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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 237 (1988), S. 91-100 
    ISSN: 1433-8491
    Keywords: Basilar artery stenosis ; Basilar artery occlusion ; Continuous-wave Doppler sonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the past 5 years we have investigated 29 patients with symptomatic basilar artery stenoses (14 cases) and occlusions (14) and a patent primitive trigeminal artery with thin-calibered basilar and vertebral arteries (1) using directional continuous-wave Doppler sonography of the vertebral arteries. A total of 19 patients survived, and 17 of them were clinically and sonographically reexamined after 40.4 ± 15.8 months (mean ± SD). Among the 8 patients with basilar stenoses, 6 — with no further transient ischemic attacks (TIAs) in the interval — exhibited an increase in the summed modified Pourcelot indices (relative end-diastolic flow velocities) of the vertebrals by 0.18 ± 0.16; the other 2 showed a decrease by 0.26 each, in 1 case temporally related to a TIA, in the 2nd case without further clinical deterioration. In the 8 survivors with basilar occlusions, 5 remained — by sonographic criteria — unchanged with summed modified Pourcelot indices of the vertebrals of 0.00, while 3 patients exhibited a slight increase in the summed modified Pourcelot indices of 0.13 ± 0.03. While the difference between the outcome of subsets of patients treated with regimens of 30,000–40,000 units heparin/day or phenprocoumon and less radical drugs were statistically not significant, the former regimen appeared clinically more efficacious in preventing further deterioration in approximately two-thirds of the patients affected. Due to the potential recurrence of neurological symptoms, a treatment period with phenprocoumon of 6 months after discharge from hospital appears justified. Due to these therapeutic efforts, approximately half of the patients initially affected survived with no or only a mild neurological deficit. Directional continuous-wave Doppler sonography is, in our opinion, a reliable technique for examining the short- and long-term changes in peripheral vascular resistance.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1434-9949
    Keywords: Ultrasound ; Bone ; Material Quality ; Modulus of Elasticity ; Age ; Bone Mineral Density
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The square of ultrasound transmission velocity in a material is related to the modulus of elasticity, which is known to be an indicator of stability in bone. The aim of our study was to use ultrasound transmission velocity to obtain information about the material properties of bone tissue, keeping other factors possibly influencing ultrasound transmission as constant as possible. Apparent phalangeal ultrasound transmission velocity (APU) measured in 54 isolated, fresh pig phalanges was shown to be independent of bone mineral density (BMD) measured by SPA. Fastest sound transmission led exclusively through cortical bone so that intertrabecular connectivity in spongious bone could not influence the result. In humans APU was measured in the mediolateral direction at the midphalanx of the middle finger. In 53 healthy subjects (15–81 years old; 27 women, 26 men), there was a decrease of APU with age (r=−0.30, p〈0.05). Further, when comparing the results of both hands intraindividually almost identical values indicated constant intraindividual architecture of bone at this location. There was no evidence for a relation of APU to physical load comparing dominant and nondominant hand and relating the results to subjectively estimated physical load. In a second group of 43 perimenopausal women (47–60 years old), APU, which again decreased with age (r=−0.33, p〈0.05), was found not be correlated to BMD measured by SPA at the distal forearm (cortical bone). In a third group of 40 women (17–78 years old), APU again decreased with age (r=−0.60, p〈0.001) and was not correlated to BMD measured by SPA at the midphalanx of the middle finger, i.e. the same measuring location as APU. We conclude that this method provides information about the modulus of elasticity of bone with negligible influence of bone mineral density. Our results indicate that there is a deterioration of bone material quality with age independent of decreasing bone mineral density.
    Type of Medium: Electronic Resource
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