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1

Middle segment pancreatectomy can be safely incorporated into a pancreatic surgeon's clinical practice1  

UK PubMed Central (United Kingdom)

Middle segment pancreatectomy (MSP) is a new operation where the advantages of parenchymal preservation are counterbalanced by a high postoperative complication rate and unease among surgeons with adopting...Full Text Available

2008-12-01

2

Variations of endonasal anatomy: relevance for the endoscopic endonasal transsphenoidal approach  

UK PubMed Central (United Kingdom)

BackgroundThe endoscopic endonasal transsphenoidal approach (EETA) to the pituitary is performed by ear, nose, and throat (ENT) surgeons in collaboration with neurosurgeons but also...Full Text Available

2010-06-01

3

Surgeons' beliefs and perceptions about removal of orthopaedic implants  

UK PubMed Central (United Kingdom)

BackgroundThe routine removal of orthopaedic fixation devices after fracture healing remains an issue of debate. There are no evidence-based guidelines on this matter, and little...Full Text Available

4

Quality of Surgical Instruments  

UK PubMed Central (United Kingdom)

INTRODUCTIONMany surgeons will have encountered the scissors that would not cut, and the artery clip that comes off in a deep difficult location, but it would be reasonable to assume...Full Text Available

2006-07-01

5

The Use of Self-Expanding Plastic Stents in the Management of Oesophageal Leaks and Spontaneous Oesophageal Perforations  

UK PubMed Central (United Kingdom)

Leakage after oesophageal anastomosis or perforation remains a challenge for the surgeon. Traditional management has been operative repair or intensive conservative management. Both treatments are...Full Text Available

2011-01-01

6

TECAB - Totally Endoscopic Coronary Artery Bypass  

Medline Plus

... CT angiograph for the peripheral rteries. a beautiful 3D-vision on the structures inside e chest. Okay. ... have an angled camera here. This is a 3D camera, and the surgeon has got th What ...

7

Surgery for hip fractures: Does surgical delay affect outcomes?  

UK PubMed Central (United Kingdom)

Hip fractures are associated with a high rate of mortality and profound temporary and sometimes permanent impairment of quality of life. Current guidelines indicate that surgeons should perform surgery...Full Text Available

2011-01-01

8

Long-term results of extracapsular cataract extraction and posterior chamber intraocular lens insertion in Nepal.  

UK PubMed Central (United Kingdom)

We performed a prospective study evaluating the 2-year success rate of extracapsular cataract surgery and posterior chamber IOL insertion performed in 610 eyes by an experienced surgeon in the Nepal...Full Text Available

1991-01-01

9

Expression of genes for bone morphogenetic proteins BMP-2, BMP-4 and BMP-6 in various parts of the human skeleton  

UK PubMed Central (United Kingdom)

BackgroundDifferences in duration of bone healing in various parts of the human skeleton are common experience for orthopaedic surgeons. The reason for these differences is not obvious...Full Text Available

10

Increased M?ller Cell De-Differentiation After Grafting of Retinal Stem Cell in the Sub-Retinal Space of Royal College of Surgeons Rats  

British Library Electronic Table of Contents (United Kingdom)

In several vertebrate classes, the M?ller glia are capable of de-differentiating, proliferating, and acquiring a progenitor-like state in response to acute retinal injury or in response to exogenous growth factors. Our previous study has shown that M?ller cells can be activated and de-differentiated into retinal progenitors during Royal College of Surgeons (RCS) rats' degeneration, although the limited proliferation cannot maintain retinal function. We now report that rat retinal stem cells (rSCs) transplanted into RCS rats slowed the progression of retinal morphological degeneration and prevented the functional disruption. Further, we found that retinal progenitor cells labeled with Chx10 were increased significantly after rSCs transplantation, and most of them are mainly from activated M...

2011-01-01

11

Association of area sociodemographic characteristics and capacity for treatment with disparities in colorectal cancer care and mortality  

British Library Electronic Table of Contents (United Kingdom)

AbstractBACKGROUND: Disparities in treatment and mortality for colorectal cancer (CRC) may reflect differences in access to specialized care or other characteristics of the area where an individual lives. METHODS: Surveillance, Epidemiology and End Results Program-Medicare data for seniors diagnosed with CRC were linked to area measures of the sociodemographic characteristics and the capacity of surgeons, medical oncologists, and radiation oncologists. Outcomes included receipt of stage-appropriate CRC care and mortality. RESULTS: After adjustment, blacks and Hispanics were less likely than whites to undergo surgery (odds ratio [OR] 0.57, 95% confidence interval (CI) 0.52-0.63 and OR 0.82, 95% CI 0.70-0.95, respectively). Individuals who lived in areas with the highest tertile of surgeon c...

2011-01-01

12

State of Surgery in Tropical Africa: A Review  

British Library Electronic Table of Contents (United Kingdom)

This is a review of recently published literature on surgery in tropical Africa. It presents the current state of surgical need and surgical practice on the continent. We discuss the enormous burden of surgical pathology (as far as it is known) and the access to and acceptability of surgery. We also describe the available facilities in terms of equipment and manpower. The study looked at the effects of the human immunodeficiency virus, the role of traditional healers, anesthesia, and the economics of surgery. Medical training and research are discussed, as are medical migration out of Africa and the concept of task shifting, where surgical procedures are performed by others when surgeons are not available. It closes with recommendations for involvement and action in this area of great glob...

2011-01-01

13

[The contribution of N.I. Pirogov to the development of forensic medicine (on the occasion of his 200th birthday anniversary)].  

Science.gov (United States)

The main facets of professor N.I. Pirogov's professional activity are outlined. Forensic medicine (in the first place its organizational and practical aspects) was an integral component of his scientific and clinical work, along with applied anatomy and surgery. Landmark publications of N.I. Pirogov are listed with special reference to those concerned with forensic medical expertise of medical malpractice cases, postmortem inspection and intravital examination procedures, wound ballistics studies, the atlas of forensic pathology, etc. The surgeon and anatomist N.I. Pirogov can be justly regarded as a founder of forensic medicine in this country. PMID:21866839

14

Wound ballistics of gunshot injuries to the head and neck.  

Science.gov (United States)

It is important for the trauma surgeon to understand the basic principles of terminal gunshot ballistics and the study of the projectile's effect on striking soft tissue. The amount of kinetic energy dissipated to the tissue is directly related to the mass and velocity of the projectile as follows: K = MV2/2. Doubling the velocity quadruples the energy, while doubling the mass only doubles the energy. A temporary tissue cavity is produced as the striking projectile compresses the surrounding tissue; the higher the energy release, the more extensive the inapparent compressive damage. The permanent cavity that remains is the result of extrusion of tissue from the pathway of the projectile. The higher the velocity, the higher the likelihood of extensive damage. If the missile expands or fragments within the tissues, more damage will occur. PMID:6847483

1983-05-01

15

Systems-based approaches to osteoporosis and fracture care: policy and research recommendations from the workgroups  

British Library Electronic Table of Contents (United Kingdom)

Participants in the conference selected to attend two different working group sessions. The working groups discussed different perspectives of system-based approaches to osteoporosis and fracture care. The group on postfracture case management recommended that nurse case managers be used to improve communication among patients, orthopaedic surgeons, and those providing ongoing clinical care. The hospital working group discussed the impact of and barriers to improved postfracture management in the hospital setting. The health systems group emphasized the difference between a closed system in which long-term benefits of interventions were more likely to be appreciated than in fee for service systems. The health information technology group discussed the advantages and challenges of electroni...

2011-01-01

16

Single Setting Bilateral Laparoscopic Orchiopexy for Bilateral Intra-Abdominal Testicles  

British Library Electronic Table of Contents (United Kingdom)

Purpose The laparoscopic surgical approach to unilateral intra-abdominal testis has replaced the open approach at several large centers. There is considerable literature on experience with unilateral intra-abdominal testes but little on the management of bilateral intra-abdominal testes. We assessed the feasibility and safety of performing single setting bilateral laparoscopic orchiopexy in boys with bilateral intra-abdominal testes. Materials and Methods A single surgeon experience was reviewed. The surgical technique was similar in all cases and on each side, including infra-umbilical access, diagnostic evaluation, peritoneal mobilization lateral to the spermatic vessels and inferior to the vas deferens, gubernacular transection, and a decision for or against a Fowler-Stephens procedure ...

2008-01-01

17

Robotics in pediatric surgery: perspectives for imaging  

International Nuclear Information System (INIS)

Robotic surgery will give surgeons the ability to perform essentially tremorless microsurgery in tiny spaces with delicate precision and may enable procedures never before possible on children, neonates, and fetuses. Collaboration with radiologists, engineers, and other scientists will permit refinement of image-guided technologies and allow the realization of truly remarkable concepts in minimally invasive surgery. While robotic surgery is now in clinical use in several surgical specialties (heart bypass, prostate removal, and various gastrointestinal procedures), the greatest promise of robotics lies in pediatric surgery. We will briefly review the history and background of robotic technology in surgery, discuss its present benefits and uses and those being explored, and speculate on the future, with attention to the current and potential involvement of imaging modalities and the role of image guidance. (orig.)

2004-06-01

18

Relationships of the Lateral Femoral Cutaneous Nerve to Bony Landmarks  

British Library Electronic Table of Contents (United Kingdom)

Background The lateral femoral cutaneous nerve (LFCN) can be at risk during, for example, the insertion of pins in the anterior superior iliac spine (ASIS) during external fixation of the pelvis, total hip arthroplasty through a direct anterior approach, open surgery for impingement in the hip through an anterior approach, and periacetabular osteotomy. During surgery, the surgeon usually assumes the location of the LFCN by using the ASIS as a landmark. Questions/purposes We investigated (1) whether there is any relationship between the LFCN and the ASIS and (2) the anatomy of the LFCN at the lateral border of the psoas major. Methods Using 25 formalin-fixed cadavers, we determined the location of the LFCN emergence point as above, same level with, or below the iliac crest (IC). We measured...

2011-01-01

19

Postoperative pressure-induced alopecia after segmental osteotomy at the upper and lower frontal edentulous areas for distraction osteogenesis  

British Library Electronic Table of Contents (United Kingdom)

Introduction Postoperative alopecia is a relatively rare event, and therefore both patients and surgeons are puzzled once it develops even though it is said to improve spontaneously with time in most cases. We report a parieto-occipital pressure-induced alopecia firstly developed in a patient who had undergone repeated surgery for 10?years after a traffic accident. Case report A 29-year-old male underwent segmental osteotomy at the upper and lower frontal edentulous areas for distraction osteogenesis. Throughout the operation, he was in the supine position with the hair covered with a paper cap and the head on a plastic vinyl chloride-covered soft foam horseshoe-shaped urethane sponge placed on the horseshoe-shaped headrest. About 2?weeks after the surgery, two patches of parieto-occipital...

2011-01-01

20

Outcomes of extremely low risk prostate cancer following radical prostatectomy  

British Library Electronic Table of Contents (United Kingdom)

The optimal management of men with very favorable clinicopathological factors who develop biochemical recurrence (BCR) after radical prostatectomy (RP) has not been previously reported. Both local and systemic recurrences are unlikely in this cohort. This study examines their management and outcomes. Between October 2000 to March 2010, 1627 men underwent open RP by a single surgeon. In all, 448 (27.5%) met the following criteria for extremely low risk disease: preoperative PSA level <10?ng?ml?1, clinical stage T1c/T2a, Gleason score ?6, estimated cancer volume in the surgical specimen ?5% and no evidence for positive surgical margin. Undetectable PSA was defined as ?0.04?ng?ml?1. BCR was defined as PSA ?0.2?ng?ml&#...

2011-01-01

 
 
 
 
21

MRI imaging of fetal neck masses with airway compromise: utility in delivery planning  

International Nuclear Information System (INIS)

We present two cases of fetal neck masses that were initially diagnosed by ultrasound and further evaluated with prenatal MRI. MRI findings aided in further delineating the neck masses, increasing confidence in the final diagnosis (cervical teratoma and cystic hygroma). With the fetal airway typically filled with fluid that is of high signal on T2-weighted sequences, MRI images in three planes could identify whether the fetal larynx and trachea were partially or completely compressed by the neck tumor. This information was particularly useful in determining if a controlled delivery such as ex utero intrapartum treatment (EXIT) was necessary and aided the surgeons in planning their approach to establishing airway control in the delivery room. (orig.)

2001-10-01

22

Laboratory techniques for determining the effects of pyridostigmine bromide. Interim report, May 1985-May 1986  

Energy Technology Data Exchange (ETDEWEB)

The USAF Surgeon General approved pyridostigmine bromide (PB) pretreatment for flying personnel as of 21 March 1986. However, specific side effects resulting from taking PB during high sustained + G/sub z/ stress, altitude stress, and periods of potential spatial disorientation had not yet been fully investigated. The USAF school of Aerospace Medicine (UASFSAM), Crew Technology Division, was therefore tasked with this clinical research effort. For effective investigation of these potential problem areas, rapid and accurate methods have had to be established for determining the blood plasma PB levels and the resultant inhibition of acetylcholinesterase activity. The basic purpose of this report is to describe in detail the analytical techniques used at USAFSAM to support the clinical research programs involving the physiological and performance aspects of USAF aircrews taking PB.

1986-11-01

23

Information-seeking behaviour and coping style of women opting for either implant or DIEP-flap breast reconstruction  

British Library Electronic Table of Contents (United Kingdom)

Background: High satisfaction rates have been reported after autologous breast reconstruction. Yet, most mastectomy patients receive implant reconstructions (ImBR). Independent and active decision makers have shown mainly to choose for autologous reconstructions, such as the Deep inferior epigastric perforator (DIEP) flap (DiepBR). To further explore the decision making to opt for either ImBR or DiepBR, we investigated patient knowledge, informational resources used, effect of plastic surgeons' advice, coping style and personal independence. Methods: A total of 153 women, who were planned for DiepBR or ImBR preoperatively, completed a study-specific and standardised validated psychological questionnaire. Analyses were aimed at information-seeking behaviour, personal independence and coping...

2011-01-01

24

Importance of preoperative imaging with 64-row three-dimensional multidetector computed tomography for safer video-assisted thoracic surgery in lung cancer  

British Library Electronic Table of Contents (United Kingdom)

Purpose Video-assisted thoracic surgery (VATS) has recently been adopted for complicated anatomical lung resections. During these thoracoscopic procedures, surgeons view the operative field on a two-dimensional (2-D) video monitor and cannot palpate the organ directly, thus frequently encountering anatomical difficulties. This study aimed to estimate the usefulness of preoperative three-dimensional (3-D) imaging of thoracic organs. Methods We compared the preoperative 64-row three-dimensional multidetector computed tomography (3DMDCT) findings of lung cancer-affected thoracic organs to the operative findings. Results In comparison to the operative findings, the branches of pulmonary arteries, veins, and bronchi were well defined in the 3D-MDCT images of 27 patients. Conclusion 3D-MDCT imag...

2009-01-01

25

Identification and validation of a logistic regression model for predicting serious injuries associated with motor vehicle crashes  

British Library Electronic Table of Contents (United Kingdom)

A multivariate logistic regression model, based upon National Automotive Sampling System Crashworthiness Data System (NASS-CDS) data for calendar years 1999-2008, was developed to predict the probability that a crash-involved vehicle will contain one or more occupants with serious or incapacitating injuries. These vehicles were defined as containing at least one occupant coded with an Injury Severity Score (ISS) of greater than or equal to 15, in planar, non-rollover crash events involving Model Year 2000 and newer cars, light trucks, and vans. The target injury outcome measure was developed by the Centers for Disease Control and Prevention (CDC)-led National Expert Panel on Field Triage in their recent revision of the Field Triage Decision Scheme (American College of Surgeons, 2006). The ...

2011-01-01

26

Application of microvascular free osteocutaneous flaps in the management of post-radiation recurrent oral cancer  

Energy Technology Data Exchange (ETDEWEB)

Fifty-nine patients underwent free flap osteocutaneous reconstruction that consisted of flaps of the dorsum of the foot in 26 patients and iliac crest flaps in 33 with a success rate of 92 percent and a mortality rate of 1.6 percent. These flaps, which require the expertise of microvascular surgeons, are time-consuming and complicate operating room and time management, but they represent a remarkable advance in reconstruction that can facilitate cosmetic and functional recovery of the patient. In particular, they promote healing in radiation-recurrent oral cancer and represent a definitive form of management for established radionecrosis of the mandible. The large volume of tissue available with iliac crest osteocutaneous grafts permits the management of patients with extensive cancer involving the skin, mucosa, and bone, but cancer control may still be disappointing and there is a need for improved adjuvant chemotherapy protocols. This technique appears to be a ...

1985-10-01

27

Unsolved problems in the diagnosis and surgical treatment of intramedullary tumors  

Energy Technology Data Exchange (ETDEWEB)

Problems and solutions in the diagnosis and operative treatment were clarified by retrospective evaluation of cases of intramedullary tumor in which MRI and surgery had been performed. The subjects were 16 patients (21-75 years old, mean age: 45 years) whose tumor was surgically removed between 1991 and 1998. MRI was performed preoperatively, and T1-weighted images, T2-weighted images, and enhanced images were obtained. Angiography was also performed in some cases. The histological diagnosis based on the MRI findings before surgery were compared with the pathological diagnosis after the operation. In 9/16 cases (56%), the preoperative histological diagnosis based on the MR images was the same as the pathological diagnosis after the operation. In 8 of the 11 cases (73%) whose images showed clear tumor margins and well shaped the tumor, the tumors were completely removed. The concordance rate between the pathological diagnosis during and after the operation was 67%. Spinal cord ...

2001-04-01

28

Visual recovery after vitrectomy for macular hole using 25-gauge instruments  

British Library Electronic Table of Contents (United Kingdom)

Abstract. Purpose: To determine whether vitrectomy with 25-gauge instruments contributes to better postoperative visual recovery after macular hole (MH) surgery. Methods: The medical records for 46 consecutive eyes operated for MH by a single surgeon were retrospectively examined. Vitrectomy had been performed with a 25-gauge instrument in 23 eyes (25-G group) and with a 20-gauge instrument in 23 eyes (20-G group). Postoperative visual acuity (VA) in logMAR (logarithm of the minimum angle of resolution) units after 1 week and 1, 3, 6, 9 and 12 months, operating time, and volume of intraocular irrigating fluid were compared between the two groups. Results: Mean preoperative logMAR VA was 0.72 in the 25-G group and 0.68 in the 20-G group (p = 0.282, unpaired t-test). One week after surgery, ...

2008-01-01

29

Value of ultrasonography, Ct and MR imaging in the diagnosis of primary hyperparathyroidism  

Energy Technology Data Exchange (ETDEWEB)

Purpose: To evaluate the significance of preoperative localization of abnormal parathyroid glands to the surgical outcome in patients with primary hyperparathyroidism. Material and Methods: Thirty-nine patients with primary hyperparathyroidism were studied preoperatively with US (39 patients), CT (30 patients) and MR imaging (18 patients). The overall diagnostic accuracy for US was 87%, CT 66% and MR 94%. In patients with a single parathyroid adenoma US was the most cost-effective localization technique with a detection rate of 96%. CT had a lower detection rate (78%) but was of particular value for fairly large ectopic adenomas in the root of the neck. MR imaging was a good confirmatory test (93%). In patients with multiple gland disease (primary hyperplasia and multiple adenomas), no single localization study alone was sufficient. Combination of all 3 studies, however, alerted the physician to the presence of disease in more than one gland in 87% of these patients. Conclusion: US, CT ...

1996-09-01

30

Treatment of cancer of the pancreas by intraoperative electron beam therapy: physical and biological aspects  

Energy Technology Data Exchange (ETDEWEB)

Radiation therapy has had a significant and an expanded role in the management of cancer of the pancreas during the last decade. In particular, for locally advanced disease, radiation therapy has improved the median survival of patients to 1 year. Intraoperative electron beam therapy has been applied to unresectable and resectable pancreatic cancer in an attempt to enhance local control of disease and to improve patient survival. This paper presents a survey of the role of radiation therapy in treatment of cancer of the pancreas, provides information on the radiobiological aspects of this treatment modality and details the physical and dosimetric characteristics of intraoperative radiation therapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, applicator parameters, dose distribution data, shielding, treatment planning and means of verification. Emphasis is placed on the collaboration and cooperation necessary for all members of the ...

1989-01-01

31

Treatment of cancer of the pancreas by intraoperative electron beam therapy: physical and biological aspects  

International Nuclear Information System (INIS)

Radiation therapy has had a significant and an expanded role in the management of cancer of the pancreas during the last decade. In particular, for locally advanced disease, radiation therapy has improved the median survival of patients to 1 year. Intraoperative electron beam therapy has been applied to unresectable and resectable pancreatic cancer in an attempt to enhance local control of disease and to improve patient survival. This paper presents a survey of the role of radiation therapy in treatment of cancer of the pancreas, provides information on the radiobiological aspects of this treatment modality and details the physical and dosimetric characteristics of intraoperative radiation therapy with electrons. Presented are the design specifics of an applicator system, central axis beam data, applicator parameters, dose distribution data, shielding, treatment planning and means of verification. Emphasis is placed on the collaboration and cooperation necessary for all members of the ...

32

Localization of abnormal parathyroid glands using thallium-201  

Science.gov (United States)

Ectopically located parathyroid adenomas may be difficult to find during initial neck exploration. They account for over 70 percent of missed adenomas found at reexploration. Preoperative localization of parathyroid adenomas would reduce unnecessary dissection and possibly reduce the number of negative results of initial neck exploration. Before reoperative parathyroid surgery is performed, some means of localization is mandatory to detect ectopic adenomas in the neck and mediastinum. Computed tomography and ultrasonography cannot effectively evaluate the mediastinum. Angiography and venous parathyroid hormone sampling are invasive, costly, and tedious to perform. We have shown that thallium-201 will accurately localize ectopic parathyroid adenomas. All 10 adenomas found in positions not immediately adjacent to the thyroid gland were detected by thallium-201 scintigraphy. One was a mediastinal adenoma resected with a median sternotomy. Our results suggest that thallium-201 scintigraphy ...

1984-07-01

33

Is turbinate surgery necessary when performing a septoplasty?  

Science.gov (United States)

Many otolaryngologists perform septoplasty with or without turbinate surgery and the surgical method relies largely on the surgeon's clinical judgment. This study used computed tomography (CT) of the sinuses of 20 patients to examine the correlation between a unilateral deviated nasal septum and compensatory hypertrophy of the contralateral inferior turbinate to suggest guidelines for septal and turbinate surgery. The thickness of the mucosa and conchal bone, the projection angle of the conchal bone, and the distances between the conchal bone, and lateral nasal line and median line were measured. The volume of the inferior turbinate was measured from the three-dimensional reconstruction. Each measurement was compared with those of the nasal cavity on the contralateral and of normal control subjects. The inferior turbinate on the concave side had a significantly greater volume, including the thickness of medial mucosa and the thickness and projection angle of ...

2008-11-11

34

Infected nonunion of the long bones.  

Science.gov (United States)

BACKGROUND: Although definitions vary, infected nonunion has been defined as a state of failure of union and persistence of infection at the fracture site for 6 to 8 months.>). Infected nonunions of the supracondylar region of the femur are uncommon and are mostly due to a severe open fracture with extensive comminution and segmental bone loss or after internal fixation of a comminuted closed fracture. Associated factors include exposed bone devoid of vascularized periosteal coverage for more than 6 weeks, purulent discharge, a positive bacteriological culture from the depth of the wound, and histologic evidence of necrotic bone containing empty lacunae. Soft-tissue loss with multiple sinuses, osteomyelitis, osteopenia, complex deformities with limb-length inequality, stiffness of the adjacent joint, polybacterial multidrug-resistant infection, and smoking all complicate treatment and recovery. Although uncommon in incidence, infected nonunions of the long bones present a great ...

2007-08-01

35

Function-preserving surgery for rectal cancer  

International Nuclear Information System (INIS)

When total mesorectal excision (TME) is accurately performed, dysfunction, theoretically, does not occur. However, there are differences among individuals in the running patterns and the volumes of nerve fibers, and if obesity or a narrow pelvis is present, nerve identification is difficult. Currently, the rate of urinary dysfunction after rectal surgery ranges from 33% to 70%. Many factors other than nerve preservation play a role in minor incontinence. Male sexual function shows impotence rates ranging from 20% to 46%, while 20%-60% of potent patients are unable to ejaculate. In women, information on sexual function is not easily obtained, and there are more unknown aspects than in men. As urinary, sexual, and defecation dysfunction due to adjuvant radiotherapy have been reported to occur at a high frequency, the creation of a protocol that enables analysis of long-term functional outcome will be essential for future clinical trials. In the treatment of rectal cancer, ...

2006-10-01

36

Visual search behaviour in skeletal radiographs: a cross-speciality study  

Energy Technology Data Exchange (ETDEWEB)

Aim: To determine whether experience improves the consistency of visual search behaviour in fracture identification in plain radiographs, and the effect of specialization. Material and methods: Twenty-five observers consisting of consultant radiologists, consultant orthopaedic surgeons, orthopaedic specialist registrars, orthopaedic senior house officers, and accident and emergency senior house officers examined 33 skeletal radiographs (shoulder, hand, and knee). Eye movement data were collected using a Tobii 1750 eye tracker with levels of diagnostic confidence collected simultaneously. Kullback-Leibler (KL) divergence and Gaussian mixture model fitting of fixation distance-to-fracture were used to calculate the consistency and the relationship between discovery and reflective visual search phases among different observer groups. Results: Total time spent studying the radiograph was not significantly different between the groups. However, the expert groups had a ...

2007-11-15

37

Usefulness of Computed Tomography in pre-surgical evaluation of maxillo-facial pathology with rapid prototyping and surgical pre-planning by virtual reality  

International Nuclear Information System (INIS)

Purpose. To validate a protocol for creating virtual models to be used in the construction of solid prototypes useful for the planning-simulation of maxillo-facial surgery, in particular for very complex anatomical and pathologic problems. To optimize communications between the radiology, engineering and surgical laboratories. Methods and materials. We studied 16 patients with different clinical problems of the maxillo-facial district. Exams were performed with multidetector computed tomography (MDCT) and single slice computed tomography (SDCT) with axial scans and collimation of 0.5-2 mm, and reconstruction interval of 1 mm. Subsequently we performed 2D multiplanar reconstructions and 3D volume-rendering reconstructions. We exported the DICOM images to the engineering laboratory, to recognize and isolate the bony structures by software. With these data the solid prototypes were generated using stereolitography. To date, surgery has been preformed on 12 patients after simulation of the ...

2005-11-01

38

Native kidney reincarnation following a failed transplant  

International Nuclear Information System (INIS)

Full text: A 51-year-old woman with end stage renal failure secondary to Haemolytic Uraemic syndrome underwent a cadaveric renal transplant. A routine post transplant DTPA scan was performed which demonstrated satisfactory renal transplant perfusion and function. Incidental note was made of tracer uptake in the pelvis in the mid-line, which was suspected to be a uterine fibroid. This was confirmed on ultrasonography and at surgery. One week post transplantation the patient became acutely unwell and at laparotomy a perforated diverticular abscess was drained. Intraoperatively the transplant kidney was examined and the surgeon thought there was a area of infarction. This was confirmed on biopsy. As the patient's creatinine was rising a repeat DTPA study was performed. Perfusion and function of the transplant kidney was virtually absent while Doppler studies showed no flow. The patient however continued to produce urine and the creatinine was stable. Subsequently a ...

2002-05-04

39

Distinguishing benign notochordal cell tumors from vertebral chordoma  

Energy Technology Data Exchange (ETDEWEB)

The objective was to characterize imaging findings of benign notochordal cell tumors (BNCTs). Clinical and imaging data for 9 benign notochordal cell tumors in 7 patients were reviewed retrospectively. Conventional radiographs (n = 9), bone scintigrams (n = 2), computed tomographic images (n = 7), and magnetic resonance images (n = 8) were reviewed. Eight of the 9 lesions were stained with hematoxylin-eosin and microscopically examined. There were 3 male and 4 female patients with an age range of 22 to 55 years (average age, 44 years). Two patients had two lesions at different sites. The lesions involved the cervical spine in 4 patients, the lumbar spine in 2, the sacrum in 2, and the coccyx in 1. The most common symptom was mild pain. The lesions of 2 patients were found incidentally during imaging studies for unrelated conditions. Five patients underwent surgical procedures. One patient died of surgical complications. All other patients have been well without recurrent or progressive ...

2008-04-15

40

The role of 3D Helical CT in the reconstructive treatment of maxillofacial cancers  

International Nuclear Information System (INIS)

Purpose of this work is to investigate the role of Helical CT and the usefulness of three-dimensional (3D) imaging for pre-operative planning and follow-up of reconstructive maxillofacial surgery with alloplastic material in neoplastic disease involving this region. From 1996 to 1999 eleven patients were examined with Helical CT and 3D images for planning of maxillofacial plastic and reconstructive surgery for advanced cancer of this anatomically complex region. A 3D-modulated titanium mesh (100%) or micro nets was used to rebuild the anterior surface of maxillary bone and the orbital floor. The mesh was cut to the appropriate size and shape and curved where necessary. Within the residual sinusal cavity a siliconed filling was used surmounting an acrylic prosthesis with dental arch to rebuild the palate. A rehydrated bovine pericardium was affixed and moduled on the borders in two cases only. Three-dimensionally reconstructed CT images were obtained preoperatively and at least 6 months ...

2000-12-01

 
 
 
 
41

Liver trauma from penetrating injuries. Miscellanea, personal series, clinical and CT findings  

International Nuclear Information System (INIS)

Penetrating liver wounds are related to many causes and rank second after blunt abdominal and liver trauma. In this report are examined the clinical and radiological findings of personal series of patients with penetrating trauma, especially by firearms and stab and cut wounds. It will also tried to define the diagnostic workup of these traumas, which is especially based on CT signs of liver damage and associated changes and which is of basic importance for following treatment, both surgical or conservative. In the last seven years it was retrospectively reviewed 31 cases of penetrating liver trauma. The patients were 19 men and 12 women, ranging in age 18 to 73 (mean 42), with penetrating liver injuries from firearms (16 patients) and stab (9 cases) wounds; 6 patients had injuries from different cases. Abdominal CT was carried out in emergency with the CT Angiography (CTA) technique in all patients. In the patients with suspected chest and abdomen involvement CT was performed from the ...

2000-12-01

42

Gunshot wounds to the head. Correlations between CT and clinical findings, neurosurgical treatment and long-term sequels; Traumi cranio-encefalici da proiettile: correlazione tra tomografia computerizzata, clinica, trattamento neurochirurgico e sequele a distanza  

Energy Technology Data Exchange (ETDEWEB)

With the aim of demonstrating the usefulness of computerised tomography (CT) findings in the planning of brain neurosurgery in gunshot victims, for prompt and successful treatment, 30 patients with brain gunshot wounds were examined with CT over 5 years. The mortality rate of firearm wounds of the skull base was 34% higher than that of the hemisphere; this is due to carotid hemorrhage and midbrain damage. Such traumas require emergency radiological diagnosis and neurosurgical treatment because of their severity and early irreversible complications. Complex operations and skilled surgeons may prevent disabling postoperative sequels. CT findings are indispensable and must be correctly interpreted. The radiologist and the neurosurgeon must collaborate closely and both must consider several diagnostic factors affecting surgical planning. [Italian] Scopo dello studio e' stato quello di dimostrare l'utilita' della semeiologia della tomografia ...

2000-03-01

43

Liver trauma from penetrating injuries. Miscellanea, personal series, clinical and CT findings; Traumi epatici da lesioni penetranti. Miscellanea, casistica personale, aspetti clinici e con Tomografia Computerizzata  

Energy Technology Data Exchange (ETDEWEB)

Penetrating liver wounds are related to many causes and rank second after blunt abdominal and liver trauma. In this report are examined the clinical and radiological findings of personal series of patients with penetrating trauma, especially by firearms and stab and cut wounds. It will also tried to define the diagnostic workup of these traumas, which is especially based on CT signs of liver damage and associated changes and which is of basic importance for following treatment, both surgical or conservative. In the last seven years it was retrospectively reviewed 31 cases of penetrating liver trauma. The patients were 19 men and 12 women, ranging in age 18 to 73 (mean 42), with penetrating liver injuries from firearms (16 patients) and stab (9 cases) wounds; 6 patients had injuries from different cases. Abdominal CT was carried out in emergency with the CT Angiography (CTA) technique in all patients. In the patients with suspected chest and abdomen involvement CT was performed from the ...

2000-12-01