1
|
Chu D, Duda S, Solo K, Yaacoub S, Schunemann H. Physical Distancing, Face Masks, and Eye Protection to Prevent Person-to-Person Transmission of SARS-CoV-2 and COVID-19: A Systematic Review and Meta-Analysis. J Vasc Surg 2020. [PMCID: PMC7503118 DOI: 10.1016/j.jvs.2020.07.040] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
2
|
Crabtree-Ramírez B, Jenkins C, Jayathilake K, Carriquiry G, Veloso V, Padgett D, Gotuzzo E, Cortes C, Mejia F, McGowan CC, Duda S, Shepherd BE, Sterling TR. HIV-related tuberculosis: mortality risk in persons without vs. with culture-confirmed disease. Int J Tuberc Lung Dis 2020; 23:306-314. [PMID: 30871661 DOI: 10.5588/ijtld.18.0111] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) diagnosis in human immunodeficiency virus (HIV) positive persons is difficult, particularly in resource-limited settings. The relationship between TB culture status and mortality in HIV-positive persons treated for TB is unclear. METHODS We evaluated HIV-positive adults treated for TB at or after their first HIV clinic visit in Argentina, Brazil, Chile, Honduras, Mexico or Peru from 2000 to 2015. Anti-tuberculosis treatment included 2 months of isoniazid, rifampicin (RMP)/rifabutin (RBT), pyrazinamide ± ethambutol, followed by continuation phase treatment with isoniazid + RMP/RBT. RESULTS Of 759 TB-HIV patients, 238 (31%) were culture-negative, 228 (30%) had unknown culture status or did not undergo culture and 293 (39%) were culture-positive. The median CD4 at TB diagnosis was 96 (interquartile range 40-228); 636 (84%) received concurrent antiretroviral therapy (ART) and anti-tuberculosis treatment. There were 123 (16%) deaths: 90/466 (19%) with TB culture-negative, unknown or not performed vs. 33/293 (11%) who were TB culture-positive (P = 0.005). In Kaplan-Meier analysis, mortality in TB patients without culture-confirmed disease was higher (P = 0.002). In a Cox model adjusted for age, sex, CD4, ART timing, disease site and stratified by study site, mortality in persons without culture-confirmed TB was not significantly increased compared to those with culture-positive TB (hazard ratio 1.39, 95%CI 0.89-2.16, P = 0.15). CONCLUSION Most HIV-positive patients treated for TB did not have culture-confirmed TB, and mortality tended to be higher in patients without culture-confirmed disease, although the association was not statistically different after adjusting for other variables. Accurate TB diagnosis in HIV-positive persons is crucial.
Collapse
Affiliation(s)
- B Crabtree-Ramírez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - C Jenkins
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - K Jayathilake
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - G Carriquiry
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - V Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - D Padgett
- Hospital Escuela Universitario and Instituto Hondureño de Seguridad Social, Tegucigalpa, Honduras
| | - E Gotuzzo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - C Cortes
- Fundación Arriarán, University of Chile School of Medicine, Santiago, Chile
| | - F Mejia
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - C C McGowan
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - S Duda
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - B E Shepherd
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - T R Sterling
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
3
|
Schroeder H, Meyer DR, Lux B, Ruecker F, Martorana M, Miller L, Duda S. A Pilot Study of Femoropopliteal Artery Revascularisation with a Low Dose Paclitaxel Coated Balloon: Is Predilatation Necessary? J Vasc Surg 2017. [DOI: 10.1016/j.jvs.2017.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
4
|
Schroeder H, Meyer DR, Lux B, Ruecker F, Martorana M, Miller LE, Duda S. A Pilot Study of Femoropopliteal Artery Revascularisation with a Low Dose Paclitaxel Coated Balloon: Is Predilatation Necessary? Eur J Vasc Endovasc Surg 2017; 54:348-355. [PMID: 28778456 DOI: 10.1016/j.ejvs.2017.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 06/23/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE/BACKGROUND The objective was to compare 2 year outcomes in patients treated with or without predilatation prior to drug coated balloon (DCB) angioplasty for symptomatic femoropopliteal lesions. METHODS This prospective multicentre pilot study was conducted at three sites in Germany. It compared claudicants undergoing predilatation with a bare percutaneous transluminal angioplasty (PTA) balloon before DCB (predilatation group) with patients undergoing direct DCB (direct DCB group). Patients were followed for 2 years. Outcomes included late lumen loss at 6 months, and ankle brachial index (ABI), major adverse events, and primary patency at 2 years. A Clinical Events Committee and core laboratories analysed adverse events and angiographic/duplex images, respectively. RESULTS Between December 2011 and November 2012, 50 patients were enrolled to the predilatation group (12% total occlusions) and 28 to the direct DCB group (5% total occlusions). Follow-up compliance at the 2 year visit was 88% (n = 44) and 86% (n = 24), respectively. Late lumen loss at 6 months was lower in the direct DCB group (0.03 ± 0.68 mm vs. 0.54 ± 0.97 mm; p = .01). Major adverse events over 2 years occurred in seven (15%) patients who underwent predilatation and in five (19%) after direct DCB. Mean ABI at 2 years was 0.94 ± 0.15 after predilatation and 1.0 ± 0.12 after direct DCB. Over 2 years, primary patency (80.3% vs. 78.2%; p = .55) was not statistically different between the groups. After propensity score adjustments, 2 year findings remained unchanged. CONCLUSION Paclitaxel coated PTA, with or without bare predilatation, is effective over 2 years in symptomatic patients with femoropopliteal stenotic lesions. Adequately powered randomised controlled comparisons are required to confirm these preliminary results.
Collapse
Affiliation(s)
- H Schroeder
- Centre for Diagnostic Radiology and Minimally Invasive Therapy, Jewish Hospital, Heinz-Galinski-Str. 1, 13347 Berlin, Germany.
| | - D-R Meyer
- Department of Diagnostic and Interventional Radiology, Hubertus Hospital, Berlin, Germany
| | - B Lux
- Centre for Diagnostic Radiology and Minimally Invasive Therapy, St. Joseph Hospital, Wüsthoffstraße 15, 12101 Berlin, Germany
| | - F Ruecker
- Centre for Diagnostic Radiology and Minimally Invasive Therapy, Jewish Hospital, Heinz-Galinski-Str. 1, 13347 Berlin, Germany
| | - M Martorana
- Centre for Diagnostic Radiology and Minimally Invasive Therapy, Jewish Hospital, Heinz-Galinski-Str. 1, 13347 Berlin, Germany
| | - L E Miller
- Miller Scientific Consulting, Inc., 1854 Hendersonville Road, #231, Asheville, NC 28803, USA
| | - S Duda
- Centre for Diagnostic Radiology and Minimally Invasive Therapy, Jewish Hospital, Heinz-Galinski-Str. 1, 13347 Berlin, Germany
| |
Collapse
|
5
|
Duda S. Sicht des am Krankenhaus niedergelassenen Radiologen. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
6
|
Duda S. alles über Gefäßstents. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
7
|
Marcelin A, Perodin C, Baja C, Bright A, Duperval J, Duplan M, Dérilus F, Duda S, Pape J. Developing an Electronic Medical Record for Interlinked Care Services in Haiti. Stud Health Technol Inform 2015; 216:883. [PMID: 26262185 PMCID: PMC4573958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A large clinical care and research organization in Haiti required an electronic medical record system (EMR) to serve the needs of its 30 interlinked clinical programs. After assessing available open source software, the local team designed and implemented a modular proprietary EMR that is improving data quality and patient care. Despite the many benefits of existing open source medical record systems, clinical centers with complex workflow patterns--even those in resource-limited settings--should consider developing sustainable, local systems that fit their care model.
Collapse
Affiliation(s)
- A Marcelin
- Groupe Haïtien d'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO)
| | - C Perodin
- Groupe Haïtien d'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO)
| | - C Baja
- Groupe Haïtien d'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO)
| | - A Bright
- Groupe Haïtien d'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO)
| | - J Duperval
- Groupe Haïtien d'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO)
| | - M Duplan
- Groupe Haïtien d'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO)
| | - F Dérilus
- Groupe Haïtien d'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO)
| | | | - J Pape
- Groupe Haïtien d'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO)
| |
Collapse
|
8
|
Duda S, Schröder H. Alles über beschichtete Ballons. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
9
|
Bennett K, Walter S, Diaz-Granados N, Duda S, Rice M, Manassis K, Cheung A, Wilansky-Traynor P. Efficacy of CBT for Anxious Children & Youth: Findings From an Individual Patient Data Metaanalysis. Ann Epidemiol 2012. [DOI: 10.1016/j.annepidem.2012.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
10
|
Schmidt D, Clasen S, Schäfer J, Rempp H, Erdtmann B, König CW, Duda S, Trübenbach J, Kluba T, Claussen CD, Pereira PL. Manuelle versus maschinelle Bohrung in der CT gesteuerten RFA von Osteoid-osteomen - 11-jährige klinische Erfahrung. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
11
|
Schmidt D, Clasen S, Schaefer J, Rempp H, Duda S, Trübenbach J, König C, Erdtmann B, Claussen C, Pereira P. CT-gesteuerte Radiofrequenz(RF)-Ablation von Osteoidosteomen: klinische Langzeitergebnisse. ROFO-FORTSCHR RONTG 2011; 183:381-7. [DOI: 10.1055/s-0029-1245998] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
12
|
Abarzua S, Drechsler S, Fischer K, Pietschmann N, Stapel J, Duda S, Richter DU, Ehret R, Piechulla B, Briese V. Online monitoring of cellular metabolism in the MCF-7 carcinoma cell line treated with phytoestrogen extracts. Anticancer Res 2010; 30:1587-1592. [PMID: 20592346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Phytoestrogens are naturally occurring, plant-derived, nonsteroidal phytochemicals with anticarcinogenic potential. The aim of this study was to isolate phytoestrogens from the flax root of Linum usitatissimum and to test their effect on cellular metabolism in the human mammalian carcinoma cell line MCF-7 using the Bionas 2500 analysis system. MATERIALS AND METHODS Metabolically relevant parameters such as acidification, oxygen consumption and cell adhesion were registered continuously over 8 and 24 hours on six sensor chips in parallel at different concentrations of flax root extracts. RESULTS The extracts from flax roots of L. usitatissimum reduced extracellular acidification, respiration and adhesion in a concentration-dependent manner. CONCLUSION The Bionas 2500 analysis system allows multiparametric online monitoring of cellular processes and can be used to detect the mode of action of anticarcinogenic compounds in cellular metabolism.
Collapse
Affiliation(s)
- S Abarzua
- Department Biological Sciences, University of Rostock, Institute of Biological Sciences, Rostock, Germany.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Schmidt D, Clasen S, Schäfer J, Rempp H, König CW, Duda S, Erdtmann B, Claussen C, Pereira PL. 10-jährige klinische Erfahrung der CT gesteuerten Radiofrequenzablation von Osteoid-Osteomen. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
14
|
Tepe G, Schmehl J, Reddig F, Heller S, Wiesinger B, Claussen CD, Duda S. Long-term follow-up von Sirolimus beschichteten Stents in der Arteria Carotis im Schweinemodell. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-941006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
15
|
Heller S, Ouriel K, Duda S, Claussen CD, Tepe G. Auswirkung von Reteplase auf den Fibrinogenspiegel und die Blutungsinzidenz bei der Behandlung der peripheren arteriellen Verschlusskrankheit (RELAX-Studie). ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
16
|
Duda S. PTCD: Grundlagen und neue Entwicklungen. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
17
|
Tepe G, Fischmann A, Wiskirchen J, Heller S, Duda S, Stauder NI, Claussen CD. Verschluss der arteriellen Punktionsstelle mit Nitinolclips bei peripheren arteriellen Interventionen. Die StarCom-Studie. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
18
|
Tepe G, Wiskirchen J, Heller S, Fischmann A, Pereira P, Claussen CD, Duda S. Verschluss der arteriellen Punktionsstelle mit Nitinolclips. Die StarCom-Studie. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
19
|
Schmehl J, Tepe G, Wendel HP, Schaffner S, Claussen CD, Duda S. In-vitro-Evaluation der Thrombogenität verschiedener Oberflächenmodifikationen und Beschichtungen von Nitinol-Stents. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
20
|
Wiesinger B, Beregi JP, Oliva V, Dietrich T, Tepe G, Bosiers M, Müller-Hülsbeck S, Duda S. PTFE gecoverte, selbstexpandierbare Stents in der Behandlung hochgradiger iliakaler und femoraler Stenosen und Verschlüsse: Endergebnisse einer prospektiven Studie. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
21
|
Schmidt D, Pereira P, Erdtmann B, Clasen S, Boss A, Claussen CD, Duda S. CT-gesteuerte Radiofrequenz (RF)-Ablation von Osteoid Osteomen: klinische Ergebnisse unter Verwendung einer geschlossen perfundierten. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
22
|
Tepe G, Heller S, Baumgartner I, Zeller T, Stauder N, Pereira P, Claussen CD, Duda S. Rekanalisation von chronischen langstreckingen Verschlüssen bei pAVK - Die RIO-Studie. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
23
|
Reimer P, Landwehr P, Vorwerk D, Brassel F, Link J, Müller-Hülsbeck S, Alfke K, Duda S, Papke K, Puskas Z. Interventionstraining am virtuellen Gefäßmodell. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
24
|
Wiskirchen J, Khorchidi S, Kehlbach R, Bantleon R, Tepe G, Wiesinger B, Claussen CD, Duda S. Vergleichende Beurteilung der wachstumsinhibierenden Effekte der Spindelgifte Paclitaxel und Combretastatin A-4 auf kultivierte humane glatte Muskelzellen und Endothelzellen. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
25
|
Tepe G, Heller S, Wiskirchen J, Stauder N, Wiesinger B, Claussen CD, Duda S. Drug Eluting-Stents und Glycoprotein IIb/IIIa-Blockade bei arteriellen Interventionen im Unterschenkel - Die BELOW-Studie. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
26
|
Bader BD, Berger ED, Heede MB, Silberbaur I, Duda S, Risler T, Erley CM. What is the best hydration regimen to prevent contrast media-induced nephrotoxicity? Clin Nephrol 2004; 62:1-7. [PMID: 15267006 DOI: 10.5414/cnp62001] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hydration is a commonly used method to prevent the decline in GFR after contrast media (CM) application. So far, there have been no controlled, randomized trials investigating the most effective route of fluid administration. METHODS Thirty-nine patients with normal renal function (65 +/- 9 years, serum creatinine 0.9 +/- 0.2 mg/dl, GFR = 110 +/- 31 ml/min/1.73 m2) receiving at least 80 ml of low-osmolality CM during an angiographic procedure were randomized to one of the following hydration regimens: Group 1: volume expansion with 300 ml saline during CM administration (n = 20, serum creatinine 0.8 +/- 0.1 mg/dl, GFR 119 +/- 27 ml/min/1.73 m2); Group 2: intravenous administration of at least 2,000 ml saline within 12 h before and after CM application (n = 19, serum creatinine 0.9 +/- 0.2 mg/dl, GFR 101 +/- 32 ml/min/1.73 m2). GFR was measured by CM clearance (Renalyzer) at baseline and 48 hours after CM administration. The primary end point was the mean change in the GFR after 48 hours, the secondary one was the incidence of CM-induced nephropathy (CMIN), defined as a decrease in GFR of more than 50% from the baseline GFR within 48 hours. RESULTS Patients of group 1 showed a significantly (p < 0.05) higher decline in GFR (delta GFR 34.6 +/- 25.7 ml/min/1.73 m2) compared to patients receiving the intravenous prehydration regimen (delta GFR 18.3 +/- 25.0 ml/min/1.73 m2). The incidence of CMIN was lower in prehydrated patients (5.3%) compared to the other group (15%). CONCLUSION In patients with normal renal function, intravenous prehydration seems to be a very effective and feasible method to prevent the decline in GFR after contrast media exposure. Volume expansion given only during the CM exposure appears not to be sufficient enough to prevent renal damage.
Collapse
Affiliation(s)
- B D Bader
- Department of Internal Medicine III, Section of Nephrology and Hypertension, University of Tübingen, Tübingen, Germany
| | | | | | | | | | | | | |
Collapse
|
27
|
Schöber W, Erdtmann B, Drews K, Guglimetti A, Claussen C, Duda S. Uncommon case of a foreign body ingestion with consecutive small-bowel obstruction in a child. Eur J Pediatr Surg 2004; 14:279-82. [PMID: 15343470 DOI: 10.1055/s-2004-815876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A 12-year-old boy with Lennox syndrome presented with an acute abdomen and a history of progressive abdominal pain and vomiting over 3 weeks. The uncommon finding in this case was a foreign body detected in a lower loop of the jejunum causing radiological and clinical signs of jejunitis/ileitis. The foreign body had to be removed surgically and turned out to be a hard (originally soft) plastic part of a towel rack.
Collapse
Affiliation(s)
- W Schöber
- Department of Diagnostic Radiology, Eberhard-Karls-Universität, Tübingen, Germany.
| | | | | | | | | | | |
Collapse
|
28
|
Stubner A, Schauf B, Duda S, Kurek R, Gall C, Claussen C, Neis KJ, Wallwiener D, Aydeniz B. Embolisation of uterine arteries or laparascopic uterine artery ligation as possible treatment of uterine leiomyoma. ACTA ACUST UNITED AC 2004. [DOI: 10.1007/s10397-004-0020-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
29
|
Duda S. Antikoagulation und Antiaggregation. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
30
|
Abstract
PURPOSE Imaging artifacts in magnetic resonance tomography (MRT) caused by metallic vascular implants (stents) were characterized systematically in dependence on the material and the construction of the implants as well as with respect to different measurement protocols and for different static field strength B (0). METHODS Twelve stents, different in material (stainless steel, nitinol, Co-alloy) and/or construction, were examined at B (0) = 0.2 T and 1.0 T with two 2D gradient echo (GE) sequences (TE = 4 and 10 ms), one 3D GE sequence and one spin echo (SE) sequence. The stents were put into water with Gd-DTPA contrast agent. The dependence on the orientation was analyzed for the 9 possibilities of an orthogonal alignment of the stent axis, the direction of B (0), the slice, the read out, and the phase encoding direction. Special interest was given to the visibility of the stent lumen at forced rf excitation, as well as to the influence of broken struts on the signal obtained. RESULTS For the examined stents GE technique showed, due to spin dephasing regions a total signal loss ranging up to 8 mm away from the stent mashes. The value depends on the stent material, the stent orientation in the scanner and grows with voxel size, echo time and B (0). In SE technique dephasing artifacts vanish and wrong spatial encoding gets visible, rf shielding is more pronounced. The visibility of the stent lumen ranges from nearly unperturbed down to a complete signal loss. An improvement is possible using enlarged flip angles. Broken struts can not be imaged significantly. DISCUSSION The MR representation of metallic stents commercially available at the time, especially of nitionol stents, can be optimized with a suitable adaptation of the imaging parameters. However, a profound improvement can only be expected from new stent material and design.
Collapse
Affiliation(s)
- H Graf
- Sektion für Experimentelle Radiologie, Eberhard-Karls-Universität Tübingen, Tübingen.
| | | | | | | | | | | |
Collapse
|
31
|
Schmidt D, Trübenbach J, König CW, Brieger J, Duda S, Claussen CD, Pereira PL. [Radiofrequency ablation ex vivo: comparison of the efficacy of impedance control mode versus manual control mode by using an internally cooled clustered electrode]. ROFO-FORTSCHR RONTG 2003; 175:967-72. [PMID: 12847653 DOI: 10.1055/s-2003-40436] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To compare the effectiveness of pulsed (impedance control mode) and non-pulsed (manual control mode) radiofrequency ablation (RFA) by using an internal cooled-clustered electrode. MATERIALS AND METHODS Ex vivo RF ablations (n = 93) were performed with a 200 W RF generator (Model-Cooled Tip, Radionics, USA) in 10 bovine livers, using the impedance and manual control mode. In the impedance control mode, the generator automatically adjusted the applied RF power to the tissue impedance measured during RF ablation. In the manual control mode, the application of the RF power was constant. Both applications were investigated in a capacity range between 5 and 200 W. The duration for each RF ablation was between 2 and 60 minutes. After RF ablation, the short axis diameter of the necrosis was determined macroscopically and the peripheral zone of the necrosis histologically. RESULTS The impedance control mode produced lesions with short axis diameters of 5.3 +/- 0.3 cm at a power of 200 W after 60 minutes of RF ablation and the manual control mode lesions with short axis diameters of 4.1 +/- 0.4 cm at a power of 70 W after 8 +/- 2 minutes of RF ablation. The impedance control mode increased significantly the time of RF ablation with higher power and the size of necrosis (p < 0.01). CONCLUSION In comparison to non-pulsed RF ablation, pulsed RF ablation with internal cooled-clustered electrodes significantly increases the size of the lesions and represents a methodical optimization in our opinion.
Collapse
Affiliation(s)
- D Schmidt
- Uniklinik Tübingen, Radiologische Klinik, Abteilung für Radiologische Diagnostik.
| | | | | | | | | | | | | |
Collapse
|
32
|
Lauer UA, Klemm T, Graf H, Duda S, Claussen CD, Schick F. [Minimizing artefacts of metallic instruments and implants in MRI]. BIOMED ENG-BIOMED TE 2003; 47 Suppl 1 Pt 1:455-7. [PMID: 12451891 DOI: 10.1515/bmte.2002.47.s1a.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- U A Lauer
- Sektion für Experimentelle Radiologie, Universitätsklinikum Tübingen.
| | | | | | | | | | | |
Collapse
|
33
|
|
34
|
Mondon JA, Duda S, Nowak BF. Histological, growth and 7-ethoxyresorufin O-deethylase (EROD) activity responses of greenback flounder Rhombosolea tapirina to contaminated marine sediment and diet. Aquat Toxicol 2001; 54:231-247. [PMID: 11489309 DOI: 10.1016/s0166-445x(01)00146-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Pathological abnormalities and mixed function oxygenase (MFO) enzyme changes are frequently used as indicators of anthropogenic contaminant exposure and effect. However, there is a paucity of research investigating the effects of contaminated sediment on native Australian benthic teleosts. As part of an ecotoxicological assessment of contaminated marine sediments in northern Tasmania, CYP1A induction, histological and growth response of the greenback flounder, Rhombosolea tapirina, exposed to contaminated marine sediments were examined. Hatchery reared flounder were exposed to reference sediment, contaminated sediment or contaminated sediment and diet for 6 weeks. CYP1A induction, using the ethoxyresorufin-O-deethylase (EROD) assay, and the histological and growth response in the flounder were examined on cessation of the exposure trial. Significant differences were found between treatments in histological, growth and EROD response. Exposure to contaminated sediment and diet elicited a multi-organ histological response: principally partial and total epidermal erosion and multifocal necrosis of the liver. The prevalence of total epidermal erosion was greatest with exposure to disturbed contaminated sediment (66.65+/-16.65%). The prevalence of multifocal necrosis of the liver was greatest with exposure to contaminated sediment and diet (66.65+/-16.65%). Growth reduction, measured as percentage growth inhibition, was evident in flounder exposed to contaminated sediment and diet (18.2+/-11.99%). Additionally, exposure to contaminated sediment and diet elicited elevated induction of the EROD liver detoxification enzyme (139.65+/-24.22 pmol/min/mg protein) compared to exposure to contaminated sediment and non-contaminated diet (6.25+/-0.81 pmol/min/mg) indicating the presence and potential bioavailability of xenobiotics via food. Further, more inhibited growth and histological alteration associated with exposure to contaminated sediment and diet suggest contaminants in Deceitful Cove sediment are cytotoxic.
Collapse
Affiliation(s)
- J A Mondon
- School of Aquaculture, Tasmanian Aquaculture and Fisheries Institute, University of Tasmania, PO Box 1214, Launceston, Tasmania 7250, Australia.
| | | | | |
Collapse
|
35
|
Klemm T, Duda S, Machann J, Seekamp-Rahn K, Schnieder L, Claussen CD, Schick F. MR imaging in the presence of vascular stents: A systematic assessment of artifacts for various stent orientations, sequence types, and field strengths. J Magn Reson Imaging 2000; 12:606-15. [PMID: 11042644 DOI: 10.1002/1522-2586(200010)12:4<606::aid-jmri14>3.0.co;2-j] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
A systematic evaluation of the potential quality of magnetic resonance images recorded in the presence of metallic stents was performed on a low-field open imager operating at 0.2 T and on a high-field closed unit operating at 1.0 T. Eight different stent types were examined by two-dimensional gradient-echo sequences with echo times of 4 and 10 msec and by a fast spin-echo technique. In addition, a three-dimensional gradient-echo sequence was applied with an echo time of 2.4 msec. A set of sequence and slice parameters was used on both scanners. Thus, artifacts due to susceptibility effects depending on the magnetic field strength could be distinguished from radiofrequency shielding effects in the lumen of the stents (independent of the field strength). Nine different orthogonal orientations of the stent axis and the image (in terms of slice, read, and phase-encoding direction) were tested, and the artifacts (extension of signal void and visibility of the lumen) were compared. The optimal strategy for visualization of vascular and perivascular regions outside the stents was fast spin-echo imaging with the stent axis and read direction parallel to the static field. Susceptibility-induced signal void in gradient-echo images was minimal using the three-dimensional approach. Increased transmitter amplitudes above usual values provided clearly improved insight in the lumen using gradient-echo sequences.
Collapse
Affiliation(s)
- T Klemm
- Department of Diagnostic Radiology, University of Tübingen, D-72076 Tübingen, Germany
| | | | | | | | | | | | | |
Collapse
|
36
|
Mondon JA, Duda S, Nowak BF. Immune response of greenback flounder Rhombosolea tapirina after exposure to contaminated marine sediment and diet. Mar Environ Res 2000; 50:443-450. [PMID: 11460731 DOI: 10.1016/s0141-1136(00)00253-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Non-specific immune response of greenback flounder, Rhombosolea tapirina, exposed to contaminated marine sediments was examined. Reference sediments from Port Sorell and contaminated sediments from Deceitful Cove, Tasmania, Australia were investigated. Hatchery-reared flounder were exposed to reference sediment, contaminated sediment or contaminated sediment and diet for 6 weeks. Phagocytic capacity and lysozyme response in flounder were examined on cessation of exposure trial. Significant differences were found in phagocytic capacity and lysozyme response between treatments. Exposure to contaminated sediment, irrespective of diet or benthic disturbance elicited inhibition of phagocytic efficiency in flounder. Disturbance of contaminated sediment stimulated lysozyme activity. The immune response in flounder indicates potential immunotoxicity of sediment from Deceitful Cove.
Collapse
Affiliation(s)
- J A Mondon
- School of Aquaculture, University of Tasmania, PO Box 1214, Launceston, Tasmania 7250, Australia
| | | | | |
Collapse
|
37
|
Haase KK, Rose C, Duda S, Baumbach A, Oberhoff M, Anthanasiadis A, Karsch KR. Perspectives of coronary excimer laser angioplasty: multiplexing, saline flushing, and acoustic ablation control. Lasers Surg Med 2000; 21:72-8. [PMID: 9228643 DOI: 10.1002/(sici)1096-9101(1997)21:1<72::aid-lsm11>3.0.co;2-b] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Bubble formation, pressure wave generation, and cavitations constitute major factors influencing the outcome of clinical Excimer laser angioplasty. Thus, the rationale of this study was to determine the extent of pressure waves occurring during excimer laser ablation and to discuss possibilities that allow a less traumatic plaque removal in the coronary circulation. STUDY DESIGN/MATERIALS AND METHODS Conventional and experimental Xenon-Chlorid-Excimer lasers emitting light at a wave-length of 308 nm and a pulse duration of 115 ns were used for testing of signals. Whereas the conventional excimer laser light source transmits light through all fibers of a 1.7 mm laser catheter simultaneously, the prototype excimer laser divides the laser beam into several areas of uniform energy fluence by scanning the beam from one section to the other using the intermission between two laser discharges. Hydrophones consisting of piezoelectric films detected the acoustic signals, which were obtained on normal arterial wall and atherosclerotic plaque. RESULTS Multiplexing decreases maximum pressures for both normal arterial wall and calcified plaque significantly, whereas pressure rise time remains comparable. During ablation of pure blood, a linear increase of peak pressures of 1 MPa at 10 mJ/mm2 to 7.5 MPa at 50 mJ/mm2 is found. Contrast media intensifies the extent of pressure wave formation. At 20 mJ/mm2, 60% contrast media added to blood results in an increase of maximum pressures from 1.5 MPa up to 5 MPa. Dilution with saline solution is effective; however, high concentrations of > 90% are required to achieve a significant pressure wave reduction. CONCLUSION Peak pressures of several thousand kPa occur during excimer laser ablation of contrast media, blood, calcified plaque, and normal arterial wall in a decreasing order. Multiplexing and saline flushing are capable of reducing the intensity of the generated acoustic signals during tissue ablation. It has to be taken into consideration, however, that high concentrations of saline solution are necessary to achieve a significant reduction of peak pressures.
Collapse
Affiliation(s)
- K K Haase
- Department of Medicine, University of Tübingen, Germany
| | | | | | | | | | | | | |
Collapse
|
38
|
Steins A, Duda S, Schott U, Schneider W, Greschniok A, Jünger M, Möhrle M. Raynaud-Phänomen als Leitsymptom bei Takayasu-Arteriitis. Phlebologie 2000. [DOI: 10.1055/s-0037-1617341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungDie Takayasu-Arteriitis ist eine seltene entzündliche Erkrankung der Arterien. Neben allgemeinen Krankheitserscheinungen können durch Gefäßstenosierungen und -okklusionen vielfältige ischämische Symptome auftreten. Im vorliegenden Fall fungierte das einseitige Raynaudphänomen einer 34jährigen Patientin als Leitsymptom und führte zur klinischen und angiologischen Diagnosestellung. Einseitige Blutdruckerniedrigung rechts, verlängerte Pulswellenlaufzeit, poststenotische Doppler-Spektren der rechten A. brachialis sowie eine Flußumkehr der A. vertebralis wiesen auf eine Stenose im Bereich der A. subclavia hin. Duplexsonographisch und angiographisch wurden Stenosen der A. subclavia und des Truncus brachiocephalicus festgestellt. Nachdem zwischenzeitlich transitorische ischämische Attacken unter immunsuppressiver Therapie auftraten, wurde interdisziplinär die Indikation zu gefäßchirurgischem Vorgehen gestellt. Histologisch konnte die Diagnose Takayasu-Arteriitis bestätigt werden. Die Patientin wird klinisch und angiologisch interdisziplinär weiterbetreut.
Collapse
|
39
|
Duda S, Dziedzic K. [Pneumothorax in cigarette smokers]. Przegl Lek 2000; 56:613-5. [PMID: 10695370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
From 1.01.1992 to 31.12.1998 ill prisoners were treated because of so called spontaneous pneumothorax. Their age was between 24 to 57, which was 33 in average. All of them were males and heavy smokers. In one case of the coat pneumothorax the treatment was limited only to the breathing exercises, to ten other patients an under-water-seal drainage was applied, in the next case with pneumothorax and clear symptoms of bronchial fistula, the lung expansion was obtained no sooner than after the usage of a suction drainage. The risk of recurrence of the illness was limited by injection of 40% glucose solution through the drain to the pleural cavity to increase adhesions.
Collapse
Affiliation(s)
- S Duda
- Oddziału Chirurgicznego Szpitala przy Areszcie Sledczym w Krakowie
| | | |
Collapse
|
40
|
Hahn U, Miller S, Nägele T, Schick F, Erdtmann B, Duda S, Claussen CD. Renal MR angiography at 1.0 T: three-dimensional (3D) phase-contrast techniques versus gadolinium-enhanced 3D fast low-angle shot breath-hold imaging. AJR Am J Roentgenol 1999; 172:1501-8. [PMID: 10350280 DOI: 10.2214/ajr.172.6.10350280] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the diagnostic usefulness of three different MR angiographic techniques at 1.0 T. SUBJECTS AND METHODS In 22 patients with renal artery stenosis confirmed at intraarterial catheter angiography, we also performed unenhanced and gadolinium-enhanced three-dimensional phase-contrast MR angiography and gadolinium-enhanced single breath-hold three-dimensional fast low-angle shot MR angiography. We determined circulation time to optimize signal acquisition in gadolinium-enhanced breath-hold MR angiography after bolus injection of contrast material. RESULTS Sensitivity, defined as the detection of a hemodynamically significant stenosis (>50% luminal narrowing), was 85% for enhanced phase-contrast MR angiography, 91% for gadolinium-enhanced MR angiography, and 95% for unenhanced phase-contrast MR angiography. The combination of unenhanced phase-contrast MR angiography and gadolinium-enhanced MR angiography yielded 100% sensitivity for hilar artery stenoses. There were 13 false-positive findings with unenhanced phase-contrast MR angiography, 10 with enhanced phase-contrast MR angiography, and four with gadolinium-enhanced MR angiography (specificity: 38%, 52%, and 79%, respectively). Accessory renal arteries were not seen on unenhanced or enhanced phase-contrast MR angiography (0/8 patients) but were detected with gadolinium-enhanced MR angiography in five of the eight patients. Interobserver agreement (kappa = .62) was best with gadolinium-enhanced MR angiography. The quality of the images was unsatisfactory for adequate evaluation of segmental renal arteries with all three MR angiographic techniques. CONCLUSION A combination of unenhanced phase-contrast MR angiography and gadolinium-enhanced MR angiography at 1.0 T proved useful as a screening protocol for renal artery stenosis.
Collapse
Affiliation(s)
- U Hahn
- Department of Diagnostic Radiology, Eberhard-Karls-University of Tübingen, Germany
| | | | | | | | | | | | | |
Collapse
|
41
|
Steins A, Hahn M, Volkert B, Duda S, Schott U, Jünger M. [Color duplex ultrasound of the finger arteries. An alternative to angiography?]. Hautarzt 1998; 49:646-50. [PMID: 9759566 DOI: 10.1007/s001050050802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
By means of modern color-coded duplex sonography (CCDS) even very small vessels can be visualized. Maximum resolution nowadays is about 0.5 mm diameter of the vessel. We compared the use of CCDS and angiography in studying of acral perfusion. Besides morphologic criteria, hemodynamic criteria were recorded. Arteries in healthy fingers appear as long and straight vessels with a clearly defined border. The physiological maximal blood flow velocity exceeded 20 cm/s. CCDS revealed tortuosity of finger arteries as typical finding in thrombangiitis obliterans. Segmental stenosis can either be identified morphologically or quantified by measurement of the flow velocity with poststenotic maximal systolic velocities of less than 20 cm/s or by the acceleration of the blood flow within the stenosis, as proven by angiographic examinations. CCDS is suitable for evaluation of acral perfusion in patients suffering from secondary Raynaud's syndrome. Apart from diagnosis of disturbed acral circulation, other possible applications of CCDS are in in the surgical field, for example replantations in hand or finger surgery.
Collapse
Affiliation(s)
- A Steins
- Universitäts-Hautklinik, Eberhard-Karls-Universität Tübingen
| | | | | | | | | | | |
Collapse
|
42
|
Taube T, Seeger K, Beyermann B, Hanel C, Duda S, Linderkamp C, Henze G. Multiplex PCR for simultaneous detection of the most frequent T cell receptor-delta gene rearrangements in childhood ALL. Leukemia 1997; 11:1978-82. [PMID: 9369435 DOI: 10.1038/sj.leu.2400825] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A rapid and simple multiplex polymerase chain reaction (PCR) is described that is capable of identifying the six most frequent rearrangements of the T cell receptor (TCR)-delta gene segments in childhood acute lymphoblastic leukemia (ALL). The PCR products amplified in a single reaction are of different size for each TCR-delta gene rearrangement. Therefore, they are readily and unambiguously distinguished after agarose gel electrophoresis and assigned to a specific V-D-J gene rearrangement. There is no need for labor-intensive and time-consuming Southern blot hybridization or nested PCR. To evaluate the multiplex assay we chose 45 DNA samples of childhood ALL analyzed beforehand for TCR-delta gene rearrangements by Southern blot and single PCR of which 30 showed TCR-delta gene rearrangements. The multiplex PCR results corresponded to the Southern blot and single PCR analyses. The described multiplex PCR enables the detection of clonal markers in about 50% of patients in order to monitor minimal residual disease (MRD) in prospective studies with a high turnover of samples.
Collapse
Affiliation(s)
- T Taube
- Department of Pediatric Oncology/Hematology, Charité-Virchow Medical Center, Humboldt-University Berlin, Germany
| | | | | | | | | | | | | |
Collapse
|
43
|
Abstract
A 25-year-old carpenter with severe localised Raynaud syndrome of the lateral three fingers of his right hand is described. The patient reported digital ischaemia caused by cold or vibration, and especially when both were present simultaneously. He was initially diagnosed with thrombangitis obliterans, but failed to respond to intravenous prostaglandin therapy, pentoxifyllin or aspirin. Diagnostic procedures performed in our hospital, especially angiography, confirmed our suspicion of hypothenar hammer syndrome. Radiological examination revealed severe anatomical and functional changes of the distal ulnar artery and, digital arteries of the affected digits. The differential diagnosis of Raynaud syndrome should include the hypothenar hammer syndrome as a possible cause. Early diagnosis and prevention of hand trauma is the only possible way to stop progression of this disease, which leads to invalidity.
Collapse
Affiliation(s)
- T Klyscz
- Universität-Hautklinik, Tübingen
| | | | | | | |
Collapse
|
44
|
Bail DH, Schneider W, Duda S. [The popliteal artery entrapment syndrome in an older patient. Its diagnosis after unsuccessful laser-assisted percutaneous transluminal angioplasty]. Dtsch Med Wochenschr 1996; 121:336-40. [PMID: 8681723 DOI: 10.1055/s-2008-1043010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
HISTORY AND FINDINGS A 52-year-old patient complained of progressively increasing pain in his left leg when walking. The pain-free walking distance was 50-100 m. He was smoking about 20 cigarettes daily. No pulses were palpable in the left leg below the inguinal fossa. Recapillarisation time was normal in both legs and there were no trophic changes. INVESTIGATIONS The Doppler perfusion pressure values were up to 40 mm Hg less in the left than the right leg. Ankle oscillography record showed a definite stenosis curve on the left. Digital subtraction angiography of the left leg showed a short occlusion of the popliteal artery with many collaterals and atypical medical deviation of the artery. The findings were interpreted as indicating peripheral arterial vascular disease. TREATMENT AND COURSE Laser-assisted percutaneous transluminal angioplasty with balloon dilatation merely achieved a narrow lumen which again closed on plantar flexion of the left foot. The reversible occlusion suggested popliteal artery entrapment. At operation the popliteal artery coursed atypically over the dorsal medial aspect of the medial head of the gastrocnemius muscle. The arterial segment in the stenotic area was replaced by an autologous venous graft and the gastrocnemius muscle fixed laterally. The patients no longer experienced any impairment on walking and repeat angiography showed unimpeded flow through the graft even on plantar flexion. CONCLUSION Popliteal artery entrapment is rare in the elderly and may be overlooked without provocation test and complete visualisation of the leg and pelvic arteries.
Collapse
Affiliation(s)
- D H Bail
- Abteilung für Thorax-, Herz- und Gefässchirurgie, Universität Tübingen
| | | | | |
Collapse
|
45
|
Duda S, Ksel M, Ziemski T, Szuba S, Lipiarz A, Dziedzic K. [Foreign bodies in the digestive tract]. Przegl Lek 1996; 53:94-96. [PMID: 8754329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
In the past two years time 128 patients-prisoners, who had swallowed foreign bodies, have been observed. Six anchors and crosses, which had been stuck in the esophagus, were immediately and successfully removed endoscopically. Long rods and crosses (60 cases) situated mostly in the stomach or descending part of the duodenum were operated without any complications. A few weeks delay of operation caused the covered perforation of the alimentary tract wall nearly 20% of cases and one of which died. Ingested small foreign bodies (less than 10 cm in length) are harmless, pass spontaneously through the gastrointestinal tract and don't need any surgical intervention. In a few cases those small foreign bodies perforated the guts, covered outside the digestive tract without any complaints.
Collapse
Affiliation(s)
- S Duda
- Rejonowym Areszcie Sledczym w Krakowie
| | | | | | | | | | | |
Collapse
|
46
|
Pfeiffer K, Widmann M, Deusch H, Guggenberger H, Duda S, Seboldt H. [Inadvertant suture fixation of a Swan-Ganz catheter to the pulmonary artery following heart surgery]. Anaesthesist 1995; 44:782-4. [PMID: 8678269 DOI: 10.1007/s001010050213] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We report a patient undergoing redo cardiac surgery for combined replacement of the aortic and mitral valves. During the course of the operation, a Swan-Ganz catheter - positioned preoperatively - was accidentally fixed to the wall of the pulmonary artery. As this did not interfere with cardiac output measurement or the pulmonary artery pressure wave form, the fixation was not noticed until an attempt was made to remove the catheter. Fluoroscopy revealed both the catheter's immobility and the location of the suture fixation. The patient required a sternotomy to remove the catheter. In order to avoid this complication, the indications for pulmonary artery catheters during cardiac surgery should be carefully considered. If catheters are inserted, their mobility should by all means be ensured before the chest is closed.
Collapse
Affiliation(s)
- K Pfeiffer
- Klinik für Anästhesiologie, Eberhard-Karls-Universität Tübingen
| | | | | | | | | | | |
Collapse
|
47
|
Schick F, Duda S, Dürk H, Bunse M, Lutz O, Claussen CD. Eosinophilia-myalgia syndrome: findings at MR imaging and proton spectroscopy of the lower leg. Magn Reson Imaging 1994; 12:513-22. [PMID: 8007781 DOI: 10.1016/0730-725x(94)92545-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Five magnetic resonance (MR) studies of the lower leg were performed in three patients with eosinophilia-myalgia syndrome (EMS). The 1H spectroscopic and imaging findings were compared with seven examinations of age-matched healthy controls. Standard imaging with proton density-, T1-, and T2-weighted spin-echo (SE) sequences at 1.5 T showed marked atrophy of the calf muscles and slightly increased signal strength of muscle tissue in T2-weighted SE images. The application of frequency selective chemical shift imaging (SENEX) exhibited skin changes similar to those of scleroderma with increased water content and thickened cutis in the water selective images. In one patient the tibialis muscles showed irregular structures, but no fatty degeneration as demonstrated in the fat selective images. Proton signals from volume elements of (20 mm)3 within the soleus and gastrocnemius muscle were recorded by the PRESS localization method. A reduction of the creatine/water and the choline/water ratios was found in the 1H spectra from the EMS patients compared to the controls. Localized 1H spectroscopy exhibited modified distributions of the lipid signals in two EMS patients with slightly elevated signals from unsaturated fatty acids. The transverse relaxation of choline and creatine signals was accelerated in both examinations of one patient compared with the healthy controls.
Collapse
Affiliation(s)
- F Schick
- Department of Diagnostic Radiology, University of Tübingen, Germany
| | | | | | | | | | | |
Collapse
|
48
|
Schick F, Einsele H, Kost R, Duda S, Jung WI, Lutz O, Claussen CD. Hematopoietic reconstitution after bone marrow transplantation: assessment with MR imaging and H-1 localized spectroscopy. J Magn Reson Imaging 1994; 4:71-8. [PMID: 8148560 DOI: 10.1002/jmri.1880040115] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Magnetic resonance (MR) studies were performed in 14 patients as early as possible (21-110 days) after bone marrow transplantation (BMT). MR characteristics of lumbar vertebral bone marrow were studied with T1-weighted spin-echo imaging, water- and fat-selective imaging with a frequency-selective excitation technique, and point-resolved spatially localized proton spectroscopy. Signals from water and fat protons and their T1 and T2 values were analyzed. Water proton signal intensity correlated well with cellularity within bone marrow, as determined with parallel iliac crest biopsies. The fraction of signal from water in red bone marrow of patients with allogeneic transplants from siblings (four cases) was significantly higher than in four patients with autologous transplants. The latter showed very low cellularity in the period of about 4 weeks after BMT because of the cytotoxic pretreatment of the bone marrow. The MR results in six patients with allogeneic transplants from unrelated donors ranged widely, depending on the complications after BMT. Analysis of data obtained with the different techniques showed that water- and fat-selective MR imaging and spectroscopic methods are useful for noninvasive monitoring of hematopoietic reconstitution after BMT.
Collapse
Affiliation(s)
- F Schick
- Department of Diagnostic Radiology, University of Tübingen, Germany
| | | | | | | | | | | | | |
Collapse
|
49
|
Schick F, Duda S, Laniado M, Jung WI, Claussen CD, Lutz O. [Special MR methods for primary bone tumors: II. Volume selective 1H-spectroscopy]. ROFO-FORTSCHR RONTG 1993; 159:325-30. [PMID: 8219117 DOI: 10.1055/s-2008-1032773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The method of localised 1H MR spectroscopy was used in 19 examinations in 9 patients with primary bone tumours in order to obtain spectral signals and to determine whether these are specific for tumour classification. The spectra were obtained by a double spin echo method and the tumour tissue showed very high water content and only minor lipid and proton signals which showed J-coupling characteristics. The latter are not found in normal bone marrow and are probably due to products of tumour metabolism. The resolution of the spectra within a 13 mm or 20 mm tissue cube depends largely on the structural homogeneity of the tumour. The signal patterns in the spectra were not specific to histological tumour types.
Collapse
Affiliation(s)
- F Schick
- Abteilung für Radiologische Diagnostik, Eberhard-Karls-Universität Tübingen
| | | | | | | | | | | |
Collapse
|
50
|
Schick F, Duda S, Laniado M, Jung WI, Claussen CD, Lutz O. [Special MR methods for primary bone tumors: I. Chemical shift selective imaging]. ROFO-FORTSCHR RONTG 1993; 159:258-63. [PMID: 8374113 DOI: 10.1055/s-2008-1032760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The value of selective imaging of fat and water compared with proton density, T1- and T2- weighted MR sequences was studied in the course of 32 examinations on 22 primary bone tumours in various parts of the body. Fat selective images showed practically signal free areas for osteogenic tumours which could be distinguished from surrounding fat containing soft tissues. Water selective images improved definition of the tumour margin from oedema in the bone marrow. Chemical shift artefacts are avoided by these methods and therefore fat and water selective images provide better spatial resolution for identical pixel sizes.
Collapse
Affiliation(s)
- F Schick
- Abteilung für Radiologische Diagnostik, Eberhard-Karls-Universität Tübingen
| | | | | | | | | | | |
Collapse
|