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| 2. |
- Sundgren, P, et al.
(författare)
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Paragangliomas of the spinal canal
- 1999
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Ingår i: Neuroradiology. - : Springer Science and Business Media LLC. - 1432-1920 .- 0028-3940. ; 41:10, s. 788-794
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Tidskriftsartikel (refereegranskat)abstract
- We report the clinical MRI and histopathological features of five consecutive cases of spinal paraganglioma. Three intradural tumours were found in the typical location (two at the L4, one at the S2 level); one intradural extramedullary tumour arose at an unusual level, from the ventral C2 root, and one extradural tumour growing along the L5 nerve root sheath had an aggressive growth pattern with early, local paraspinal recurrence and, eventually, intradural metastatic spread. This type of growth pattern has not been described previously. Paragangliomas of the spinal canal are more common than previously thought and can be located anywhere along the spine, although the lumbosacral level is the most common. Their appearance on MRI can not distinguish them from other tumours in the spinal canal. Even though paragangliomas in general are benign and slowly growing their growth pattern can vary and be more aggressive, to the point of metastatic spread.
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| 3. |
- Levring Jäghagen, Eva, et al.
(författare)
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Persisting dysphagia after uvulopalatoplasty performed with steel scalpel.
- 1999
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Ingår i: The Laryngoscope. - 0023-852X .- 1531-4995. ; 109:1, s. 86-90
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES/HYPOTHESIS: The aim of the present study was to determine the incidence of postoperative persisting dysphagia after uvulopalatoplasty performed with conventional steel scalpel (UPP) and to videoradiographically evaluate the oral and pharyngeal phases of swallowing in patients reporting persisting dysphagia. The hypothesis to be tested was that patients treated with UPP would demonstrate a lower incidence of persisting dysphagia than previously found after uvulopalatoplasty performed with laser technique (LUPP).STUDY DESIGN: Retrospective.METHODS: Sixty-eight of 76 consecutive patients treated with UPP answered a questionnaire concerning outcome and late complications after the operation. The patients who reported postoperative dysphagia were additionally interviewed at a minimum of 1 year postoperatively, and the oral and pharyngeal phases of swallowing were videoradiographically examined in those with persisting dysphagia.RESULTS: The incidence of persisting dysphagia after UPP was 29%. Videoradiographically 71% of the dysphagic patients showed a deviant pharyngeal swallowing pattern.CONCLUSION: The incidence of persisting dysphagia after UPP did not differ from that reported after laser uvulopalatoplasty. Dysphagia after UPP was mostly associated with videoradiographic signs of deviant pharyngeal swallowing function. Patients should be informed that there is a risk of developing dysphagia after uvulopalatoplasty.
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| 4. |
- Malina, Martin, et al.
(författare)
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Endovascular management of the juxtarenal aortic aneurysm: can uncovered stents safely cross the renal arteries?
- 1999
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Ingår i: Seminars in Vascular Surgery. - 0895-7967. ; 12:3, s. 182-192
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Tidskriftsartikel (refereegranskat)abstract
- A short or otherwise suboptimal neck precludes the use of endovascular repair in 30% to 50% of patients with abdominal aortic aneurysms. Stent-graft fixation in an unsuitable neck carries the risk of technical failure owing to development of a proximal endoleak or stent-graft migration. Furthermore, in some patients, the neck dilates postoperatively. Endovascular healing with tissue incorporation into the graft material seems in and of itself insufficient to fixate the stent-graft adequately or to prevent neck dilation. Therefore, neck dilation is often associated with detachment of the stent-graft from the aortic wall, which is followed by the development of a proximal endoleak or stent-graft migration. Fixation of stent-grafts can be improved by placing the proximal stent above one or both of the renal artery orifices. Current experimental and clinical data suggest that renal function is not impaired by suprarenal aortic stents during the first year; however, this finding may not apply to all types of stents. Fixation of stent-grafts also may be improved by using stents with barbs that pierce the aortic wall. Additionally, the force that is exerted on the anchoring device may well be reduced by fully stented grafts with an associated increase in column strength. In the future, the risk of neck dilation and stent-graft dislodgement might also be limited by novel techniques such as laparoscopic banding of the neck or endoluminal stapling devices.
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| 5. |
- Resch, Tim, et al.
(författare)
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Distal migration of stent-grafts after endovascular repair of abdominal aortic aneurysms
- 1999
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Ingår i: Journal of Vascular and Interventional Radiology. - 1051-0443. ; 10:3, s. 257-264
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To analyze patients after endovascular repair of abdominal aortic aneurysm (AAA) with respect to distal migration of stent-grafts and its underlying causes. MATERIALS AND METHODS: Sixty-five patients underwent endovascular repair between January 1994 and February 1997. There were seven women and 58 men, with a mean age of 71 years (range, 51-84 years). Three patients died in the perioperative period (one of myocardial infarction and two of multiorgan failure) and two patients died within 4 months of the procedure of non-procedure-related causes. In addition, two patients were followed at another hospital. The remaining 58 patients were followed up with spiral computed tomography scans at 1, 3, and 6 months, and biannually thereafter. Angiography was performed at 1 month and 1 year after the procedure and additionally when deemed clinically necessary. Mean follow-up was 29 months (range, 1-49). Migration more than 5 mm was considered significant. RESULTS: Twenty-six patients (45%) showed distal migration of stent-grafts during follow-up. Mean follow-up time at detection of migration was 13 months (range, 1-36 months). Thirteen cases of migration were ascribed to dilatation of the proximal aneurysmal neck during follow-up. Ten cases of migration were ascribed to causes other than neck dilatation or poor patient selection. In three cases, no obvious cause for the migration was found. The migration was complete in eight cases, leading to late conversion to open surgical repair. On two of these occasions, complete migration lead to aneurysm rupture. In addition, four patients received additional stent-grafts as proximal extensions. CONCLUSIONS: Distal migration of stent-grafts after endovascular AAA repair occurred frequently in this series. Dilatation of the proximal aneurysmal neck is a major cause of distal migration of stent-grafts. Improved proximal fixation is needed to secure long-term durability.
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| 6. |
- Benjegård, S A, et al.
(författare)
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Evaluation of three gamma detectors for intraoperative detection of tumors using 111In-labeled radiopharmaceuticals.
- 1999
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Ingår i: Journal of nuclear medicine : official publication, Society of Nuclear Medicine. - 0161-5505. ; 40:12, s. 2094-101
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Tidskriftsartikel (refereegranskat)abstract
- Attempts to detect tumors with intraoperative scintillation using tumor-binding radiopharmaceuticals have intensified recently. In some cases previously unknown lesions were found, but in most cases no additional lesions were detected. In this study the physical characteristics of three detector systems and their ability to detect tumors through accumulation of an 111In-labeled radiopharmaceutical were investigated. The first was a sodium iodide (NaI[TI]) detector; the second, a cesium iodide (CsI[TI]) detector; and the third, a cadmium telluride (CdTe) detector.
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| 7. |
- Lindau, Tommy R, et al.
(författare)
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Fractures of the distal forearm in young adults. An epidemiologic description of 341 patients
- 1999
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 70:2, s. 124-128
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Tidskriftsartikel (refereegranskat)abstract
- We describe the epidemiology of all distal radial fractures in young adults (men 20-59 years, women 20-49 years) in Lund (1992-95) and Malmo (1994-95), Sweden. During the study period, there were 341 patients with 346 fractures in the two cities, found through the Hospital Register of Diagnoses in Lund and the register of the Radiology Department in Malmo. More than half of the fractures were dislocated and 2/3 of the cases involved the radiocarpal or radioulnar joints, in contrast to the predominantly extra-articular fractures in the elderly. There was an even distribution between sexes and the fractures were mainly caused by a severe trauma, i.e., more than a simple fall, most often sports injuries in January, February and May. Our findings suggest that distal radial fractures in nonosteoporotic young adults should be regarded as a special entity, at least in epidemiological studies. Possibly they also require treatment differing from that for osteoporotic fractures.
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| 8. |
- Björkman-Burtscher, Isabella
(författare)
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Proton Magnetic Resonance Spectroscopy in Brain Tumors - Clinical Applications
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims: · to present a test phantom and test method for evaluation of proton magnetic resonance spectroscopy (1H-MRS) single volume localization techniques regarding signal contamination; · to describe the introduction of 1H-MRS in the daily routine of a standard MR-unit; · to evaluate the possibilities offered by 1H-MRS to improve preoperative diagnostic accuracy in patients scheduled for stereotactic biopsy of intracranial mass lesions; · to evaluate the possibilities offered by 1H-MRS to improve diagnostics and therapy control in patients with brain abscesses; · to test the hypothesis that 1H-MRS might be useful for differentiation of brain tumors, based on metabolic changes in tissue across brain lesions or surrounding tissue. Results and conclusions: · The test phantom and test method allow quality assessment with good reproducibility. Contamination values for the tested sequence types and sizes of volume of interest (VOI) differed between 0.7% and 13.8% in one dimension and between 7% and 19.1% in three dimensions. · Of the first 102 MRS measurements performed 85% were of high spectral quality. Main reasons for poor quality were mal-positioning of the VOI, susceptibility problems due to hemorrhage, and post operative changes. · Metabolite ratios of normal tissue differed from those representing stereotactic target points. No significant difference between metabolite ratios representing different histopathologic tumor types could be seen. MRS could improve diagnostic accuracy in differentiation between infiltrating and circumscribed brain lesions based on different spatial distribution of pathologic spectra across the lesion. · MR spectra from abscesses showed resonances, not found in other intracranial pathologies and vanishing under antibiotic treatment, and can therefore be used to differentiate abscesses from other ring-enhancing lesions and might be used for therapy control. · Metabolite ratios representing different components of brain lesions or adjacent tissue differed significantly for the following differential diagnoses: a) high-grade glioma versus metastasis: NAA/Cho and Cr/Cho in contrast-enhancing tissue, and NAA/Cho in tissue adjacent to and at one voxel distance to the lesion; b) meningeoma versus low-grade glioma and metastasis: NAA/Cho in contrast-enhancing tissue; c) low-grade glioma versus metastasis: NAA/Cr in tissue adjacent to the lesion. Our data support the hypothesis that proton MRS can be useful for the reliable differentiation between brain tumors, tending to infiltrate adjacent tissue, and circumscribed, non-infiltrating brain lesions.
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| 9. |
- Greiff, Lennart, et al.
(författare)
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Effects of hydrogen peroxide on the guinea-pig tracheobronchial mucosa in vivo
- 1999
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Ingår i: Acta Physiologica Scandinavica. - : Wiley. - 0001-6772 .- 1365-201X. ; 165:4, s. 415-420
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Tidskriftsartikel (refereegranskat)abstract
- Lumenal entry of plasma (mucosal exudation) is a key feature of airway inflammation. In airways challenged with histamine-type mediators and allergen the mucosal exudation response occurs without causing epithelial derangement and without increased airway absorption. In contrast, reactive oxygen metabolites may cause mucosal damage. In this study, involving guinea-pig airways, we have examined effects of H2O2 on airway exudation and absorption in vivo. Vehicle or H2O2 (0.1 and 0.5 M) was superfused onto the tracheobronchial mucosal surface through an oro-tracheal catheter. 125I-albumin, given intravenously, was determined in tracheobronchial tissue and in lavage fluids 10 min after challenge as an index of mucosal exudation of plasma. The tracheobronchial mucosa was also examined by scanning electron microscopy. In separate animals, 99mTc-DTPA was superfused 20 min after vehicle or H2O2 (0.1 and 0.5 M) had been given. A gamma camera determined the disappearance rate of 99mTc-DTPA from the airways as an index of airway absorption. The high dose of H2O2 (0.5 M) produced epithelial damage, increased the absorption of 99mTc-DTPA (P < 0.001), and increased the exudation of plasma (P < 0.001). Notably, it appeared that all extravasated plasma had entered the airway lumen within 10 min. These data demonstrate that H2O2 differs from exudative autacoids such as histamine by causing both epithelial damage and plasma exudation responses. These data also agree with the view that the epithelial lining determines the rate of absorption and is responsible for the valve-like function that allows lumenal entry of extravasated bulk plasma without any increased inward perviousness.
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| 10. |
- Elmståhl, Sölve, et al.
(författare)
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Treatment of dysphagia improves nutritional conditions in stroke patients
- 1999
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Ingår i: Dysphagia. - 1432-0460. ; 14:2, s. 61-66
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Tidskriftsartikel (refereegranskat)abstract
- Dysphagia is a common symptom in stroke patients, and malnutrition is prevalent among these patients. Thus far, nutritional effects of dysphagic treatment have not been evaluated. The aim of the present report was to study the effects of swallowing techniques on nutritional and anthropometric variables. A survey with follow-up was performed at the Departments of Geriatric Medicine and Neurology, Malmo University Hospital, Sweden. Thirty-eight stroke patients, 53-89 years of age, with subjective complaints of dysphagia and oral/pharyngeal dysfunction according to videofluoroscopic barium swallowing examination (VSBE), were given swallowing treatment. The treatment included oral motor exercise, different swallowing techniques, positioning, and diet modification. Plasma protein levels, body composition, VSBE, and a viso-analogical scale for subjective complaints were repeated before and after treatment. At baseline, 94% of cases had signs of penetration and 50-72% had plasma protein levels below recommended levels. Treatment reduced the degree of oral dysfunction, (dissociation) and pharyngeal dysfunction (penetration and constrictor paresis). Sixty percent of cases showed an improved overall VSBE score, and improved levels of albumin and total iron-binding capacity were restricted to this group. In cases with unchanged or decreased VSBE score, body weight was reduced and a negative correlation to total iron-binding capacity was noted (r = -0.60, p < 0.05). Changes of subjective complaints did not correlate with swallowing function or nutritional improvements. Swallowing treatment improves swallowing function, and improved swallowing function is associated with improvements in nutritional parameters. Subjective complaints is not sufficient to evaluate the clinical course, and nutritional parameters should be monitored in patients with oral or pharyngeal dysfunction.
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