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1.
Urologe A ; 55(5): 645-7, 2016 May.
Artigo em Alemão | MEDLINE | ID: mdl-27119961

RESUMO

Emphysematous cystitis is a rare disease with a high mortality rate. Generally elderly women with diabetes mellitus are affected. Diagnosis is made radiologically using plain abdominal X­ray or computed tomography. The therapy includes urine drainage, antibiotic treatment and hyperglycaemic control to avoid progress of the infection and the development of complications. In the current report we present a case of a 79-year-old woman with uncontrolled diabetes mellitus and an incidental diagnosis of emphysematous cystitis.


Assuntos
Cistite/diagnóstico , Cistite/terapia , Complicações do Diabetes/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Enfisema/diagnóstico , Enfisema/terapia , Infecções por Escherichia coli/diagnóstico , Idoso , Neoplasias da Mama/complicações , Cefuroxima/uso terapêutico , Complicações do Diabetes/terapia , Progressão da Doença , Infecções por Escherichia coli/terapia , Feminino , Hidratação , Hemoglobina A Glicada/metabolismo , Humanos , Tomografia Computadorizada por Raios X , Cateterismo Urinário
2.
J Neural Eng ; 10(5): 056022, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24045617

RESUMO

OBJECTIVE: Detonation nanodiamond monolayer coatings are exceptionally biocompatible substrates for in vitro cell culture. However, the ability of nanodiamond coatings of different origin, size, surface chemistry and morphology to promote neuronal adhesion, and the ability to pattern neurons with nanodiamonds have yet to be investigated. APPROACH: Various nanodiamond coatings of different type are investigated for their ability to promote neuronal adhesion with respect to surface coating parameters and neurite extension. Nanodiamond tracks are patterned using photolithography and reactive ion etching. MAIN RESULTS: Universal promotion of neuronal adhesion is observed on all coatings tested and analysis shows surface roughness to not be a sufficient metric to describe biocompatibility, but instead nanoparticle size and curvature shows a significant correlation with neurite extension. Furthermore, neuronal patterning is achieved with high contrast using patterned nanodiamond coatings down to at least 10 µm. SIGNIFICANCE: The results of nanoparticle size and curvature being influential upon neuronal adhesion has great implications towards biomaterial design, and the ability to pattern neurons using nanodiamond tracks shows great promise for applications both in vitro and in vivo.


Assuntos
Adesão Celular/fisiologia , Diamante , Nanopartículas , Rede Nervosa/fisiologia , Neurônios/fisiologia , Animais , Interfaces Cérebro-Computador , Hipocampo/citologia , Processamento de Imagem Assistida por Computador , Imuno-Histoquímica , Camundongos , Microscopia de Força Atômica , Tamanho da Partícula , Cultura Primária de Células , Espectroscopia de Infravermelho com Transformada de Fourier , Análise Espectral Raman , Propriedades de Superfície
3.
AJNR Am J Neuroradiol ; 34(5): 1072-6, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23221946

RESUMO

BACKGROUND AND PURPOSE: CT in low dose technique is the criterion standard imaging modality for evaluation of the paranasal sinus. Our aim was to evaluate the dose-reduction potential of a recently available sinogram-affirmed iterative reconstruction technique, regarding noise, image quality, and time duration when evaluating this region. MATERIALS AND METHODS: CT was performed on a phantom head at different tube voltages (120 kV, 100 kV) and currents (100 mAs, 50 mAs, 25 mAs). Each protocol was reconstructed (in soft tissue and bony kernel) by using standard filtered back-projection and 5 different SAFIRE strengths, and image noise was evaluated. Subjective image quality was evaluated on noise-aligned image triplets acquired at tube currents of 100% (FBP), 50% (SAFIRE), and 25% (SAFIRE) by using a 5-point scale (1 = worst, 5 = best). The time duration for image reconstruction was noted for calculations with FBP and SAFIRE. RESULTS: SAFIRE reduced image noise by 15%-85%, depending on the iterative strength, rendering kernel, and dose parameters. Noise reduction was stronger at a bone kernel algorithm both in 1- and 3-mm images (P < .05). Subjective quality evaluation of the noise-adapted images showed preference for those acquired at 100% tube current with FBP (4.7-5.0) versus 50% dose with SAFIRE (3.4-4.4) versus 25% dose with SAFIRE (2.0-3.1). The time duration for FBP image sets was 2.9-6.6 images per second versus SAFIRE with 0.9-1.6 images per second. CONCLUSIONS: For CT of the paranasal sinus, SAFIRE algorithms are suitable for image-noise reduction. Because image quality decreases with dosage, careful choice of the appropriate iterative method is necessary to achieve an optimal balance between image noise and quality.


Assuntos
Algoritmos , Seios Paranasais/diagnóstico por imagem , Doses de Radiação , Proteção Radiológica/métodos , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Humanos , Imagens de Fantasmas , Intensificação de Imagem Radiográfica/métodos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/instrumentação
4.
Rofo ; 184(1): 42-7, 2012 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-22033845

RESUMO

PURPOSE: The purpose of this study was to examine the clinical use of MR-guided biopsies in patients with suspicious lesions using a new MR-compatible assistance system in a high-field MR system. MATERIALS AND METHODS: Six patients with suspicious focal lesions in various anatomic regions underwent percutanous biopsy in a high-field MR system (1.5 T, Magnetom Espree, Siemens) using a new MR-compatible assistance system (Innomotion). The procedures were planned and guided using T 1-weighted FLASH and TrueFISP sequences. A servopneumatic drive then moved the guiding arm automatically to the insertion point. An MRI compatible 15G biopsy system (Somatex) was introduced by a physician guided by the needle holder and multiple biopsies were performed using the coaxial technique. The feasibility, duration of the intervention and biopsy findings were analyzed. RESULTS: The proposed new system allows accurate punctures in a high-field MR system. The assistance device did not interfere with the image quality, and guided the needle virtually exactly as planned. Histological examination could be conducted on every patient. The lesion was malignant in four cases, and an infectious etiology was diagnosed for the two remaining lesions. Regarding the differentiation of anatomical and pathological structures and position monitoring of the insertion needle, TrueFISP images are to be given preference. The average intervention time was 41 minutes. Lesions up to 15.4 cm beneath the skin surface were punctured. CONCLUSION: The proposed MR-guided assistance system can be successfully utilized in a high-field MR system for accurate punctures of even deep lesions in various anatomic regions.


Assuntos
Biópsia por Agulha/instrumentação , Processamento de Imagem Assistida por Computador/instrumentação , Imageamento Tridimensional/instrumentação , Imagem por Ressonância Magnética Intervencionista/instrumentação , Imagem por Ressonância Magnética/instrumentação , Robótica/instrumentação , Adulto , Idoso , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Software
5.
Rofo ; 182(11): 947-53, 2010 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-20725875

RESUMO

In recent years MR imaging has played an increasingly important role in the diagnosis and treatment of prostate cancer. MR imaging of the prostate allows clear delineation of the anatomic structures and prostate tumors using T 2-weighted images combined with spectroscopy and dynamic examinations. The advantages of MRI make it possible to perform interventions, like biopsies, brachytherapy or different local therapies of the prostate gland. MRI robotic assistance will improve the accuracy of the interventions. Due to the advantages of MR imaging, MR-guided prostate interventions will play a greater role in the future.


Assuntos
Braquiterapia/instrumentação , Imagem por Ressonância Magnética Intervencionista/instrumentação , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Neoplasias da Próstata/terapia , Robótica/instrumentação , Ressecção Transuretral da Próstata/instrumentação , Adulto , Idoso , Biomarcadores Tumorais/sangue , Biópsia por Agulha/instrumentação , Meios de Contraste/administração & dosagem , Meios de Contraste/farmacocinética , Diagnóstico Precoce , Desenho de Equipamento , Humanos , Espectroscopia de Ressonância Magnética/instrumentação , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Antígeno Prostático Específico/sangue , Sensibilidade e Especificidade , Adulto Jovem
6.
Rofo ; 181(7): 658-63, 2009 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-19517340

RESUMO

PURPOSE: The purpose of this study was to evaluate the safety and clinical value of MR-guided biopsies in an open 0.2 T low-field system. MATERIALS AND METHODS: A total of 322 patients with suspicious lesions of different body regions were biopsied in a low-field MRI system (0.2 T, Concerto, Siemens). The procedures were guided using T 1-weighted Flash sequences (TR/TE = 100/9; 70 degrees). The lesions were repeatedly biopsied using the coaxial technique with a 15-gauge (diameter 2 mm) puncture needle. Complications and biopsy findings were analyzed retrospectively. RESULTS: In all cases the biopsy procedures were successfully performed with MR guidance. In 298 patients diagnosis was able to be confirmed on the basis of the probes. The clinical follow-up showed that in 24 patients the lesions were missed by MR-guided biopsy. From this a sensitivity of 86%, a specificity of 87% and an accuracy of 93% were calculated. In two patients major complications were observed (morbidity rate 0.6 %). CONCLUSION: MR-guided biopsy can be performed safely and precisely in a low-field MR system and are a supplement to US or CT-guided biopsies.


Assuntos
Biópsia por Agulha/métodos , Processamento de Imagem Assistida por Computador/métodos , Imagem por Ressonância Magnética Intervencionista/métodos , Neoplasias/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
7.
Eur Radiol ; 18(7): 1356-63, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18351356

RESUMO

The influence of various variables on the rate of pneumothorax and intrapulmonal hemorrhage associated with computed tomography (CT)-guided transthoracic needle biopsy of the lung were evaluated retrospectively. One hundred and thirty-three patients underwent CT guided biopsy of a pulmonary lesion. Two patients were biopsied twice. Variables analyzed were lesion size, lesion location, number of pleural needle passes, lesion margin, length of intrapulmonal biopsy path and puncture time. Eighteen-gauge (18G) cutting needles (Trucut, Somatex, Teltow, Germany) were used for biopsy. Pneumothorax occurred in 23 of 135 biopsies (17%). Chest tube placement was required in three out of 23 cases of pneumothorax (2% of all biopsies). Pneumothorax rate was significantly higher when the lesions were located in the lung parenchyma compared with locations at the pleura or chest wall (P < 0.05), but all pneumothorax cases which required chest tube treatment occurred in lesions located less than 2 cm from the pleura. Longer puncture time led to an increase in pneumothorax rate (P < 0.05). Thirty-seven (27%) out of 135 biopsies showed perifocal hemorrhage. Intrapulmonal biopsy paths longer than 4 cm showed significantly higher numbers of perifocal hemorrhage and pneumothorax (P < 0.05). Significantly more hemorrhage occurred when the pleura was penetrated twice during the puncture (P < 0.05). Lesion size <4 cm is strongly correlated with higher occurrence of perifocal hemorrhage (P < 0.05). Lesion margination showed no significant effect on complication rate. CT-guided biopsy of smaller lesions correlates with a higher bleeding rate. Puncture time should be minimized to reduce pneumothorax rate. Passing the pleura twice significantly increases the risk of hemorrhage. Intrapulmonal biopsy paths longer than 4 cm showed significantly higher numbers of perifocal hemorrhage as well as pneumothorax.


Assuntos
Biópsia por Agulha/efeitos adversos , Hemorragia/etiologia , Pneumopatias/patologia , Pneumotórax/etiologia , Radiografia Intervencionista , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Tubos Torácicos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
8.
Rofo ; 180(3): 246-51, 2008 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-18278732

RESUMO

PURPOSE: With the development and refinement of digital imaging, conventional fluoroscopic units are increasingly being replaced by state-of-the-art digital units for the practice of gastrointestinal imaging. The purpose of this study was to compare digital and conventional methods of gastrointestinal imaging by enteroclysis based on radiation exposure to the patient and fluoroscopy time. MATERIALS AND METHODS: The medical records of 241 patients who underwent enteroclysis by the conventional technique in 1990 and 309 patients who underwent enteroclysis by digital technique between 2000 and 2004 were reviewed. The radiation exposure of the patient and the fluoroscopy time were evaluated. RESULTS: The mean radiation exposure was significantly lower (p < or = 0.05) for patients examined by the digital technique (4945.07 cGy x cm (2)) than for patients examined by the conventional technique (7513.6 cGy x cm (2)). The fluoroscopy time was significantly lower with the conventional technique (mean fluoroscopy time 9 min 43 sec) than with the digital technique (17 min 10 sec). CONCLUSION: We conclude that radiation exposure does not correlate directly with fluoroscopy time. Technical refinements of the digital technique such as Last Image Hold frames, which allow images to be stored with no increase in radiation dose and help to reduce digital fluorography exposures and pulsed fluoroscopy, result in significant dose reduction.


Assuntos
Fluoroscopia/métodos , Intestino Delgado/diagnóstico por imagem , Doses de Radiação , Intensificação de Imagem Radiográfica , Sulfato de Bário , Distribuição de Qui-Quadrado , Doença de Crohn/diagnóstico por imagem , Duodeno/diagnóstico por imagem , Enema , Feminino , Humanos , Íleo/diagnóstico por imagem , Jejuno/diagnóstico por imagem , Masculino , Estatísticas não Paramétricas , Fatores de Tempo
9.
Anaesthesist ; 57(2): 147-50, 2008 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-17928974

RESUMO

For more than 20 years percutaneous vertebroplasty has been used in the minimally invasive treatment of vertebral fractures. We report on a patient with embolisation of bone cement into the pulmonary artery and the right ventricle, which was perforated. The final diagnosis was delayed due to a combination of complications, previous disorders as well as a second embolisation.


Assuntos
Traumatismos Cardíacos/etiologia , Complicações Pós-Operatórias/etiologia , Embolia Pulmonar/etiologia , Disfunção Ventricular Direita/etiologia , Vertebroplastia/efeitos adversos , Anestesia , Cimentos para Ossos/efeitos adversos , Diagnóstico Diferencial , Eletrocardiografia , Traumatismos Cardíacos/diagnóstico , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/terapia , Testes de Função Respiratória , Fraturas da Coluna Vertebral/cirurgia , Espirometria , Tomografia Computadorizada por Raios X , Disfunção Ventricular Direita/diagnóstico , Disfunção Ventricular Direita/terapia
10.
Artigo em Inglês | MEDLINE | ID: mdl-17763096

RESUMO

In recent years MR imaging has played an increasingly important role in the diagnosis and treatment of prostate cancer. MR imaging of the prostate allows a clear delineation of the anatomic structures and prostate tumors when performing interventions such as biopsies, brachytherapy or thermal therapy of the prostate gland. MRI robotic assistance will improve the accuracy of the interventions. Due to the advantages of MR imaging MR-guided prostate interventions will play an increasing role in future.


Assuntos
Imagem por Ressonância Magnética Intervencionista/métodos , Próstata , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/terapia , Biópsia , Braquiterapia , Ablação por Cateter , Humanos , Imagem por Ressonância Magnética Intervencionista/instrumentação , Masculino , Próstata/patologia , Próstata/efeitos da radiação
11.
Mol Pharmacol ; 69(4): 1251-9, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16436589

RESUMO

N-Methyl-D-aspartate (NMDA) receptor (NMDAR) activity regulates the net number of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors (AMPAR) at the cell surface by modulating the balance between AMPAR membrane insertion and endocytosis. In this study, we addressed the role of NMDAR subtypes and of NMDAR-mediated Ca2+ influx in the NMDAR-induced endocytosis of GluR2-containing AMPARs in primary murine hippocampal neurons. We found that NMDAR activation enhanced the endocytosis of AMPARs containing the GluR2 splice variants with short, but not long, cytoplasmic tails. NMDA-induced GluR2 endocytosis was completely inhibited by pharmacological block of NR2B-containing NMDARs. In turn, preferential block of NR2A-containing NMDARs did not affect NMDA-induced AMPAR endocytosis, indicating that AMPAR internalization is controlled by a restricted set of NMDARs. The NMDA-induced GluR2 internalization was also observed in the absence of extracellular Na+ ions, suggesting that membrane depolarization is not a prerequisite for this effect. Furthermore, the activation of Ca2+-impermeable NMDARs containing the mutant NR1(N598R) subunit failed to enhance AMPAR endocytosis, indicating a requirement of Ca2+ influx directly through the NMDAR channels. In summary, our findings suggest that the NMDAR-induced selective internalization of short C-terminal GluR2-containing AMPARs requires a Ca2+ signal that originates from NMDAR channels and is processed in an NMDAR subtype-restricted manner.


Assuntos
Endocitose/fisiologia , Receptores de AMPA/metabolismo , Receptores de N-Metil-D-Aspartato/fisiologia , Animais , Sequência de Bases , Primers do DNA , Proteínas de Fluorescência Verde/genética , Hipocampo/citologia , Hipocampo/metabolismo , Camundongos , Neurônios/metabolismo , Fenótipo
12.
HIV Med ; 6(3): 179-84, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-15876284

RESUMO

OBJECTIVES: The aim of the study was to evaluate the safety and efficacy of abacavir (ABC) and efavirenz (EFV) instead of a protease inhibitor (PI) in HIV-1-infected subjects treated with two nucleoside reverse transcriptase inhibitors (NRTIs) and one PI with undetectable viral loads (< 50 HIV -1 RNA copies/mL). To be eligible for inclusion, patients had to have a history of viral load < 400 copies/mL for at least 3 months and had to be naive to treatment with nonnucleoside reverse transcriptase inhibitors (NNRTIs) and ABC, but multiple pretreatment and treatment failure were allowed. DESIGN: An open-label, single-centre pilot study of duration 48 weeks was conducted. ABC was added to the original treatment with two NRTIs and one PI at baseline, and at week 6 the PI was replaced by EFV. At each study visit, CD4 cell count, viral load [measured by polymerase chain reaction (PCR)] and clinical chemistry were measured. Fasting blood samples were taken at baseline and at weeks 12, 24, 36 and 48 to measure levels of cholesterol [high-density lipoprotein (HDL)/low-density lipoprotein (LDL)], triglycerides, insulin and C-peptide. Additionally, an oral glucose tolerance test (OGTT) was performed. A bioelectric impedance analysis (BIA) and a single slice abdominal and mid-thigh computed tomography (CT) scan were carried out to assess changes in body composition. RESULTS: Thirty patients were included in the study. Three patients experienced ABC-hypersensitivity and one patient demonstrated virological failure caused by nonadherence. At week 48, all remaining patients had viral loads < 50 copies/mL with stable CD4 counts. The fasting metabolic parameters and abdominal fat distribution remained unchanged. CONCLUSIONS: In heavily pretreated patients, ABC and EFV in combination provide an effective, simplified and well-tolerated alternative to PI treatment.


Assuntos
Didesoxinucleosídeos/uso terapêutico , Infecções por HIV/tratamento farmacológico , HIV-1 , Oxazinas/uso terapêutico , Inibidores da Transcriptase Reversa/uso terapêutico , Adulto , Idoso , Terapia Antirretroviral de Alta Atividade , Benzoxazinas , Composição Corporal/efeitos dos fármacos , HDL-Colesterol/sangue , Esquema de Medicação , Quimioterapia Combinada , Feminino , Infecções por HIV/imunologia , Infecções por HIV/virologia , Inibidores da Protease de HIV/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estatísticas não Paramétricas , Carga Viral
13.
J Neurochem ; 92(6): 1306-16, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15748150

RESUMO

The postsynaptic density (PSD) is an electron-dense structure located at the synaptic contacts between neurons. Its considerable complexity includes cytoskeletal and scaffold proteins, receptors, ion channels and signaling molecules, in line with the role of PSDs in signal transduction and processing. The phosphorylation state of components of the PSD is central to synaptic transmission and is known to play a role in synaptic plasticity, learning and memory. The presence of a range of kinases and phosphatases in the PSD defines potential key players in this context. However, the substrates that these enzymes target have not been fully identified to date. We analyzed the protein composition of purified PSD samples from adult mouse brains by strong cation exchange chromatography fractionation of a tryptic digest followed by nano-reverse phase liquid chromatography coupled with electrospray ionization-quadrupole time of flight tandem mass spectrometry. This led to the identification of 244 proteins. To gain an insight into the phosphoproteome of the PSD we then purified phosphorylated tryptic peptides by immobilized metal ion affinity chromatography. This approach for the specific enrichment of phosphopeptides resulted in the identification of 42 phosphoproteins in the PSD preparation, 39 of which are known PSD components. Here we present a total of 83 in vivo phosphorylation sites.


Assuntos
Proteínas de Membrana/química , Proteínas do Tecido Nervoso/química , Fosfoproteínas/química , Membranas Sinápticas/química , Animais , Química Encefálica , Cromatografia por Troca Iônica , Enzimas/química , Enzimas/metabolismo , Proteínas de Membrana/metabolismo , Camundongos , Proteínas do Tecido Nervoso/metabolismo , Peptídeos/química , Peptídeos/metabolismo , Fosfoproteínas/metabolismo , Fosforilação , Proteoma/química , Espectrometria de Massas por Ionização por Electrospray , Frações Subcelulares/química , Membranas Sinápticas/metabolismo , Transmissão Sináptica/fisiologia
14.
Exp Clin Endocrinol Diabetes ; 112(8): 451-7, 2004 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-15372366

RESUMO

A plethora of systemic and local signaling molecules regulate ovarian function, but how different signaling molecules interact within an ovarian target cell is not known. Here we report that endocrine cells of the ovary express a phosphoprotein, DARPP-32 (dopamine and cyclic AMP-regulated phosphoprotein of Mr 32,000), which integrates signaling molecules in neurons. We thus hypothesized that DARPP-32 might act in a similar way in ovarian endocrine cells and therefore studied whether DARPP-32 gene deletion has consequences for ovarian functions in mice. Reproductive performance of adult mutants did not differ from wild-type females, as judged from numbers of litters and pups delivered. Similar steroid levels in mutant and wild-type mice ruled out gross abnormalities in the hypothalamic-pituitary-ovarian axis. However, an analysis of ovarian morphology, using serially sectioned ovaries, revealed several differences. Ovaries of young adult mutant mice at 2 - 3 months contained luteinized follicles, but fewer corpora lutea. At 5 - 6 months, large cysts were found in mutant mice, as well as reduced numbers of preantral follicles and antral follicles. Interstitial cell hypertrophy and degeneration was marked in all mutant ovaries at this age. Thus, while the lack of DARPP-32 does not overtly alter reproductive performance in adult mice, it is associated with progressive alterations and derangements of growth and development of ovarian follicles, suggesting premature ovarian ageing. This implies that ovarian DARPP-32 is involved in follicular development, presumably by integrating effects of signaling molecules, which act together to ensure efficient follicular development.


Assuntos
Deleção de Genes , Proteínas do Tecido Nervoso/genética , Ovário/patologia , Fosfoproteínas/genética , Animais , Fosfoproteína 32 Regulada por cAMP e Dopamina , Feminino , Atresia Folicular , Hipertrofia , Camundongos , Proteínas do Tecido Nervoso/metabolismo , Cistos Ovarianos/patologia , Ovário/metabolismo , Fosfoproteínas Fosfatases/metabolismo , Fosfoproteínas/metabolismo , Progesterona/sangue , Reação em Cadeia da Polimerase Via Transcriptase Reversa
15.
Eur Radiol ; 14(10): 1751-60, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15300395

RESUMO

The objective is to evaluate different multidetector-row CT (MDCT) strategies for adequate classification of spinal and pelvic injuries. Seventy intubated patients after multiple trauma underwent conventional radiography (CR) and MDCT. Examinations included the pelvis (P), the lumbar spine (LS) and the thoracic spine (TS). Conventional radiographs, 3-mm (CT5) and 5-mm scans (CT3) and 3-mm and 5-mm scans combined with MPR (CT3R/CT5R) were compared to surgery, autopsy and clinical course. MDCT led to significantly better results than CR (P<0.01). Correlation coefficients were r=1.0 (CT3R), r=0.96 [TS] to r=1.0 [P/LS] (CT5R), r=0.8 [P] to r=1.0 [TS] (CT3), r=0.80 [P] to r=0.86 [TS] (CT5) and r=0.3 [TS] to r=0.69 [P] (CR). Fractures were identified by CT3R in 100% of cases, by CT5R in 95%, by CT3 in 90% [P]-100% [TS], by CT5 in 83.3% [LS]-90% [P] and by CR in 57.1% [TS]-87.2% [P]. Unstable fractures were identified in 100% by CT3R, CT5R and CT3, 85.7% [TS]-100% [P/LS] by CT5 and 57.1% [TS]-80% [P] by CR. Only overlapping thin-slice multiplanar reformation allows for an adequate classification of spinal and pelvic injuries and thus is highly emphasized in patients after severe blunt trauma.


Assuntos
Fraturas Ósseas/diagnóstico por imagem , Vértebras Lombares/lesões , Ossos Pélvicos/lesões , Fraturas da Coluna Vertebral/diagnóstico por imagem , Vértebras Torácicas/lesões , Tomografia Computadorizada Espiral , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fraturas Ósseas/classificação , Fraturas Ósseas/cirurgia , Humanos , Processamento de Imagem Assistida por Computador/métodos , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Traumatismo Múltiplo/diagnóstico por imagem , Ossos Pélvicos/diagnóstico por imagem , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Fraturas da Coluna Vertebral/classificação , Fraturas da Coluna Vertebral/cirurgia , Vértebras Torácicas/diagnóstico por imagem , Tomografia Computadorizada Espiral/métodos , Tomografia Computadorizada Espiral/estatística & dados numéricos , Ferimentos não Penetrantes/diagnóstico por imagem
16.
Hamostaseologie ; 24(3): 157-61, 2004 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-15314699

RESUMO

AIM: Determination of the conditions for good acute and long term results of interventional therapy of lesions of the thoracic aorta using stent-grafts. PATIENTS, MATERIAL AND METHODS: 51 patients with aneurysm of the thoracic aorta (type B dissections) covered rupture and aortobronchial fistula were evaluated. All cases were discussed in an interdisciplinary conference consisting of thoracic surgeon and interventional radiologist. Primarily, 20 patients were operated and 31 were treated by intervention. For all a multidetector row CT angiography was ordered prior to the discussion. All procedures were performed in a DSA suite under general anaesthesia. In 29 patients Talent LPS trade mark tube grafts and in four patients an Excluder trade mark graft was implanted. RESULTS: 29 patients had an aneurysm of the thoracic aorta, 21 a type B dissection, 19 a perforation and one patient had an aortobronchial fistula. The follow up was 13.4 months. In 29 patients the stent-graft implantation was successful, in 2 patients stent-graft delivery failed due to severe calcification and kincking of both common iliac arteries. One patient had an iliacal dissection after stent-graft delivery which was treated successfully by surgery. In two patients CT angiographic control detected endoleaks, which were treated with a second stent-graft placement. One patient with an acute perforation of the descending aorta died due to cardiac failure prior to stent-graft implantation. Any neurological complication did not occur. CONCLUSION: Percutaneous treatment of lesions of the descending thoracic aorta using stent-grafts is a safe and feasible alternative treatment to surgical repair. Prior to the a multidetector row CT angiography is necessary for exact planning of the endo-luminal treatment.


Assuntos
Aorta Torácica , Doenças da Aorta/terapia , Stents , Idoso , Idoso de 80 Anos ou mais , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Dissecante/cirurgia , Aneurisma Dissecante/terapia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Aneurisma da Aorta Torácica/terapia , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
17.
Z Gastroenterol ; 42(6): 509-12, 2004 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-15190446

RESUMO

The less frequent complications of colonoscopy include pneumothorax, pneumoperitoneum, emphysema of the retroperitoneum or of the subcutis, septicemia and injuries of visceral organs (mainly the spleen). Since the mid 1970 s more than 30 splenic injuries during colonoscopy have been described. Any cause of increased splenocolic adhesions (inflammatory bowel disease, pancreatitis or prior abdominal surgery) might be a predisposing factor for splenic injury during colonoscopy. Other contributing factors are techniques that result in a strong torsion of the spleno-colic ligament. Patients with left shoulder and abdominal pain, hypotension, and a drop in hemoglobin without rectal bleeding after colonoscopy should be suspected to have splenic injury. Many physicians are not aware of splenic injuries as a potential complication of colonoscopy. Therefore the diagnosis of splenic injury during colonoscopy is often described in the literature as delayed (hours until 10 days). Since a colonoscopic splenic injury can be fatal, this exceedindly rare event must be considered when a patient shows the above-mentioned symptoms and no signs of colon perforation.


Assuntos
Colonoscopia/efeitos adversos , Baço/lesões , Ruptura Esplênica/diagnóstico , Ruptura Esplênica/etiologia , Diagnóstico Diferencial , Humanos , Doenças Raras/diagnóstico , Doenças Raras/etiologia , Esplenopatias/diagnóstico , Esplenopatias/etiologia
19.
Hamostaseologie ; 23(2): 67-70, 2003 May.
Artigo em Alemão | MEDLINE | ID: mdl-12736701

RESUMO

AIM: We demonstrate patients to reveal the conditions for good results with respect to acute and long term out-come of interventional therapy of iliac artery occlusion. MATERIAL AND METHODS: 225 Patients with aortoiliacal occlusion who underwent surgery or intervention were evaluated. All patients were discussed in an interdisciplinary angiologic conference. 63 patients primary had an operation, 161 patients primary were treated by intervention. The two cohorts were compared concerning their structure, the primary success and the primary and secondary patency over one year. RESULTS: Both cohorts showed significant differences, the surgical treated patient had a higher clinical stage as well as more complex iliacal occlusion. The interventional treated patients had higher comorbidity. Primary technical success and patency rates did not show any difference. The complication rate was equally low in both cohorts. In percutaneous treated patients after predilatation, embolization into the periphery occurred. With primary stent PTA, there was no embolization. CONCLUSION: The percutaneous recanalization also of long iliac occlusion is a save, successful alternative to surgery. Nevertheless, there are limits. For optimal therapy management an interdisciplinary consultation is necessary. To avoid embolization, after recanalization primary stent PTA should be performed.


Assuntos
Arteriopatias Oclusivas/cirurgia , Stents , Arteriopatias Oclusivas/diagnóstico por imagem , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Radiografia
20.
Radiologe ; 43(2): 113-21, 2003 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-12624668

RESUMO

Screening for colorectal cancer starts with digital exploration of the rectum and was extended in 1977 using the haemoccult test. It was referred to detect 24% of malignancies, but with a high number of false positive findings. Combination of regular follow up examinations and coloscopy reached a sensitivity of 80%. International studies demonstrated the need of a complete colon examination, so that the coloscopy is actually an important screening method in Germany. The coloncontrast examination is a safe, cost-effective method with a low complication rate. It is suitable especially for patients, in which the colonoscopic evaluation of the colon was not complete and provides additional morphological informations in many cases.


Assuntos
Neoplasias Colorretais/diagnóstico por imagem , Meios de Contraste/administração & dosagem , Pólipos Adenomatosos/diagnóstico por imagem , Pólipos Adenomatosos/patologia , Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Pólipos do Colo/diagnóstico por imagem , Pólipos do Colo/patologia , Colonoscopia , Neoplasias Colorretais/patologia , Enema , Humanos , Mucosa Intestinal/diagnóstico por imagem , Mucosa Intestinal/patologia , Programas de Rastreamento , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Radiografia , Sensibilidade e Especificidade
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