CT follow-up and clinical outcome in severe traumatic brain injury patients.

Determining a patient's prognosis after severe traumatic brain injury remains difficult and complex. The purpose of the present study was following up patients with severe traumatic brain injury by correlating their clinical outcome and sequential computer tomography (CT) findings. We investigated 51 patients who survived the first year following an accident. All patients underwent successive CT examinations within a maximum period of 2 years. The patients' outcomes depended on the underlying brain damage and are presented by the Glasgow Outcome Scale. Based on the investigated data we concluded that the worst outcomes were experienced by patients with initial massive cerebral edema, extensive subdural hematoma and intraventricular hemorrhage, followed by stroke as subacute CT finding and cerebral atrophy as chronic finding visible at follow-up CT scans. The majority of lesions identified by CT scan were found in the frontal lobes, basal ganglia, and temporal lobes. We suggest that CT examination still represents a simple and useful tool in attempting to predict the clinical outcome in patients with severe traumatic brain injury.

[Feasibility of alpha-blockers in chronic category III prostatitis]. / Uloga alfa-blokatora kod kronicnog prostatitisa tipa III.

Studies were identified on internet by searching on address: http://www.ncbi.nlm.nih.gov/pubmed/ with criteria that studies should be placebo-controlled and randomized in trials of alpha-blockers in chronic category III prostatitis evaluated by symptom-score NIH-CPSI. From 13 clinical studies three were excluded because of not using NIH-CPSI, three were in Chinese language and two were congress abstracts. Analysed were five studies with four or five Jadad scale including 563 patients. Alpha-blockers alfuzosin, terazosin, tamsulosin and doxazosin have been used through 6 weeks and 6 months. Better results were accomplished by less selective alpha-blockers alfuzosin, terazosin and doxazosin through 3-6 months in patients having higher NIH-CPSI score and higher voiding score.

[The role of ultrasonography in evaluation of pathomorphological changes in humeroscapular periarthritis]. / Uloga dijagnostickog ultrazvuka u razlikovanju patomorfoloskih promjena kod humeroskapularnog periartritisa.

The aim of this study was to present the distribution and representation of shoulder ultrasonographic (US) examination findings in patients with diagnosis of humeroscapular periarthritis. US examination findings in 141 patients, that is 147 symptomatic shoulders with diagnosis of humeroscapular periarthritis, were evaluated retrospectively. Outcomes of ultrasonography were distributed in groups by anatomical location, US examination finding and age. Descriptive statistics were used to analyze the data. Out of 147 analyzed shoulders, 87 (59.2%) were positive and 60 (40.8%) were negative upon US examination. The most frequent US abnormalities were detected in a supraspinatus tendon (55.3%), followed by long head of the biceps tendon (15.2%), bursitis (12.6%), subscapularis tendinitis (10.6%) and infraspinatus tendinitis (0.7%). The highest number of US abnormalities, as well as negative ultrasonographies, were detected at the age 40 to 65. The least negative US examination findings were at age over 65, where also the highest number of supraspinatus tears were detected. Due to high specificity and sensitivity in the evaluation of the rotator cuff, subacromial bursa and long head of the biceps tendon changes, ultrasound is a reliable method for evaluation of patients with painful shoulder. Its availability, noninvasivity and relatively low cost make it a method of choice for inital evaluation of such patients. Detailed history and clinical examination are going to lessen inadequate medical requests for ultrasonography.

Virtual endoscopy and 3D volume rendering in the management of frontal sinus fractures.

Frontal sinus fractures (FSF) are commonly caused by traffic accidents, assaults, industrial accidents and gunshot wounds. Classical roentgenography has high proportion of false negative findings in cases of FSF and is not particularly useful in examining the severity of damage to the frontal sinus posterior table and the nasofrontal duct region. High resolution computed tomography was inavoidable during the management of such patients but it may produce large quantity of 2D images. Postprocessing of datasets acquired by high resolution computer tomography from patients with severe head trauma may offer a valuable additional help in diagnostics and surgery planning. We performed virtual endoscopy (VE) and 3D volume rendering (3DVR) on high resolution CT data acquired from a 54-year-old man with with both anterior and posterior frontal sinus wall fracture in order to demonstrate advantages and disadvantages of these methods. Data acquisition was done by Siemens Somatom Emotion scanner and postprocessing was performed with Syngo 2006G software. VE and 3DVR were performed in a man who suffered blunt trauma to his forehead and nose in an traffic accident. Left frontal sinus anterior wall fracture without dislocation and fracture of tabula interna with dislocation were found. 3D position and orientation of fracture lines were shown in by 3D rendering software. We concluded that VE and 3DVR can clearly display the anatomic structure of the paranasal sinuses and nasopharyngeal cavity, revealing damage to the sinus wall caused by a fracture and its relationship to surrounding anatomical structures.

Our experience with virtual endoscopy of paranasal sinuses.

The main goal of our work was to evaluate advantages and disadvantages of virtual endoscopy (VE) techniques in routinely diagnostic and preoperative management of patients with various sinus diseases or head traumas in our practice. Fly-through algorithm was performed using an Xeon based workstation on data sets created from axial CT images acquired from 320 patients with various paranasal sinus disorders. Images were created using Siemens Somatom Emotion 16 continiously rotating helical CT scanner and archived in DICOM format. In comparison with real endoscopy, the VE has several advantages. It is completely non-invasive. It is possible to repeat the same procedure several times, therefore it may be a valuable tool for training. Interactive control of all virtual camera parameters, including the field-of-view is possible. Endoscopic viewing as opposed to real endoscopy is not restricted to the spaces defined by inner surfaces. The viewer may penetrate the walls and see the extent of lesions within and beyond the wall as well as the adjacent anatomic structures. Virtual endoscopy also has a potential to stage tumors by determining the location and the extent of transmural extension.

Virtual bronchoscopy and 3D spiral CT reconstructions in the management of patient with bronchial cancer--our experience with Syngo 3D postprocessing software.

Multislice helical CT generated virtual bronchoscopy (VB) represents one of the most recent developments in three-dimensional computer aided visualisation techniques. VB allows non-invasive and relatively accurate 3D evaluation of tracheobronchal tree. We performed virtual bronchoscopy and in-space 3D volume analysis on CT-data set acquired from sixty-four-year old male with bronchial cancer in order to demonstrate advantages and disadvantages of these methods in diagnostics and preoperative management of metastatic bronchial cancer. Siemens Somatom Emotion 16 helical CT scanner was used for data acquisition. Data post-processing was done with 3D Syngo 2006G software package from Siemens medical systems. CT scanning of the thorax was performed in heavy smoker with an expansive T4N1M1 malignant process in a superior lobe of the right lung accompanied with large metastatic lesion attached on the right lateral chest wall. Metastatic lesions were also found in vertebral column. In-space 3D analysis followed with virtual bronchoscopy had revealed obstruction of apical branch of superior lobe segmental bronchus. External compression done by tumor to the superior segmental and right main bronchus was found. We concluded that multi-slice CT in connection with VB became a possible non-invasive alternative to bronchoscopy, if tissue samples are not required.

12th WINFOCUS world congress on ultrasound in emergency and critical care.

TABLE OF CONTENTS: A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization. A novel approach in emergency departmentMargarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA5 Clinical ultrasound in a septic and jaundice patient in the emergency departmentMargarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA6 Characterization of the eyes in preoperative cataract Saudi patients by using medical diagnostic ultrasoundMustafa Z. Mahmoud, Abdelmoneim SuliemanA7 High-frequency ultrasound in determining the causes of acute shoulder joint painMustafa Z. MahmoudA8 Teaching WINFOCUS Ultrasound Life Support Basic Level 1 for Providers in resource-limited countriesAbbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H. Lester Kirchner, Gregor ProsenA9 Changes of arterial stiffness and endothelial function during uncomplicated pregnancyAjda Anzic, Paul LeesonA10 Cardiovascular haemodynamic properties before, during and after pregnancyAjda Anzic, Paul LeesonA11 An old man with generalized weaknessMaryam Bahreini, Fatemeh RasooliA12 Ultrasonography for non-specific presentations of abdominal painMaryam Bahreini, Houman HosseinnejadA13 Introduction of a new imaging guideline for suspected renal colic in the emergency department: effect on CT Urogram utilisationGabriel Blecher, Robert Meek, Diana Egerton-WarburtonA14 Transabdominal ultrasound screening for pancreatic cancer in Croatian military veterans: a retrospective analysis from the first Croatian veteran's hospitalEdina Catic Cuti, Stanko Belina, Tihomir Vancina, Idriz KovacevicA15 The challenge of AAA: unusual case of obstructive jaundiceEdina Catic Cuti, Nadan RustemovicA16 Educational effectiveness of easy-made new simulator model for ultrasound-guided procedures in pediatric patients: vascular access and foreign body managementIkwan Chang, Jin Hee Lee, Young Ho Kwak, Do Kyun KimA17 Detection of uterine rupture by point-of-care ultrasound at emergency department: a case reportChi-Yung Cheng, Hsiu-Yung Pan, Chia-Te KungA18 Abdominal probe in the hands of interns as a relevant diagnostic tool in revealing the cause of heart failureEla Curcic, Ena Pritisanac, Ivo Planinc, Marijana Grgic Medic, Radovan RadonicA19 Needs assessment of the potential utility of point-of-care ultrasound within the Zanzibar health systemAbiola Fasina, Anthony J. Dean, Nova L. Panebianco, Patricia S. HenwoodA20 Ultrasonographic diagnosis of tracheal compressionOliviero Fochi, Moreno Favarato, Ezio BonanomiA21 The role of ultrasound in the detection of lung infiltrates in critically ill patients: a pilot studyMarijana Grgic Medic, Ivan Tomic, Radovan RadonicA22 The SAFER Lasso; a novel approach using point-of-care ultrasound to evaluate patients with abdominal complaints in the emergency departmentYoungrock Ha, Hongchuen TohA23 Awareness and use of clinician-performed ultrasound among clinical clerkship facultyElizabeth Harmon, Wilma Chan, Cameron Baston, Gail Morrison, Frances Shofer, Nova Panebianco, Anthony J. DeanA24 Clinical outcomes in the use of lung ultrasound for the diagnosis of pediatric pneumoniasAngela Hua, Sharon Kim, James TsungA25 Effectiveness of ultrasound in hypotensive patientsIsa Gunaydin, Zeynep Kekec, Mehmet Oguzhan AyA26 Moderate-to-severe left ventricular ejection fraction related to short-term mortality of patients with post-cardiac arrest syndrome after out-of-hospital cardiac arrestJinjoo Kim, Jinhyun Kim, Gyoosung Choi, Dowon ShimA27 Usefulness of abdominal ultrasound for acute pyelonephritis diagnosis after kidney transplantationJi-Han LeeA28 Lung ultrasound for assessing fluid tolerance in severe preeclampsiaJana Ambrozic, Katja Prokselj, Miha LucovnikA29 Optic nerve sheath ultrasound in severe preeclampsiaGabrijela Brzan Simenc, Jana Ambrozic, Miha LucovnikA30 Focused echocardiography monitoring in the postoperative period for non-cardiac patientsAsta Maciuliene, Almantas Maleckas, Algimantas Krisciukaitis, Vytautas Maciulis, Andrius MacasA31 POCUS-guided paediatric upper limb fracture reduction: algorithm, tricks, and tipsSharad MohiteA32 Point-of-care lung ultrasound: a good diagnostic tool for pneumonia in a septic patientZoltan Narancsik, Hugon MozinaA33 A case of undergraduate POCUS (r)evolutionSara Nikolic, Jan Hansel, Rok Petrovcic, Una Mrsic, Gregor ProsenA34 The Graz Summer School for ultrasound: from first contact to bedside application: three-and-a-half-day undergraduate ultrasound training: résumé after two years of continuous developmentSimon Orlob, Markus Lerchbaumer, Niklas Schönegger, Reinhard KaufmannA35 Usefulness of point-of-care ultrasound in the emergency room in a patient with acute abdominal painAlberto Oviedo-García, Margarita Algaba-Montes, Mayra Patricio-BordomásA36 Use of bedside ultrasound in a critically ill patient. A case reportAlberto Oviedo-García, Margarita Algaba-Montes, Mayra Patricio-BordomásA37 Diagnostic yield of clinical echocardiography for the emergency physicianAlberto Oviedo-García, Margarita Algaba-Montes, Mayra Patricio-BordomásA38 Focused cardiac ultrasound in early diagnosis of type A aortic dissection with atypical presentationChun-I Pan, Hsiu-Yung Pan, Chien-Hung WuA39 Detection of imperforated hymen by point-of-care ultrasoundHsiu-yung Pan, Chia-Te KungA40 Developing a point-of-care ultrasound curriculum for pediatric nurse practitioners practicing in the pediatric emergency departmentSarah Pasquale, Stephanie J. Doniger, Sharon Yellin, Gerardo ChiricoloA41 Use of transthoracic echocardiography in emergency setting: patient with mitral valve abscessMaja Potisek, Borut Drnovsek, Bostjan LeskovarA42 A young man with syncopeFatemeh Rasooli, Maryam BahreiniA43 Work-related repetitive use injuries in ultrasound fellowsKristine Robinson, Clara Kraft, Benjamin Moser, Stephen Davis, Shelley Layman, Yusef Sayeed, Joseph MinardiA44 Lung ultrasonography in the evaluation of pneumonia in childrenIrmina Sefic Pasic, Amra Dzananovic, Anes Pasic, Sandra Vegar ZubovicA45 Central venous catheter placement with the ultrasound aid: two years' experience of the Interventional unit, Division of Intensive Care Medicine, KBC ZagrebAna Godan Hauptman, Marijana Grgic Medic, Ivan Tomic, Ana Vujaklija Brajkovic, Jaksa Babel, Marina Peklic, Radovan RadonicA46 Duplicitas casui: two patients admitted due to acute liver failureVedran Radonic, Ivan Tomic, Luka Bielen, Marijana Grgic MedicA47 A pilot survey on an understanding of Bedside Point-of-Care Ultrasound (POCUS) among medical doctors in internal medicine: exposure, perceptions, interest, and barriers to trainingPeh Wee MingA48 Unusual case of defecation syncopeNur hafiza Yezid, Fatahul Laham MohammedA49 A case report of massive pulmonary embolism; a multidisciplinary approachZainal Abidin Huda, Wan Nasarudin Wan Ismail, W.Yus Haniff W.Isa, Hashairi Fauzi, Praveena Seeva, Mohd Zulfakar Mazlan.

Chorangioma placentae.

Chorangioma of the placenta is a rare tumor with a frequency of about 1%, which usually presents as a solitary nodule or, less frequently, as multiple nodules. It is found on the fetal surface of the placenta or in placental parenchyma. Most chorangiomas are small and possess no clinical significance. On the contrary, clinically significant chorangiomas, greater then 5 cm or multiple, may be associated with pregnancy complications. The case presented is one of the uncommon presentations of chorangioma, in which its presence and size were not related to a pregnancy disorders or developmental anomalies of the fetus.

Horner's syndrome as an initial sign of metastatic breast cancer: case report.

BACKGROUND: Horner syndrome is caused by a lesion affecting the sympathetic innervation of the lids and pupil. The most common factor producing the preganglionic Horner's syndrome is malignant tumors. METHODS: We report here a case of Horner syndrome in young women with the history of breast cancer. The patient underwent extensive neurological examinations, including MRI of head and neck, together with chest radiograph and CT thorax scan. RESULTS: Present radiographic methods revealed one-sided metastatic pleural effusion as a cause of sympathetic lesion. CONCLUSION: Metastatic breast disease usually affects lungs, bone, liver, adrenals and skin, and it is highly unusual for ocular involvement to be the first sign of its existence. This report presents a rare case of pleural metastatic breast cancer causing Horner's syndrome/Pancoast syndrome without lung involvement.