weitaus dickste Schicht dar. Sie wird gebildet von einem mächtigen elastisch-muskulösen System. Die Media ist in diesem Abschnitt sehr schwach und enthält Zirkulärmuskulatur. d) In den posthepatischen Teilen der V. cava caudalis bleibt das elastischmuskulöse System in der Adventitia bei Rind und Schaf erhalten, nimmt jedoch von Abschnitt zu Abschnitt ab, während die Media an Stärke zunimmt. e) In den posthepatischen Abschnitten der hinteren Hohlvene des Pferdes, Schweines und Hundes besteht die Adventitia vorwiegend aus elastischen bzw. kollagenen Fasern. Die Media ist bindegewebig-muskulös, variiert jedoch abschnittsweise in Stärke und Anordnung. f) Die Intima ist überall schwach entwickelt, jedoch im thorakalen Bereich weniger als im abdominalen. g) Der unterschiedliche Wandaufbau der hinteren Hohlvene in den einzelnen Abschnitten ist auf äußere Kräfte zurückzuführen, die auf das Venenrohr einwirken. Der „Blutschwamm“ Leber erzeugt im Bereich dieses Organs das geschilderte elastisch-muskulöse System, das die Aufgabe hat, die Längsspannung der Gefäßwand dem auf sie wirkenden wechselnden Außendruck anzupassen. Im posthepatischen Bereich wird das elastisch-muskulöse System wohl auf Grund besonderer Beanspruchung nur bei den Wiederkäuern entwickelt. h) Da auch in der V. azygos lediglich bei den Wiederkäuern ähnliche elastischmuskulöse Strukturen vorkommen wie in der V. cava caudalis abdominalis des Rindes und da für ihr Auftreten früher schon die Rumination verantwortlich gemacht worden war, wurde das zeitliche Auftreten der Strukturen während der Entwicklung in beiden Gefäßen ermittelt. Die V. cava caudalis erhält ihren elastisch-muskulösen Charakter im posthepatischen Bereich schon beim sechs Monate alten Embryo, die V. azygos dagegen erst beim ein bis zwei Monate alten Kalb. Der letztgenannte Zeitpunkt fällt mit dem Einsetzen der Rumination zusammen. Bei der V. azygos dürfte also die Rumination, bei der V. cava caudalis jedoch dürften die Bewegungen des embryonalen Wiederkäuermagens mit der Entstehung der elastisch-muskulösen Struktur in Zusammenhang stehen.
    Type of Medium: Electronic Resource
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