karachi intracranial stenosis: Topics by WorldWideScience.org

Stent-assisted recanalization of atherosclerotic intracranial stenosis

The computational fluid dynamics methods for the limited flow rate and the small dimensions of an intracranial artery stenosis may help demonstrate the stroke mechanism in intracranial atherosclerosis....Full Text Available

2011-07-01

Large intracranial vessel occlusion arising after radiotherapy for craniopharingioma. A case report and review of the literature

Intracranial atherosclerosis is a major cause of ischemic stroke, and depending on the studied population, it accounts for 8%-15% of all strokes that are due to cerebral atherosclerosis. The prognosis of patients with symptomatic intracranial stenoses seems to depend on the location and extent of intracranial atherosclerosis. Currently, the primary treatment in intracranial atherosclerosis is the control of vascular risk factors such as hypertension, diabetes, hypercholesterolemia, and smoking. Secondary prevention with antiplatelet therapy has been shown to reduce the risk of subsequent vascular events in patients who have suffered a recent ischemic stroke or transient ischemic attack (TIA). Unfortunately, a significant number of patients with intracranial atherosclerosis continue to suffer from repeated strokes or TIA despite maximal medical treatment. Although endovascular ...

2006-09-01

Large intracranial vessel occlusion arising after radiotherapy for craniopharingioma. A case report and review of the literature

We report a patient who developed occlusion of the intracranial major arteries induced by radiation therapy for craniopharyngioma. The patient, a 9-year-old boy, presented with deterioration of vision, nausea and vomiting. He underwent a right ventriculo-peritoneal shunt operation, and the tumor was partially removed. Postoperatively, he received focal radiation therapy with total of 60 Gy. Preoperative cerebral angiography, cerebral vessels had no sigh of occlusive lesion or stenosis. One year after irradiation, he started to have repeated cerebral ischemic attacks. But no regrowth of the tumor was detected on CT scans. Two years and 8 months after irradiation, he suddenly had right hemiparesis. Cerebral angiography revealed severe stenosis of the right anterior cerebral artery (precommunicating segment), middle cerebral artery (horizontal portion) and terminal portion of the right carotid artery. Left carotid angiography ...

1994-10-01

Treatment of intracranial atherosclerotic stenoses with balloon dilatation and self-expanding stent deployment (WingSpan)

1994-01-01

Knowledge and Awareness about Cervical Cancer and Its Prevention amongst Interns and Nursing Staff in Tertiary Care Hospitals in Karachi, Pakistan

The endovascular treatment of atherosclerotic intracranial arterial stenoses has previously been based on balloon dilatation or the deployment of a balloon expandable stent. Both methods have advantages (balloon: flexibility; balloon expandable stent: high radial force) and drawbacks (balloon: risk of elastic recoil and dissection; balloon expandable stent: limited flexibility, risk of injury to the vessel due to excessive straightening, overexpansion at ends of stent). A new combination of balloon dilatation, followed by the deployment of a self-expanding microstent has been applied in 15 patients with atherosclerotic arterial stenoses, symptomatic despite medical treatment. An anatomically and clinically adequate result was achieved in all patients. The initial degree of stenosis was 72% (mean). Balloon dilatation resulted in an average residual stenosis of 54% (mean), reduced further to a mean of 38% after stent ...

2005-03-01

Close to Transplant Renal Artery Stenosis and Percutaneous Transluminal Treatment

Background and ObjectiveCervical cancer is one of the leading causes of morbidity and mortality amongst the gynecological cancers worldwide, especially in developing countries. It...Full Text Available

MR Appearances of Intracranial Tumors with a Low Tesla (0.064 T) Permanent MR System

Purpose. To evaluate the efficacy of percutaneous transluminal angioplasty (PTA) in the management of arterial stenosis located close to the allograft anastomosis (close-TRAS)....Full Text Available

2011-01-01

KoreaScience (Korea)

Full Text Available

1993-09-01

Foraminal stenosis complicating retained broken epidural needle tip -A case report-

Flexible bronchoscopic management of benign tracheal stenosis: long term follow-up of 115 patients

2010-12-01

Automatic stenosis detection and quantification in renal arteriography.

BackgroundManagement of benign tracheal stenosis (BTS) varies with the type and extent of the disease and influenced by the patient's age and general health status, hence we sought...Full Text Available

Early Experience in the Treatment of Intra-Cranial Aneurysms by Endovascular Flow Diversion: A Multicentre Prospective Study

Visual assessment of the degree of renal artery stenosis on renal arteriography has a large inter- and intraobserver variability. This degree is usually estimated by the ratio between the most narrowed...Full Text Available

1997-01-01

A rare case of intracranial metastatic amelanotic melanoma with cyst

IntroductionFlow diversion is a new approach to the endovascular treatment of intracranial aneurysms which uses a high density mesh stent to induce sac thrombosis. These devices...Full Text Available

Large intracranial vessel occlusive vasculopathy after radiation therapy in children: clinical features and usefulness of magnetic resonance imaging.

A rare case of intracranial metastatic amelanotic melanoma with cyst is presented. The patient was a 51 year old woman with a malignant melanoma arising on her right chest. Two years after a wide excision,...Full Text Available

2003-07-01

Large intracranial vessel occlusive vasculo-pathy after radiation therapy in children: clinical features and usefulness of magnetic resonance imaging

PMID:9226309

1997-05-01

Prognostic implications of pulmonary hypertension in patients with severe aortic stenosis

No abstract prepared

1998-03-01

British Library Electronic Table of Contents (United Kingdom)

ObjectiveWe sought to determine the clinical outcomes of patients undergoing surgical aortic valve replacement with hemodynamically confirmed severe pulmonary hypertension and aortic stenosis and compare them with the outcomes of patients not undergoing aortic valve replacement and patients undergoing aortic valve replacement with mild-to-moderate pulmonary hypertension. MethodsA total of 317 patients with severe aortic stenosis (aortic valve area 35 mm Hg) was present in 81 patients, of whom 35 (43.2%) underwent surgical aortic valve replacement. We compared the clinical outcomes of these 35 patients with the 46 patient...

2011-01-01

Foraminal stenosis complicating retained broken epidural needle tip -A case report-.

Repair of a Complex Congenital Cardiac Defect

Lumbar epidural anesthesia is useful in a variety of chronic benign pain syndromes, including lumbar radiculopathy, low back pain syndrome, spinal stenosis, and vertebral compression fractures. Given the increased number of epidural nerve blocks being performed, some have reported unexplained complications of a transient or permanent nature and with varying degrees of severity. However, no case has been reported of a broken epidural needle tip retained in the lumbar facet joint area. This represents the first reported case presentation of foraminal stenosis developing in a patient after a retained epidural needle tip. PMID:21286465

2010-12-31

Medline Plus

... stenosis. It looks from the transesophageal and the 3-D echo that most of the problem is really ... posterior leaflet, which you can see on the 3-D echo image is a major source. The anterior ...

Renal artery stenosis after radiotherapy for Ewing's sarcoma

Nascent Aneurysm Formation at the Basilar Terminus Induced by Hemodynamics

Background: the fact that therapeutic irradiation can induce significant stenosis in the arteries of the head, neck, and chest, as welt as in the aorta and the iliac arteries, is familiar in daily practice and well documented in the literature. By contrast, radiation-induced renal artery stenosis seems to be a less widely known complication. Patients and methods: the sudden onset of medically refractory arterial hypertension and coma in a 27-year-old man is reported, who had been treated at age 20 with chemotherapy and radiotherapy for Ewing's sarcoma in the lumbar region. This treatment had been performed at the hospital of Sion, Switzerland in 2001. Also, the relevant literature from 1965 to 2007 is reviewed to underscore various aspects of this problem and to demonstrate the clinical relevance of renal artery stenosis as a potential long-term sequela of radiotherapy. Conclusion: radiation-induced renal artery ...

2008-09-01

Bullet injuries of the brain

Background and PurposeHemodynamic insults at arterial bifurcations are hypothesized to play a key role in intracranial aneurysm formation. This study investigates...Full Text Available

2008-07-01

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Should coronary angiography be the gold standard? A study correlating thallium myocardial scintigraphy, translesional pressure gradient and percent stenosis

Experience gained with a wide variety of missile injuries of the brain is presented. Clinical signs and intracranial pressure (ICP) studied in the early post-injury period have been correlated with...Full Text Available

1974-09-01

Assessing aortic valve area in aortic stenosis by continuity equation: a novel approach using real-time three-dimensional echocardiography

Coronary angiography provides anatomical information whereas thellium myocardial scintigraphy measures resistive tissue perfusion. Because of this fundamental difference. The authors question the validity of using coronary angiography as the gold standard to judge thellium myocardial scintigraphy. The authors studied 20 patients undergoing elective percutaneous coronary angioplasty who fulfilled the following criteria: (1) history of chest pain; (2) angiographically significant single vessel disease (>50% stenosis); (3) no prior myocardial infarction. All patients underwent maximal exercise thallium single photon emission computed tomography (T1-SPECT). Tl-SPECT was scored visually according to a 0 to 3 scale (0=absent uptake; 1=markedly decreased uptake; 2=minimally decreased uptake; 3=normal uptake). Translesional gradient and percent stenosis were measured before and after angioplasty. The authors found that significant linear ...

1985-06-02

Magnetic resonance imaging in acute intractional tuberculosis

AimsTwo-dimensional echocardiographic (2DE) continuity-equation derived aortic valve area (AVA) in aortic stenosis (AS) relies on non-simultaneous measurement of left ventricular...Full Text Available

2008-10-01

Intracranial tuberculoma: MR imaging

Bilateral brachial pull-through technique for stenting in a patient with stenosis of the vertebral artery origin: technical case report

MR studies of 6 patients with intracranial tuberculoma are reviewed. All patients also underwent CT scans which showed hypo- or isodense lesions with abnormal enhancement following contrast administration. MR showed lesions with prolongation of the T1 relaxation time in every case. On the T2-weighted sequences, the signal properties of the tuberculoma varied according to the stage of evolution of the lesion. Incipient tuberculomas appeared as scattered areas of hypointensity surrounded by edema. Mature tuberculomas were composed of a dark necrotic center surrounded by an isointense capsule which was, in turn, surrounded by edema. In one patient, the center of the lesion was hyperintense probably because of liquefaction and pus formation (tuberculous abscess). While both, CT and MR, were equally sensitive in visualizing the intracranial tuberculoma in every patient, MR was slightly superior in demonstrating the extent of the lesion, especially ...

1988-11-01

Radiation-induced large intracranial vessel occlusive vasculopathy.

Stenting for stenosis of the proximal vertebral artery (VA) is commonly performed via a femoral approach. However, iliofemoral occlusive disease such as arteriosclerosis obliterans sometimes prevents safe transfemoral access. In certain situations where both femoral access and ipsilateral brachial access are difficult because of a concomitant vascular diseases or particular anatomic setting, a contralateral brachial approach using the brachiobrachial pull-through technique may allow efficient and accurate stenting. A case of VA origin symptomatic stenosis successfully treated with stenting using the new pull-through technique from the contralateral brachial artery to the brachial artery on the affected side is described. (orig.)

2007-10-01

Radiation-induced large intracranial vessel occlusive vasculopathy

Two patients who developed large intracranial vessel occlusion after standard radiation therapy for brain tumor are described. This form of vascular occlusion is usually seen in patients who have previously been treated by radiotherapy for intracranial tumor who then develop a relatively acute change in neurologic status. Histology of the lesion mimics accelerated focal arteriosclerosis. The clinical and radiographic manifestations of one case were highly atypical. The vasculopathy became evident shortly after termination of radiation therapy for a fourth ventricular ependymoma, and the angiographic picture stimulated a diffuse arteritis. The second patient was more typical, with clinical symptoms developing 12 years after radiation therapy for an oligodendroglioma. Occlusion of a proximal vessel that had been included in the radiation port was demonstrated radiographically and confirmed by pathologic examination. The clinical, angiographic, ...

1980-01-01

The interventional treatment for biliary re-stenosis after metallic stents placement in patients with malignant obstruction due to cholangiocarcinoma

1980-01-01

Lower Urinary Obstruction in Infancy

Objective: To explore the interventional treatment for biliary re-stenosis after metallic stents placement in patients due to cholangiocarcinoma and evaluate its therapeutic effect. Methods: Percutaneous metallic stents placement or combined with continuously infusion arterial chemotherapeutic and chemotherapeutic embolization were performed in 12 patients with biliary re-stenosis using 12 metallic stents. Results: Once stent placement was 100% successful in all 12 cases, TBIL, ALT, GTP and AKP values 7 days postoperatively were significantly lower than that in preoperation. Jaundice was reduced satisfactorily in 12 patients. 3 patients were undergone continuously arterial chemotherapeutics infusion and chemotherapeutic embolization 4 weeks after stents placement. Conclusions: Percutaneous replacement of biliary metallic stents was effective and safe for palliation of malignant biliary re-stenosis and would be much better ...

2002-10-01

Left Main Coronary Stenosis as a Consequence of Bentall Operation: Percutaneous Treatment

This paper reviews 165 cases of lower urinary obstruction in infancy. The commonest lesions were posterior urethral valves (91) and ectopic ureterocele (34), stenosis or atresia of the urethra (8),...Full Text Available

1972-04-01

Fabrication and in vitro deployment of a laser-activated shape memory polymer vascular stent

A 65-year-old man suffering from ascending aorta aneurysm and atherosclerotic three vessel disease without left main involvement underwent aortic root replacement with coronary ostia reimplantation...Full Text Available

2009-01-01

Drug-Eluting Stents versus Bare Metal Stents in Unprotected Left Main Coronary Artery Stenosis: a Meta-Analysis

BackgroundVascular stents are small tubular scaffolds used in the treatment of arterial stenosis (narrowing of the vessel). Most vascular stents are metallic and are deployed either...Full Text Available

Carotid Stenting vs Endarterectomy: New Results in Perspective

ObjectivesWe undertook a meta-analysis to assess outcomes for drug-eluting (DES) and bare metal stents (BMS) in percutaneous coronary intervention (PCI) for unprotected...Full Text Available

2010-06-01

Simulation of propofol anaesthesia for intracranial decompression using brain hypothermia treatment

Carotid artery stenosis is a major risk factor for stroke, and treatments for this condition to decrease the risk of stroke include medical therapy, carotid endarterectomy (CEA), and, more recently,...Full Text Available

2010-12-01

Large intracranial vessel occlusive vasculo-pathy after radiation therapy in children: clinical features and usefulness of magnetic resonance imaging

BackgroundAlthough propofol is commonly used for general anaesthesia of normothermic patients in clinical practice, little information is available in the literature regarding the...Full Text Available

Hemangiopericytomas of the spine: case report and review of the literature

English Mar 1998 p. 278 France Omura, M. Aida, N. Sekido, K. Kakehi,

1998-03-01

Detrended Fluctuation Analysis of Intracranial Pressure Predicts Outcome Following Traumatic Brain Injury

We describe a rare case of a primary intracranial meningeal hemangiopericytoma (HPC) with late metastasis to the cervical spine. A 36-year-old woman had a left occipital lesion that was histopathologically...Full Text Available

A Case of Neurocysticercosis in Entire Spinal Level

Detrended fluctuation analysis (DFA) is a recently developed technique suitable for describing scaling behavior of variability in physiological signals. The purpose of this study is to explore...Full Text Available

2008-11-01

Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement

Cysticercosis is the most common parasitic infection affecting the central nervous system. Spinal neurocysticercosis (NCC) is very rare compared with intracranial NCC and requires more aggressive management...Full Text Available

2010-10-01

Three-dimensional rotational angiography of the carotid arteries with high-flow injection from the aortic arch. Preliminary experience

The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine catheter dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial ...

2003-04-15

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MRT of the abdomen in combination with enteroclysis in Crohn disease with oral and intravenous Gd-DTPA

Purpose: Three-dimensional rotational angiography (3DRA) is a new technique based on a rotational angiographic acquisition able to display arterial vessels in a 3D rendering mode. The system was mainly developed for neuroradiological evaluations but preliminary extracranial experiences have also been reported. The aim of our work was to compare the results of three-dimensional angiography of the carotid arteries done with high-flow injection of contrast medium from the aortic arch with the results of selective angiography. Materials and methods: Twenty patients underwent digital angiography of the supra-aortic vessels in order to quantify a stenosis of the carotid bifurcations previously detected at Doppler Ultrasound. Examinations were performed with the Philips Integris Allura system provided with the rotational angiography (RA) tool connected to a workstation for three-dimensional reconstruction able to display vessels in a 3D fashion (Volume Rendering, Shaded ...

Endoscopic management of congenital esophageal stenosis

60 patients between 17 and 72 years of age were investigated. First, an enteroclysis was performed in typical manner. The applicated methylcellulosis was blended with positive oral MR contrast media (Magnevist oral, Schering). After enteroclysis, MRI of the abdomen was performed using T1- and T2-weighted breathhold sequences (Flash 2D pre- and postcontrast and TSE) in axial and coronal planes. The length of the affected bowel and the stenosis seen with enteroclysis correlated well with the visible thickening of the small bowel wall and the stenosis seen in MRI. Using MRI, additional findings could be obtained in 28 patients, such as fistulas, abscesses or a hydronephrosis, or a better assessment of the stenosis was possible with MRI, because of the avoidance of overshadowing of the affected bowel loop with MRI. A brilliant MR-tomographic imaging of the small bowel is possible under the condition, that the small bowel ...

British Library Electronic Table of Contents (United Kingdom)

Background/Purpose: Congenital esophageal stenosis (CES) is a rare malformation. Endoscopic dilations represent a therapeutic option. This study retrospectively evaluated the efficacy and safety of a conservative treatment of CES. Patients and Methods: Patients diagnosed with CES since 1980 by a barium study or endoscopy were reviewed. Endoscopic ultrasonography (Olympus UM-3R-20-MHz radial miniprobe, Olympus Corporation, Tokyo, Japan), available from 2001, allowed for the differential diagnosis of tracheobronchial remnants (TBR) and fibromuscular hypertrophy (FMH) CES. All children underwent conservative treatment by endoscopic dilations (hydrostatic and Savary). Results: Forty-seven patients (20 men) had CES. Fifteen were associated with esophageal atresia; and 8, with Down syndrome. Mea...

2011-01-01

Blood flow quantification with MRI using the phase mapping method. Moeglichkeiten und Grenzen der Blutflussquantifizierung peripherer arterieller Gefaesse mit der MRT unter Anwendung des Phase-Mapping-Verfahrens

Evaluation of cortical current density imaging methods using intracranial electrocorticograms and functional MRI

MRT is able to demonstrate arteries while MR angiography can quantify blood flow by a non-invasive method. In the present paper blood flow measurements were carried out in four selected cases on the basis of phase mapping. In 3 patients with lesions in the pelvis or thigh, angiography was performed in order to localise the stenosis or occlusion and this was followed by qantitative blood flow measurements. The results showed that angiography may not always provide all necessary information concerning a haemodynamically significant stenosis. The method may also be used for quantifying blood flow in the renal arteries and that it has significant advantages over the colour Doppler method. (orig.).

1992-08-01

British Library Electronic Table of Contents (United Kingdom)

Objective:EEG source imaging provides important information regarding the underlying neural activity from noninvasive electrophysiological measurements. The aim of the present study was to evaluate source reconstruction techniques by means of the intracranial electrocorticograms (ECoGs) and functional MRI.Methods:Five source imaging algorithms, including the minimum norm least square (MNLS), LORETA with Lp-norm (p equal to 1, 1.5 and 2), sLORETA, the minimum Lp-norm (p equal to 1 and 1.5; when p=2, the MNLS method is mathematically equivalent to the minimum Lp-norm) and L1-norm (the linear programming) methods, were evaluated in a group of 10 human subjects, in a paradigm with somatosensory stimulation. Cortical current density (CCD) distributions were estimated from the scalp somatosensor...

2007-01-01

Characteristic features of intracranial meningiomas on magnetic resonance tomography

The application of 64 multidetector CT angiography in the evaluation of carotid stenosis and follow-up of carotid endarterectomy and percutaneous transluminal stenting

Twenty-three patients with intracranial meningiomas were examined by means of magnetic resonance tomography (MRT). In 13 patients the paramagnetic contrast medium gadolinium DTPA was used. Meningiomas show only slight changes in signal intensity compared with brain in the spin-echo mode, the greatest contrast being found on photon density images (TR 1600 ms, TE 35 ms). In T1 images more than 50% of the patients showed a low signal margin between tumour and brain. Hyperostosis of the calvarium is easily recognised, but MRT is unreliable for showing tumour calcification. After intravenous injection of gadolinium DTPA, there was marked homogeneous uptake in the meningiomas. These signs are useful for the diagnosis of a meningioma by MRT. (orig.).

Percutaneous intervention in the menagement of insufficient native arteriovenous hemodialysis fistulae

Objective: To evaluate the diagnostic value of 64 multidetector-row CT angiography for internal carotid artery (ICA) stenosis and the application in the follow-up of carotid endarterectomy and percutaneous transluminal stenting. Methods: Forty transient ischemic attack (TIA) patients with interpretable CTA and DSA of the cervical carotid arteries were selected from May 2005 to December 2005. This yielded a total of 80 vessels. The CTA curved planar reformations (CPR) and DSA images referenced to the distal cervical internal carotid were graded by two senior neuroradiologists blindly, according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) guidelines. The paired-t test was used to verify the statistical significant difference between pre-operating and post-operating of carotid endarterectomy or percutaneous transluminal stenting in measuring the vascular diameter and area of cross section using CTA. Results: When the 70% ...

2006-09-01

Lung perfusion scintigraphy in the diagnosis of peripheral pulmonary stenosis in patients after repair of Fallot tetralogy

To determine the effectiveness and patency of percutaneous intervention in insufficient native arteriovenous hemodialysis fistulae (AVFs). Between March 1997 and September 2001, 67 cases of insufficient native AVFs resulted from central vein lesion, PTA was performed in 48 cases, and thrombolytic therapy with or without PTA in 11. In eight of the cases, in which central vein stenosis had led to the insufficency, percutaneous transluminal angioplasty (PTA) was performed, and in three of the eight, a stent was inserted. Angiography findings and complications, as well as success and patency rates in the non-thrombosis and thrombosis group, were evaluated; the central vein lesion group was analysed separately. Among 84 lesions observed at angiography, three were 54 cases of stenosis, 17 of occlusion, and 13 of combined thrombosis. The lesions were located in a proximal vein (n=51), distal vein (n=14), artery (n=6), and at the site of anastomosis ...

2002-11-01

Radioisotope imaging of brain tumors in two rhesus monkeys. Final report

The frequency of peripheral pulmonary artery stenosis in patients after surgical repair of tetralogy of Fallot (TOF) ranges from 20 to 40%. This can be either primary or secondary to the surgical intervention. The influence of resulting lung perfusion alterations on the life quality of patients is difficult to predict. The aim of this study was to compare the utility of the diagnostic procedures in this group of patients, with particular focus on lung perfusion scintigraphy. This study comprised 104 patients who underwent repair of TOF at ages from 5 months to 25 years. The patients have been followed up for from 4.2 to 25 years. On the basis of chest X-ray peripheral pulmonary artery stenosis was suspected in 11 patients, in 12 on the basis of echocardiography examination. Lung perfusion scintigraphy has been performed on 87 patients. The disturbances in lung perfusion (mostly in the left lung) were show by means of lung perfusion scintigraphy ...

Computed tomograms of the newborn

Two geriatic male rhesus monkeys were used for the radioisotope imaging in this research. Discussion of the radionuclide, materials, and method used to accomplish the neurologic examination and the results obtained, both during the procedure and confirmation of the results by necropsies were accompanied by color photos of scan images. Results were that the nuclear images provided accurate images of intracranial neoplasia.

1988-04-01

Cerebral sparganosis. Case report.

Computed tomograms (CT) from 204 cases of premature and full term infants were studied. 1) In 70 infants of hyaline membrane disease, primary apnea and asymptomatic transient hypoglycemia and hypocalcemia, without any abnormal CT findings such as intracranial hemorrhage, periventricular lucency was found in 65 cases (93%) and a wide extracerebral space of the temporal lobes was found in 60 cases (86%) before 44 weeks of gestation. A wide interhemispheric fissure was found in 11 cases of extremely premature infants before term. Periventricular lucency and a wide extracerebral space of temporal lobes may not be the result of the intracranial pathological changes, but they may represent a stage of brain development. 2) In 204 cases, intracranial hemorrhage was found in 39 cases; intra ventricular 14 cases, subependymal 2 cases, intracerebral 4 cases, subarachnoid 19 cases. CT was useful in evaluating the site and extent of ...

A new self-expanding nitinol stent (Enterprise) for the treatment of wide-necked intracranial aneurysms: initial clinical and angiographic results in 31 aneurysms

The tapeworm Spirometra mansonoides infects man worldwide, particularly in Asian countries. Rarely, the central nervous system is involved; such a case is presented here. In the total of 12 reported cases, including the case described, the worm presented clinically as a mass suspicious for neoplasm or chronic abscess cavity. Surgical removal was invariably curative in each case. Although infrequent, the possibility of tapeworm infection should be entertained in the evaluation of intracranial masses in patients who have visited exotic locales. PMID:2191089

1990-07-01

3D time-of-flight MR angiography of the intracranial vessels: optimization of the technique with water excitation, parallel acquisition, eight-channel phased-array head coil and low-dose contrast administration

We report the results of a prospective clinical study using a new self-expanding nitinol stent (Enterprise) designed for the treatment of wide-necked intracranial aneurysms. We treated 31 saccular, wide-necked intracranial aneurysms in 30 patients. Ten aneurysms had recanalized after prior endovascular treatment without a stent, and 21 aneurysms had not been treated before. Stent deployment was successful in all procedures. Additional coil embolization was performed in all aneurysms. Initial complete angiographic occlusion was achieved in 6 aneurysms, a neck remnant was left in 18 aneurysms and there were 7 residual aneurysms. Angiographic follow-up examinations of 30 lesions after 6 months demonstrated 15 complete occlusions, 8 neck remnants and 7 residual aneurysms. One patient refused the 6-month angiographic follow-up. Spontaneous occlusion of the aneurysm had occurred in 14 patients, and 6 aneurysms showed recanalization. Four of these ...

2007-07-15

Quality assurance requirements for the reliability of nuclear power plants in developing countries

The aim of this study is three folds: to compare the eight-channel phased-array and standard circularly polarized (CP) head coils in visualiazation of the intracranial vessels, to compare the three-dimentional (3D) time-of-flight (TOF) MR angiography (MRA) techniques, and to define the effects of parallel imaging in 3D TOF MRA. Fifteen healthy volunteers underwent 3D TOF MRA of the intracranial vessels using eight-channel phased-array and CP standard head coils. The following MRA techniques were obtained on each volunteer: (1) conventional 3D TOF MRA with magnetization transfer; (2) 3D TOF MRA with water excitation for background suppression; and (3) low-dose (0.5 ml) gadolinium-enhanced 3D TOF MRA with water excitation. Results are demonstrating that water excitation is a valuable background suppression technique, especially when applied with an eight-channel phased-array head coil. For central and proximal portions of the ...

2004-11-01

Effect of lead exposure in children

Quality Assurance (QA) has not been taken very seriously in developing countries despite their having significant nuclear power programmes. This may affect plant reliability and demands that urgent and serious attention be given to the development and implementation of Quality Assurance programmes according to local conditions. Confusion has been created by the differences in definitions and interpretations of terminologies of Quality Assurance and Control. Problems have been aggravated by the lack of clearly defined responsibilities and accountabilities during the projects execution phases of site selection, data collection, design, equipment fabrication and construction, etc. Therefore, reliability of nuclear power plants in developing countries is relatively low. But whenever some programme of QA has been implemented it has helped to improve the plant performance. This is highlighted in this paper by the practical examples for the experience of Karachi Nuclear ...

Magnetic resonance imaging in acute intractional tuberculosis; Magnetresonanztomographie bei akuter intrakranieller Tuberkulose

Increasing prosperity and population-growth in many developing countries are resulting in accelerated growth in population of vehicles and vehicle-kilometers traveled. In Pakistan also, the number of vehicles has jumped from 0.8 million to about 4.0 million within 20 years, showing an overall increase of more than 400%. Accordingly, the consumption of petrol (motor spirit) has increased from 828,670 metric tons to 1,189,042 metric tons. The high content of lead in petrol is a serious issue, as the end- product is the release of lead into the environment. In Pakistan, prior to July 2001, lead-content in petrol was reported to be as high as 0.35-0.84 gram per liter. The reported lead-levels in air (micrograms/cubic centimeter) in different cities of Pakistan are: Karachi (1980-81) 0.13-0.24; Peshawar (1994-95) 0.21-0.79; Lahore (1993-94) 0.15-8.36 and (1999-2000) 0.89-7.85 and Rawalpindi (1999-2000) 0.71-10.00, indicating the very alarming increase and high levels of ...

Dura thickening adjacent to intracranial tumors on MRI. Histologically correlation

We reported three cases of acute intracranial tuberculosis including miliary tuberculosis, basal meningitis, tuberculomas and neuritis of cranial nerves. All patients had native and contrast enhanced CT and MRI scans. MRI revealed more granulomas and a better imaging contrast in the detection of basal meningitis. Neuritis was diagnosed only with the MRI. MRI scans should be prefered as the imaging procedure in clinically presumed intracranial tuberculosis. (orig.) [Deutsch] Die Befunde von drei Patienten mit intrakranieller Tuberkulose (intrakranielle Miliartuberkulose, Meningitis tuberculosa, Neuritis und Tuberkulome) in der Magnetresonanztomographie (MRT) wurden mit der Computertomographie (CT) verglichen. Sowohl die MRT als auch die CT wurden nativ und nach Kontrastmittelgabe durchgefuehrt. Die MRT zeigte sich im Nachweis von Granulomen insbesondere im Bereich des Hirnstamms ueberlegen. Ebenso wurde ein hoeherer Bildkontrast bei der ...

1994-12-31

Computer assisted axial tomography (Emi scan) in neurologic investigation

Purpose: With intracranial tumors a flat, contrast-enhancing, probably dural structure adjacent to the tumor can occasionally be observed on gadolinium-DTPA enhanced MR images. Therefore we have attempted to evaluate a tumor infiltration of this enthancement on MRI. Material and Methods: This study included 50 patients. 19 patients had a dural thickening at the tumor base (13 meningiomas and 6 metastases), while 31 patients did not (12 meningiomas and 19 metastases). Studies included plane T_2-weighted spin echo (SE) images as well as T_1-weighted axial, coronal, or sagittal plains with and without contrast agent. Histopathological examinations, were done on the tumor base adjacent to the dura mater. Results: 7 of 12 meningiomas showed a meningeal thickening on MRI with histopathologically proven tumor infiltration as did also 5 of 6 metastases. But 3 of 12 meningiomas and 15 of 19 metastases without dural thickening at the tumor base also showed tumor invasion ...

Actual and future strategies in interdisciplinary treatment of medulloblastomas, supratentorial PNET and intracranial germ cell tumors in childhood

Cerebral angiography, pneumoencephalography, and radioisotope brain scan with their differing diagnostic abilities have provided the neurologist and neurosurgeon with extremely valuable diagnostic techniques. It is doubtful, however, if any of these now conventional methods had the enormous impact on the practice of neurology that computer assisted axial tomography (C.A.T.) is beginning to have. Here, for the first time, is a test which, without significant risk or discomfort, can demonstrate some normal intracranial (and intraorbital) structures, can demonstrate some normal intracranial pathology and, in many cases, can make the potentially dangerous contrast studies unnecessary. After only a few months experience with C.A.T. in a clinical setting, it has become obvious that there will have to be a reappraisal of the accepted investigative work-up of many conditions. While it is too early to have formulated strict criteria for the use of ...

1974-01-01

The role of interventional radiology in management of patients with end-stage renal disease

Methods: Systemic irradiation of neuroaxis is an essential part in the management of medulloblastoma, stPNET and intracranial germ cell tumors. The introduction of quality assurance programs in radiooncology assures a precise radiotherapy of target volumes and is a prerequisite to improve survival. Results: Hyperfractionated radiotherapy has the potential of increasing dose to tumor more safely without increasing the risk for late adverse effects. Pilot studies revealed excellent tumor control in medulloblastoma with acceptable acute toxicity and a long-term survival of up to 96%. In medulloblastoma stereotactic radiation techniques reveal an acceptable toxicity and promising results in tumor control in recurrent disease or as primary treatment. They are now part of future treatment protocols in case of persisting residual tumor. Radiotherapy alone in pure germinoma is continuously yielding high cure rates. In secreting germ cell tumors cisplatin containing ...

2001-09-01

1 2 3 4 5 6

Relationship between hemodynamic response to exercise and distribution of pulmonary perfusion in mitral stenosis

The aim of the paper is to review the role of interventional radiology in the management of hemodialysis vascular access and complications in renal transplantation. The evaluation of patients with hemodialysis vascular access is complex. It includes the radiology/ultrasound (US) evaluation of the peripheral veins of the upper extremities with venous mapping and the evaluation of the central vein prior to the access placement and radiological detection and treatment of the stenosis and thrombosis in misfunctional dialysis fistulas. Preoperative screening enables the identification of a suitable vessel to create a hemodynamically-sound dialysis fistula. Clinical and radiological detection of the hemodynamically significant stenosis or occlusion demands fistulography and endovascular treatment. Endovascular prophylactic dilatation of stenosis greater than 50% with associated clinical abnormalities such as flow-rate reduction ...

2003-05-01

Radiology of facial injury

Relationship between hemodynamic response to exercise and distribution of pulmonary perfusion was studied in 71 patients with mitral stenosis. Distribution was estimated by using computerized Tc-99m-MAA perfusion images (digital perfusion images; DPI). DPI were composed of isocount areas. Various types of DPI were obtained and were classified to 6 grades (G) according to patterns of 100 - 70% isocount area in right anterior DPI, i.e. G-0 (normal), G-1 (increase of perfusion at upper zone), G-2 (uniform distribution), G-3 (disappearance of basal hyperperfusion area), G-4 (apical hyperperfusion area) and G-5 (decrease of perfusion at lower zone). Patients were devided to 4 groups according to grade. At rest there were no marked hemodynamic differences between groups (n = 71, mean pulmonary artery pressure (mPA); 24.8 +- 11.0 mmHg, cardiac index (CI); 2.7 +- 0.81 lmM/sup 2/), however hemodynamic parameter during exercise showed marked differences, i.e. G-0 (n = 13, ...

1987-11-01

Cerebral and meningeal manifestations of AIDS: Sensitivity of CT and T sub 2 -weighted MR (129 patients). Zerebrale und meningeale Manifestation des AIDS: Sensitivitaet von CT und T sub 2 -gewichteter MRT (129 Patienten)

The authors present a guide to the imaging of facial fractures. It is illustrated with conventional radiographs and computed tomograms; the magnetic resonance images primarily suggest the potential applications of this technique. This book provides a source of imaging information on facial trauma. A section on pertinent anatomy is followed by a systematic discussion of the common isolated and complex facial fractures. Perspectives are offered on some commonly seen but infrequently described relationships, such as the tripod-LeFort II association. Consideration is also given to related soft-tissue injuries. The book includes a brief chapter on the type and utility of supplementary imaging studies in the evaluation of those intracranial injuries that may occur concurrently.

1988-01-01

An intracranial aspergilloma with low signal on T2-weighted images corresponding to iron accumulation

We studied 129 AIDS patients with suspected or proved intracranial manifestations of the disease. The purpose of this study was to compare the diagnostic sensitivity of unenhanced and contrast enhanced CT and unenhanced T{sub 2}-weighted MR. Thus, in 20% of our patients MR but not CT was diagnostic. In another 20% MR provided additional diagnostic information. In conclusion, MR is recommended as the imaging modality of choice in AIDS patients with non-conclusive cranial CT. (orig./GDG).

1990-09-01

MRT of the abdomen in combination with enteroclysis in Crohn disease with oral and intravenous Gd-DTPA; MRT des Abdomens in Kombination mit der Enteroklyse bei Morbus Crohn unter Verwendung von oralem und intravenoesem Gd-DTPA

We present a case of cerebral aspergillosis in an immunocompetent patient. The MRI signal characteristics were compared with the histologic findings. Irregular low-signal zones were demonstrated between the wall of the abscess and the central necrosis on T2-weighted images; the pathology specimen revealed concentrated iron in these transitional zones but no hemosiderin. Iron is an essential element for the growth of fungal hyphae. The low-signal zones may represent the areas where there was active proliferation of aspergillus, and the unique location of the low signal may be a helpful imaging characteristic for the diagnosis of an aspergillus abscess. (orig.)

2001-07-01

Intestinal Ischemia for estenosis of the superior mesenteric artery, Treatment with angioplastia and stent implant

1998-01-01

Intracranial Dural Metastasis of Ewing's Sarcoma: a Case Report

Chronic mesenteric arterial ischemia is an uncommon condition associated a high morbidity and mortality. It is most Commonly caused by atherosclerotic occlusive disease. Patients may suffer epigastric or periumbilical postprandial pain ten to thirty minutes after eating. A case of chronic mesenteric artery stenosis, the diagnosis was performance with colonoscopy and biopsy. We present a case report of a patient with chronic mesenteric ischemia. Mesenteric arteriography was performed and documented estenosis of the mesenteric superior artery. Then percutaneous arteriography with angioplasty and implant of stent was performed. The patients became completely asymptomatic and normal colon mucous is observed in control colonoscopy. The purpose of this report is to present the case endoscopy, clinic and radiological features and to describe the percutaneous angioplasty and implant of stent. We believe that angioplasty treatment offers and improvement in this pathology ...

Self-expanding nitinol stents for treatment of infragenicular arteries following unsuccessful balloon angioplasty

Ewing's sarcoma is a malignant bone tumor that can occur anywhere in the body, but it is most commonly observed in the long bones of the arms and legs, the pelvis and in the chest. The predominant sites of metastasis include the lung (38%), bone (including the spine; 31%), and the bone marrow (11%). Metastasis of Ewing's sarcoma to the central nervous system (CNS) is relatively rare, and most of the previous reports have demonstrated involvement of the bony calvarium or brain parenchyma. We describe here the imaging findings of dural metastasis of Ewing's sarcoma, and these imaging findings have not been previously reported on in the medical literature. In conclusion, dural metastasis of Ewing's sarcoma is very rare and its imaging characteristics are similar to those of a primary tumor, which mimic the findings of a schwannoma or meningioma. Despite its rarity, secondary Ewing's sarcoma may be included in the differential diagnosis of extra-axial dural masses.

2008-02-01

Percutaneous transluminal angioplasty and thrombolysis in the management of insufficient hemodialysis access: Long-term patency rates and factors affecting patency rates

The feasibility of self-expanding nitinol stents for treatment of infragenicular arteries following unsuccessful balloon angioplasty was assessed. Options for lower limb percutaneous revascularization are limited, especially for complex vessel obstruction. Depending on the lesion and the experience of the interventionalist, the failure rate of balloon angioplasty (PTA) ranges between 10 and 40%. Until recently, no self-expanding stent for the use in the infragenicular arteries was available. This is the first report of the results for 18 consecutive patients who received 4F sheath compatible self-expanding nitinol stents following unsuccessful PTA or early restenosis. Twenty-four stents were implanted in 21 lesions for various indications residual stenosis >50% due to heavy calcification, flow-limiting dissection, occluding thrombus resistant to thrombolyis, thrombaspiration, and PTA, and early restenosis after previous PTA. Stent implantation was feasible ...

2007-08-15

Stereotactic iridium-192 interstitial brachytherapy for intracranial malignant tumors; Combined with hyperthermia

To evaluate the success rates, long-term patency rates and factors affecting the patency rates of percutaneous transluminal angioplasty(PTA) and thrombolysis in the management of insufficient access during hemodialysis. Between January 1991 and March 1995, 37 insufficient shunts(23 native fistulae and 14 graft fistulae) were treated in 31 patients. PTA was performed in 24 shunts, and thrombolysis in 13;in seven of these latter, thrombolysois was followed by PTA. The success and long-term patency rates of PTA and thrombolysis were evaluated. Shunts were subdivided according to a patient's age, type and age of the shunt, and number and length of the stenosis, and the degree of residual stenosis and in each subgroup, patency rates was compared. The overall success rate of PTA and thrombolysis for insufficient hemodialytic access was 78.4%(29/37). The success rates of PTA and thrombolysis were 91.7%(22/24) and 53.8%(7/13), respectively. ...

1997-10-01

Stereotactic iridium-192 interstitial brachytherapy for intracranial malignant tumors

The results of interstitial brachytherapy in 13 patients with malignant brain tumors (malignant glioma 9 cases, metastatic brain tumor 4 cases) were reported. In all patients, Ir-192 thin wires were implanted temporarily in afterloading catheters, which were implanted appropriately by means of MRI or CT guided stereotactic technique. Clinical results on CT scan were as follows: CR (complete response) 1 case, PR (partial response) 6 cases and NC (no change) 6 cases. Even in the NC group, tumor growth was inhibited temporarily. Tumor free intervals were ranged 2-17 months. In early series, the intervals were about 2 months due to incomplete arrangement of radioactive implants. In recent series, prolongation of tumor free interval more than 12 months was achieved due to precise arrangements of implants. MRI guided stereotactic interstitial brachytherapy may provide safe and precise intracranial arrangements of implants, which yield high radiation dose on tumors ...

1990-05-01

Noninvasive follow-up of GDC-treated saccular aneurysms by MR angiography

1990-01-01

Large intracranial vessel occlusive vasculopathy after radiation therapy in children: clinical features and usefulness of magnetic resonance imaging

The aim of this study was to determine sensitivity and specificity of magnetic resonance angiography (MRA) for the assessment of durable occlusion of intracranial aneurysms with Guglielmi detachable coils (GDC) and to point out the influence of MRA results in re-intervention strategies. Forty-five patients with 54 aneurysms that were previously treated by endovascular occlusion with GDC were selected for this study. All patients underwent digital subtraction angiography (DSA) and MRA examinations on the same day. The time-of-flight MRA studies were performed on a 1-T scanner. The MRA images were first read by radiologists who were not aware of the DSA results. In a second consensus reading by the neuroradiologists who had performed all interventional procedures of this series, the decision was made as to whether re-treatment was necessary. The distribution of aneurysm sizes, configurations and treatment results were sufficient for an unbiased evaluation. The first ...

2001-09-01

Comparison of Stereotactic Radiosurgery and Whole Brain Radiotherapy in Patients with Four or More Brain Metastases

Purpose: To assess the relationship between large intracranial vessel occlusive vasculopathy (vasculopathy) and radiation therapy, and to clarify the clinical efficacy of magnetic resonance (MR) imaging in the diagnosis and screening of the vasculopathy. Methods and Materials: We retrospectively evaluated the medical records and serial MR images for 32 pediatric patients, in whom radiation therapy had been given to fields including the circle of Willis and major cerebral arteries. All children had periodically undergone follow-up neurologic assessment and MR imaging examinations at Kanagawa Children's Medical Center for more than one year after radiation therapy (range 1.3-14 years). Patients who had not remained free of tumor progression up to the time of final evaluation were excluded. Results: Vasculopathy developed in 6 of 32 patients 2-13 years after radiation therapy. Three of them presented with transient ischemic attacks (TIA) and the other three showed ...

1997-05-01

Usefulness of myocardial imaging by [sup 123]I-MIBG in assessment of diabetic neuropathy

This study was a retrospective evaluation of the efficacy of stereotactic radiosurgery (SRS) in patients with >4 metastases to the brain. Materials and Methods: Between January 2004 and December 2006, 68 patients with ?4 multiple brain metastases were included and reviewed retrospectively. Twenty-nine patients received SRS and 39 patients received whole brain radiotherapy (WBRT). Patients with small cell lung cancers and melanomas were excluded. The primary lesions were non-small cell lung cancer (69.0%) and breast cancer (13.8%) in the SRS group and non-small cell lung cancer (64.1%), breast cancer (15.4%), colorectal cancer (12.8%), esophageal cancer (5.1%) in the WBRT group. SRS involved gamma-knife radiosurgery and delivered 10?20 Gy (median, 16 Gy) in a single fraction with a 50% marginal dose. WBRT was delivered daily in 3 Gy fractions, for a total of 30 Gy. After completion of treatment, a follow-up brain MRI or a contrast-enhanced brain CT was reviewed. The overall survival ...

2009-09-01

The accuracy and reverse effects of thallium myocardial SPECT using adenosine triphosphate loading in the diagnosis of coronary artery disease. Comparison with other loading methods semiquantitatively

In diabetic patients with autonomic neuropathy, it is suggested that there is a reduced uptake of [sup 123]I-metaiodobenzylguanidine (MIBG) in the heart. We compared the difference of myocardial [sup 123]I-MIBG accumulation between 4 diabetic patients with triopathy and 6 patients without it. In all 10 patients, coronary angiography and [sup 201]Tl imaging (rest and 4 hours later) were performed. [sup 123]I-MIBG (111 MBq) was administered intravenously and its imaging was recorded on 15 minutes and 4 hours after injection. In all 4 cases with triopathy, [sup 123]I-MIBG imaging showed defect in apical and inferior region. In 2 out of 6 cases without triopathy, rapid clearance was noticed in apical and inferior region. There was no significant stenosis in right coronary artery and no defect in initial and delayed [sup 201]Tl images in all cases. We concluded that diabetic autonomic neuropathy in the heart was prominent in apical and inferior region and [sup ...

1993-10-01

Stereotactic body radiotherapy for unresectable cholangiocarcinoma

The adverse effects and diagnostic accuracy of thallium-201 myocardial SPECT after intravenous infusion of adenosine triphosphate (ATP) were studied and compared with SPECT examinations with other type of loading. The subjects of the study were 147 patients with or without coronary artery disease, who underwent some type of loading SPECT and coronary arteriography (CAG) within 30 days. Myocardial ischemia was evaluated qualitatively in SPECT and was compared with CAG for the diagnostic accuracy of coronary artery disease. The degree of myocardial uptake defect was also calculated semiquantitatively using visual scoring method and compared with coronary artery severity score. The adverse effects occurred in 46.7% of ATP loading SPECT which was more frequent that DIP loading SPECT, but all of them were transient and mild. As for the diagnostic ability the ATP loading SPECT was as effective as other type of loading in qualitative interpretation, and the perfusion defect scores showed a ...

1999-09-01

Simultaneous assessment of left ventricular function from gated myocardial perfusion SPECT. Utility of QGS (Quantitative Gated SPECT) program

Purpose: To report outcomes of a single institution study of stereotactic body radiotherapy (SBRT) for unresectable cholangiocarcinoma. The dose-volume dependency of the observed gastrointestinal toxicity is explored. Methods and materials: Twenty-seven patients with unresectable cholangiocarcinoma (n = 26 Klatskin tumours and one intrahepatic cholangiocarcinoma (IHCC)) were treated by linac-based SBRT. The dose schedule was 45 Gy in three fractions prescribed to the isocenter. Results: The median progression-free survival and overall survival were 6.7 and 10.6 months, respectively. With a median follow-up of 5.4 years, 6 patients had severe duodenal/pyloric ulceration and 3 patients developed duodenal stenosis. Duodenal radiation exposure was higher in patients developing moderate to high-grade gastrointestinal toxicity with the difference in mean maximum dose to 1 cm"3 of duodenum reaching statistical significance. A statistically significant association between ...

2010-01-01

Regional myocardial perfusion in patients with atherosclerotic coronary artery disease, at rest and during angina pectoris induced by tachycardia

Quantitative gated SPECT (QGS) was evaluated in 7 normal volunteers and 31 patients with cardiac diseases. Adequate cut off value of a prefilter was 0.45. In phantom, the left ventricular volume value was 93.9% of determined value by 180-degree projection in L type and 98.8% by 360-degree projection in opposed type. In normal volunteers, LVEF measured by QGS program related to value by first pass method. As for functional map, regional EF and wall motion decreased at the septum side, and wall thickening at base side of heart. Good correlation was recognized (p<0.0001) between blood flow image and functional map (regional EF and wall thickening). In 20 cases of acute myocardial infarction, lesion was detected conspicuously in regional EF and wall motion. The accuracy of coronary arterial stenosis improved in functional map (regional EF 92%, wall motion 92% and wall thickening 88%). In particular, the accuracy of 3 rami lesion was 100% in functional map and higher ...

1998-08-01

Reconstructive surgery for the complications of pelvic irradiation

We studied regional myocardial perfusion by scintigraphic computer-assisted analysis of initial distribution, washout rates, and residual activity of "1"3"3Xe injected into the left coronary artery of four patients with normal arteriograms and 14 patients with coronary stenosis. At rest, residual activity in poststenotic regions was always greater than in control regions, but initial washout rates were not slower. During angina, following xenon injections, the amount of indicator distributed to the poststenotic regions was markedly reduced; the increase of the initial washout rates was smaller than in control regions relative to rest, and residual activity was higher. Initial washout rates did not differ as much as from those of normal myocardium because in severe ischemia too little indicator is deposited initially in these regions to produce a change of any magnitude. Indeed, when angina was induced immediately after the xenon injection, poststenotic washout ...

1 2 3 4 5 6

MR imaging and MR cholangiopancreatography in the preoperative evaluation of hilar cholangiocarcinoma: correlation with surgical and pathologic findings

Severe damage to the pelvic viscera is a complication of irradiation therapy that, unfortunately, cannot always be avoided. Resulting rectal and rectocolonic strictures, rectovaginal fistulas, and shortening and stenosis of the vagina present very difficult problems that frequently require a colostomy for relief and may permanently impair sexual function. The authors present a new approach to correction of these unfortunate lesions based on the use of proximal nonirradiated colon which serves as a vascular pedicle graft to correct the defect without a complicated and massive resection. Twenty-two such operations have been done with 19 satisfactory to excellent results and two total failures (one death from small bowel complications). All patterns and combinations of irradiation injury have been found amenable to this technique of repair. These have included both web and linear strictures with and without fistulas. In half of the patients, it was possible to make ...

1984-02-01

Intracardiac Echocardiography: A New Guiding Tool for Transcatheter Aortic Valve Replacement

The primary aim was to evaluate delayed contrast-enhanced MRI in depicting perineural spread of hilar cholangiocarcinoma (CCC) and consequently to determine the capability of MRI/MRCP for staging CCC. Fifteen patients that underwent MRI/MRCP and surgical treatment were retrospectively included. Two radiologists evaluated MR images to assess delayed periductal enhancement, extent of bile duct stenosis, liver parenchymal and vascular involvement and presence of liver atrophy. An agreement between delayed enhancement of the bile duct walls and perineural neoplastic spread showed a very good correlation factor (0.93). The overall accuracy in detecting biliary neoplastic invasion was higher for delayed T1-weighted images (93.3%) than for the MRCP images (80%), and T1-delayed image increased the MR accuracy in assessing the neoplastic resectability (p < 0.05). MRI correctly predicted vascular involvement in 73% and liver involvement in 80% of the cases. The number of ...

2008-10-01

British Library Electronic Table of Contents (United Kingdom)

BackgroundEchocardiography has been debated as an adjunct for transcatheter aortic valve replacement (TAVR). The aim of this prospective study was to comparatively evaluate intraprocedural guidance using intracardiac echocardiography (ICE) and transesophageal echocardiography (TEE). MethodsFifty high-risk patients with severe aortic stenosis scheduled for TAVR were randomized to either guidance using ICE (group 1; n = 25) or monitoring using TEE (group 2; n = 25). ResultsIn contrast to TEE, ICE allowed continuous monitoring. The need for probe repositioning during the procedure was much lower in group 1 (0.1 +- 0.3 vs 5.7 +- 0.7 maneuvers, P P = .003). Both coronary ostia were more frequently visualized in group 1 (18 vs 2 cases, P n = 25, r2 = 0.90, P n = 11, P = .012), but ICE did not (m...

2011-01-01

Effect of percutaneous transluminal angioplasty in insufficiency of arteriovenous fistula for hemodialysis

Ambient air pollution and congenital heart disease: a register-based study.

To evaluate the effectiveness of percutaneous transluminal angioplasty(PTA) and to determine the factors affecting the long-term patency rate in the management of insufficient hemodialytic arteriovenous fistula(AVF). Forty-nine cases of insufficient hemodialytic AVF were treated in 44 patients(native AVF:20, graft AVF:29, M:17, F:27, Age:22-70 years). In 28 thrombus patients, thrombolysis was performed with urokinase, and was followed by PTA. The initial success rate and complications of PTA were evaluated. According to the site and length of the stenosis, type and age of the AVF, the presence or abscence of thrombus, a history of diabetic mellitus, the patient's age, and the duration of renal failure, patency rates were compared within each subgroup using the Kaplan-Meier logrank test. The initial success rate of PTA for insufficient hemodialytic AVF was 88%(43/49), the patency rate of PTA was 67% at 6 months, and 50% at 12 months. The initial success ...

1999-06-01

Waterjet resection of brain metastases - first clinical results with 10 patients.

Maternal exposure to ambient air pollution has increasingly been linked to adverse pregnancy outcomes. The evidence linking this exposure to congenital anomalies is still limited and controversial. This case-control study investigated the association between maternal exposure to ambient particulate matter with aerodynamic diameter less than 10 ?m (PM(10)), sulfur dioxide (SO(2)), nitrogen dioxide, nitric oxide (NO), ozone (O(3)), and carbon monoxide (CO) and the occurrence of congenital heart disease in the population of Northeast England (1993-2003). Each case and control was assigned weekly average (weeks 3-8 of pregnancy) of pollutant levels measured by the closest monitor to the mother's residential postcode. Using exposure as both continuous and categorical variables, logistic regression models were constructed to quantify the adjusted odds ratios of exposure to air pollutants and the occurrence of each outcome group. We found exposure to CO and NO to be associated with ...

2011-02-17

Management of pitfalls for the successful clinical use of hypothermia treatment.

The waterjet technique enables precise tissue dissection without thermal damage and with preservation of vessels in general surgery. In neurosurgery, these qualities could help to avoid damage of intact brain parenchyma in tumour resections. The present study reports our first results with this technique in brain metastases. Ten patients with intracranial metastases underwent surgery with the aid of the waterjet. Resection was performed in combination with conventional neurosurgical methods. The follow-up consisted of neurological examination and MRI studies. Intraoperatively, the device was easy to handle. No complications due to the device were observed. Vessels were preserved at pressures below 20 bars. Six of the tumours consisted of soft tissue which was poorly demarcated from the surrounding brain. In these tumours, the waterjet was very helpful. It enabled tumour debulking by aspiration and - more important - precise separation of tumour and brain ...

2003-05-01

Intrapartum FHR monitoring and neonatal CT brain scan

Therapeutic hypothermia is a promising method for controlling intracranial pressure (ICP) in severely brain-injured patients. However, clinical data regarding the effect of brain hypothermia on overall outcome of these patients is limited. This may be because there are specific pitfalls associated with the clinical management of induced hypothermia in patients with severe traumatic brain injury (TBI). These pitfalls may be avoided by preventing specific risk factors when cooling is induced and with rewarming. However, these risk factors have not been well systematically discussed in the literature. In this paper, three categories of clinical issues regarding the management of brain hypothermia are discussed: (1) stress-induced secondary brain injury mechanisms; (2) technical aspects of intensive care unit (ICU) cooling management; and (3) rewarming rates and methods. For patients with a Glasgow Coma Scale (GCS) score of less than 8, management of stress-induced ...

2009-03-01

Intrapartum FHR monitoring and neonatal CT brain scan

The effect of fetal distress on the neonatal brain was investigated by neonatal CT brain scan, FHR monitoring and mode of delivery. This study involved 11 cases of full term vertex delivery in which FHR was recorded by fetal direct ECG during the second stage labor. All infants weighed 2,500 g or more. FHR monitoring was evaluated by Hon's classification. Neonatal brain edema was evaluated by cranial CT histgraphic analysis (Nakada's method). 1) Subdural hemorrhage was noted in 6 of 7 infants delivered by vacuum extraction or fundal pressure (Kristeller's method). 2) Intracranial hemorrhage was demonstrated in all of 3 infants with 5-min. Apgar score 7 or less. 3) Two cases with prolonged bradycardia and no variability had intraventricular or intracerebral hemorrhage which resulted in severe central nervous system damage. 4) The degree of neonatal brain edema correlated with 5-min. Apgar score. 5) One case with prolonged bradycardia and ...

1982-12-01

Hypoparathyroidism and intracerebral calcification in patients with beta-thalassemia major

1982-01-01

Evaluation of craniosynostosis surgery. Technetium-99m-HMPAO SPECT cerebral blood flow study in children with craniosynostosis

Background: Hypoparathyroidism is one of the most important endocrine complications of thalassemia major. This study was conducted to evaluate the prevalence of intracerebral calcifications in patients with thalassemia with and without hypoparathyroidism. Methods: 47 beta-thalassemia patients with hypoparathyroidism underwent a brain CT scan to investigate the presence and extent of intracerebral calcification. 30 age- and sex-matched beta-thalassemic patients with normal parathyroid function who had undergone brain CT for headache, or some other minor neurologic problems were also enrolled in the study serving as controls. The amount of intracerebral calcification, hematologic parameters, and some clinical findings were compared between both groups. Results: Intracerebral calcification was present in 54.2% of beta-thalassemia patients with hypoparathyroidism. The most frequent sites of calcification were basal ganglia, and frontoparietal areas of the brain. Thalami, internal capsule, ...

2009-06-15

Dura thickening adjacent to intracranial tumors on MRI. Histologically correlation; Duraverdickung am Rand intrakranieller, duranaher Raumforderungen in der MRT. Histologische Korrelation

Premature fusion of multiple cranial sutures has been associated with increased intracranial pressure and the potential for mental impairment. Isolated craniosynostosis, however, is considered a benign condition primarily reconstructed for aesthetic purposes. A comparative analysis, to assess the differences between pre- and post operatory cerebral perfusion of patients who underwent surgery for simple cranisynostosis, was performed using single positron emission computed tomography ''SPECT'' Images. Cerebral blood flow studies were performed using "9"9"mTc-HMPAO SPECT in children with simple cranisynotoses. The subjects were 8 children with craniosynostosis (age, 2 months-9 years). Preoperative revealed regional hypovascularity in the cerebral hemisphere in 5 cases (62%). In 6 patients the cerebral blood flow normalized or increased after craniofacial reconstruction. We demonstrated the presence of regional hypovascularity in the cerebral hemisphere of simple ...

1998-09-01

Actual and future strategies in interdisciplinary treatment of medulloblastomas, supratentorial PNET and intracranial germ cell tumors in childhood; Aktuelle und zukuenftige Strategien in der interdisziplinaeren Therapie von Medulloblastomen, supratentoriellen PNET und intrakraniellen Keimzelltumoren im Kindesalter

Purpose: With intracranial tumors a flat, contrast-enhancing, probably dural structure adjacent to the tumor can occasionally be observed on gadolinium-DTPA enhanced MR images. Therefore we have attempted to evaluate a tumor infiltration of this enthancement on MRI. Material and Methods: This study included 50 patients. 19 patients had a dural thickening at the tumor base (13 meningiomas and 6 metastases), while 31 patients did not (12 meningiomas and 19 metastases). Studies included plane T{sub 2}-weighted spin echo (SE) images as well as T{sub 1}-weighted axial, coronal, or sagittal plains with and without contrast agent. Histopathological examinations, were done on the tumor base adjacent to the dura mater. Results: 7 of 12 meningiomas showed a meningeal thickening on MRI with histopathologically proven tumor infiltration as did also 5 of 6 metastases. But 3 of 12 meningiomas and 15 of 19 metastases without dural thickening at the tumor base also showed tumor ...

1997-11-01

Vascular complications following 1500 consecutive living and cadaveric donor renal transplantations: A single center study

2001-09-01

Percutaneous treatment of thrombosed native arteriovenous dialysis fistula insufficiency: efficacy of mechanical thrombectomy with using the stone basket

The aim of this study was to document vascular complications that occurred following cadaveric and living donor kidney transplants in order to assess the overall incidence of these complications at our center as well as to identify possible risk factors. In a retrospective cohort study, 1500 consecutive renal transplant recipients who received a living or cadaveric donor kidney between December 1988 and July 2006 were evaluated. The study was performed at the Nemazee Hospital, Shiraz, Iran. The assessment of the anatomy and number of renal arteries as well as the incidence of vascular complications was made by color doppler ultrasonography, angiography, and/or surgical exploration. Clinically apparent vascular complications were seen in 8.86% of all study patients (n = 133) with the most frequent being hemorrhage (n = 91; 6.1%) followed by allograft renal artery stenosis (n = 26; 1.7%), renal artery thrombosis (n = 9; 0.6%), and renal vein thrombosis (n = 7; 0.5%). ...

Percutaneous transluminal angioplasty and stent insertion in central venous steno-occlusion

We wanted to evaluate the procedural success after percutaneous treatment of thrombosed native arteriovenous dialysis fistula insufficiency and the efficacy of performing mechanical thrombectomy with using the stone basket. From March 2004 to June 2005, 36 thrombosed native hemodialysis access shunts in the upper limbs (brachiocephalic fistulas: 16 and radiocephalic fistulas: 20) were percutaneously treated in 30 patients. Declotting procedures were performed with using urokinase (100,00-200,000 unit) and manual catheter-directed thrombo-aspiration in all the patients. Angioplasty (6 mm in diameter and 4 cm in length) was performed at the identified area of the stenosis and /or with maceration of the thrombus. In 14 cases with massive thrombosis that was refractory to the above mentioned declotting procedures, mechanical thrombectomy with using a Wittich nitinol stone basket (Cook, Bloomington, IN) was performed. Data regarding the procedural success rate and the ...

2006-06-15

Malignant duodenal obstructions: palliative treatment with covered expandable nitinol stent

To evaluate the efficacy of percutaneous transluminal angioplasty (PTA) and stent insertion in central venous steno-occlusion. Between August 1992 and January 1998, 11 patients with symptomatic central venous steno-occlusion (six stenoses and five occlusions) underwent pereutaneous treatment. Eleven PTAs were performed and stents were introduced in two patients because of incomplete PTA. During follow-up, a total of eight revisions were performed in five patients with recurrence (six stenoses and two occlusions). Success and long term patency rates were evaluated. The length and degree of the lesion and degree of residual stenosis, as well as pressure gradient through the lesion and decrease of the gradient after PTA, were correlated with patency rates. Complications during the procedures and follow-up period were evaluated. The overall success rate was 89.5%;those of primary and revision intervention were 90. 9% and 87.5%, respectively. Primary and revision ...

1998-12-01

Initial and mid-term results of a 4F compatible self-expanding low strut profile nitinol stent in the superficial femoral artery

To evaluate the feasibility and clinical effectiveness of using a polyurethane-covered expandable nitinol stent in the palliative treatment of malignant duodenal obstruction. Under fluoroscopic guidance, a polyurethane-covered expandable nitinol stent was placed in 12 consecutive patients with malignant duodenal obstructions. All presented with severe nausea and recurrent vomiting. The underlying causes of obstruction were duodenal carcinoma (n=4), pancreatic carcinoma (n=4), gall bladder carcinoma (n=2), distal CBD carcinoma (n=1), and uterine cervical carcinoma (n=1). The sites of obstruction were part I (n=1), part II (n=8), and III (n=3). Due to pre-existing jaundice, eight patients with part II obstructions underwent biliary decompression prior to stent placement. An introducer sheath with a 6-mm outer diameter and stents 16 mm in diameter were employed, and to place the stent, and after-loading technique was used. Stent placement was technically successful in ten patients, and no ...

2002-04-01

Time Management in Acute Vertebrobasilar Occlusion

Purpose: To evaluate the initial and mid-term results of a new self-expanding low strut profile nitinol stent for treatment of atherosclerotic lesions stenoses and occlusions in the superficial femoral artery (SFA). Materials and Methods: In 8 patients (4 male, 4 female, mean age 74.8 {+-} 8.8 years) with SFA lesions and non-satisfying results after PTA treatment alone, 10 self-expanding nitinol Xpert stents were deployed via a 4 F sheath. Stent characteristics and handling were graded by the interventionalist. Fontaine classification, duplex flow measurements and ankle brachial index (ABI) at rest and stress were taken prior and one day after stent placement. Patients were followed 3, 6 and 12 months after the procedure obtaining the same parameters at each appointment. Results: Initial stent treatment was successful in all patients. Stent handling and positioning were rated very good and safe. All patients improved clinically by at least one Fontaine stage (range before treatment: ...

2007-07-15

The effect of EC-IC bypass surgery on resting cerebral blood flow and cerebrovascular reserve capacity studied with stable Xe-CT and acetazolamide test

Acute vertebrobasilar occlusion (VBO) is associated with a high risk of stroke and death. Although local thrombolysis may achieve recanalization and improve outcome, mortality is still between 35% and 75%. However, without recanalization the chance of a good outcome is extremely poor, with mortality rates of 80-90%. Early treatment is a fundamental factor, but detailed studies of the exact time management of the diagnostic and interventional workflow are still lacking. Data on 18 patients were retrospectively evaluated. Time periods between symptom onset, admission to hospital, time of diagnosis, and beginning of intervention were correlated with postinterventional neurological status. The Glasgow Coma Scale and National Institute of Health Stroke Scale (NIHSS) were used to examine patients before and after local thrombolysis. Additionally, multivariate statistics were applied to reveal similarities between patients with neurological improvement. Primary recanalization was achieved in ...

2009-03-01

100

Extracranial-intracranial bypass surgery utilizing homologous arterial grafts irradiated with high voltage cathode rays. Experimental study and clinical application

Cerebral blood flow (CBF) and cerebrovascular reserve capacity (CRC) were measured by stable xenon computerized tomography (Xe-CT) and acetazolamide test in 15 patients with cerebrovascular disease before and after extracranial-intracranial (EC-IC) bypass surgery for minor stroke, reversible ischemic neurological deficit or transient ischemic attack. All had angiographically shown occlusive lesions of the major arterial trunk. In the present series, global analysis showed that the bypass did not increase the resting rCBF, but did increase the rCRC. We divided the patients into four groups according to the preoperative resting rCBF and rCRC. All 3 patients with normal resting rCBF and reduced rCRC showed postoperative improvement of rCRC. Of 6 patients with reduced CBF and reduced CRC, three had postoperative increase in resting CBF and four had increased CRC. One of two patients with reduced CBF and normal CRC showed only an increase in CRC. We propose that reduced ...

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101

Extracranial-intracranial bypass surgery utilizing homologous arterial grafts irradiated with high voltage cathode rays

Homologous and heterologous arterial segments were implanted in Fisher rats subcutaneously for the purpose of examining the antibody titer of the recipients' serum after implantation by means of the immune-adherence hemagglutination method. The antibody titer after implantation both of homologous and heterologous grafts decreased to 1/8 by 2.0 million (M) rads irradiation of high voltage cathode rays. The results suggested that high voltage cathode ray irradiation was not enough for heterologous graft to suppress its tissue reaction. Homografts taken from dogs 3 or 6 hours after sacrifice were irradiated with 2.0 M rads and transplanted in canine carotid artery using the technic of end-to-end anastomosis. Angiograms 6 months after operation revealed excellent patency rate in all the grafts of 28 dogs. furthermore, findings of the grafts from 1 week to 5 years after operation on scanning and transmission electron microscopies were evaluated. Clinical application of bypass ...

1982-06-01

102

Accelerators for proton and heavy ion radiotherapy

1982-01-01

103

Comparison of contrast-enhanced flash and turbo-flash with conventional spin-echo sequences as a basis for morphologocal MR imaging for planning high-precision radiotherapy of intracranial brain tumors. Comparison of FLASH-, turbo-FLASH and SE-sequences; Morphologische MR-Bildgebung mit T1-gewichteten Sequenzen zur radiotherapeutischen Zielvolumendefinition von intrakraniellen Tumoren. Vergleich von FLASH-, Turbo-FLASH- und SE-Sequenzen

The construction of Heavy Ion Medical Accelerator in Chiba (HIMAC) at the National Institute of Radiological Sciences was completed in December 1993. HIMAC consists of an injector linac, two synchrotron rings, a high energy beam transport system and a beam irradiation system. Its accelerator parameters are based on the medical requirement, and helium, carbon, neon, silicon and argon were selected as the accelerated ion species. It has 3 therapy rooms (A{approx}C). Room A has a vertical irradiation system, Room C horizontal and Room B both vertical and horizontal. Two rings can supply beams independently to the vertical and horizontal irradiation systems. Clinical trial started on June 21 1994, after several basic biological and physics experiments lasting about 2 months. Cancer is the top cause of death in Japan since 1981, and people expect good treatment results at HIMAC. Proton and heavy ion radiotherapy has the advantage of dose distribution and biological effect in comparison with ...

1995-03-01

104

Quantitative analysis of spinal CSF dynamics using magnetic resonance imaging: experimental and clinical studies; MR-tomographische Liquorflussmessungen am Spinalkanal mit einem optimierten MRT-Protokoll: experimentelle und klinische Untersuchungen

Introduction: The goal of this study was to compare contrast-enhanced T1-weighted Flash and Turbo-Flash sequences with conventional spin-echo sequences as a basis for planning high-precision radiotherapy. Methods: A total of 25 consecutive patients with different intracranial tumors and a disrupted blood-brain barrier were studied. T1-weighted Flash, Turbo-Flash and conventional spin-echo images were evaluated after controlled 30-s infusion of 0.1 mmol/kg body weight of Gd-DTPA. The evaluation of the three sequences included the measurement of the signal- and contrast-to-noise ratios, the visual inspection of the tumors and artifacts, and the measurement of tumor size. Results: The signal- and contrast-to-noise ratios were significantly (P<0.05-0.01) lower for Flash and Turbo-Flash than for conventional spin-echo sequences. However, visual inspection of the contrast-enhancing tumors revealed in 23 and 24 of 25 lesions of Flash and Turbo-Flash images, ...

1997-03-01

105

High-dose radiation therapy for inoperable non-small cell lung cancer without mediastinal involvement (clinical stage N0, N1)

Purpose: Measurement of the oscillating CSF flow in the spinal canal (SC) of healthy volunteers and in patients with post-traumatic syringomyelia (PTS) using an optimized MRI protocol as well as to determine whether stenosis induced velocity changes are detectable using MRI. Methods: In 68 healthy volunteers quantitative studies of CSF flow in the cervical, thoracic, and lumbar regions were performed. First, an optimized sequence was developed and tested in 19 volunteers using four different flow-encoding velocities (4, 8, 12, 16 cm/s). Secondly, the optimized sequence was employed in 49 volunteers to measure the different CSF patterns in the cervical, thoracic, and lumbar spinal canals (CSC, TSC, LSC). Part three of the study, in which patients with PTS are being examined is still underway. We measured the maximum velocity (cm/s), the pixel area (mm{sup 2}), and the stroke volume (ml/s). Using a flow model the velocities prior to and after compression with 5 ...

2001-04-01

106