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 22,423 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 42-year-old man with cardiac lipoma of the anterior tricuspid leaflet is reported. He had a chief complaint of epigastric discomfort, and a pansystolic murmur was heard at the left sternal border in the 4th intercostal space. Two-dimensional echocardiography disclosed a mobile high density stalkless mass having several areas of low density. Two-dimensional Doppler echocardiogram revealed a moderate degree of tricuspid regurgitation. These findings were more clearly visualized on transesophageal echocardiogram. MRI revealed a high signal intensity on the T1-weighted image and a high radiodensity surrounding the mass using a contrast medium of Gd-DTPA. A 2.0 x 1.3 x 0.8 cm hemispherical, lobulated and sessile yellow mass was excised by means of open heart surgery, and tricuspid valvuloplasty was performed. The mass was adipose tissue and was surrounded by fibrous tissue just under the lamina fibrosa. These findings were compatible with those of the preoperative examinations, although the preoperative diagnosis was not conclusive. This was our first case of cardiac lipoma in which the tricuspid valve was successfully excised.
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PMID:[A case of cardiac lipoma of the anterior tricuspid leaflet]. 141 80

The 1980s witnessed the development of many new contrast agents useful in radiographic and MRI to enhance the contrast discrimination between tissues and improve lesion conspicuity. In addition to improved efficacy, these agents are generally safer and cause less patient discomfort than older radiographic contrast media. The injection of any foreign material into the body always holds some risk, however, and it is the responsibility of clinicians and radiologists jointly to use these agents judiciously in the best interest of the patient.
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PMID:The newer radiographic contrast media. 146 74

Two cases of cardiac rhabdomyoma discovered fortuitously at foetal ultrasonography gave rise to no obstructive cardiac signs or arrhythmias either in the antenatal or postnatal periods. These multiple tumours often observed in Bourneville's tuberous sclerosis orientated the clinical investigations to the diagnosis of this disease from the outset. MRI demonstrated cortical tubers and subependymal nodules in both cases. A retinal hamartoma was present in one case. No renal involvement could be detected by ultrasonic examination. No neurological or cardiovascular symptoms appeared during follow-up (20 and 4 months after birth). Investigations in the parents were negative, these two cases being sporadic forms of Bourneville's tuberous sclerosis. The functional prognosis is related to the neurological outcome. Doppler echocardiography would appear to be the best method of following up cardiac rhabdomyomas, and enabled the demonstration of partial regression of the largest tumour in one of these two cases. Cardiac MRI is also an excellent diagnostic tool. As it is usually performed at the same time as cerebral MRI, essential in the follow-up of Bourneville's tuberous sclerosis, it does not represent additional discomfort to the patient.
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PMID:[Cardiac rhabdomyomatosis and Bourneville's tuberous sclerosis in the fetus. Apropos of 2 cases]. 153 Apr 2

A relatively simple two-node model of human thermoregulation was developed to predict response changes during MRI procedures. Subsequent modifications of the model simulated impairments in cardiovascular function in terms of altered skin blood flow. In the present work, the model was programmed to predict the consequences of certain procedures used in the clinic, namely, precooling of the patient to the prevailing environment and covering the patient with a light blanket. Some of the fundamental predictions of the model during 20-min MRI scans at a low SAR were tested on two male subjects in the clinical setting. The following conclusions may be drawn: (1) Precooling of the patient for 20 min to the prevailing ambient conditions, whether inadvertent or deliberate, has little value in terms of preventing a rise in body temperatures. At the conclusion of a subsequent 20-min MRI scan, even at SARs as low as 2 W/kg, the modest effects of precooling are all but eliminated. Thus, inadvertent precooling should be no cause for concern; deliberate precooling carries little advantage for the patient and wastes valuable time. (2) Use of a blanket during an MRI scan should be discouraged in the normal clinical setting except when the SAR is 2 W/kg or less. At higher SARs, this added insulation impedes convective and radiative heat loss through evaporation of sweat. The result is an increase of heat storage in the body and a greater rise in core temperature than would occur otherwise. (3) Clinical tests on two normal male subjects have provided limited confirmation of the predictions of the two-node model. During 20-min MRI scans at a whole-body SAR of 1.2 W/kg, core and skin temperatures, sweat rate, and judgments of thermal sensation and discomfort were very similar to predicted values. Unexpected findings of an incremental increase in core temperature with successive scans and a sweating rebound following each scan may be important for future investigation. (4) Although pleased with the limited confirmation of our predictions, we are constantly aware of the limitations of the two-node model to accurately predict thermoregulatory responses of patients undergoing clinical MRI of various body parts. It is essential to keep in mind that the simulations are based on RF exposure of the whole body; thus, the predicted increase in core temperature will be proportionately higher than would be the case if only a portion of the body were exposed within the MRI device.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Predicted thermophysiological responses of humans to MRI fields. 158 Apr 92

A 56-year-old man visited our hospital for further examination of resting electrocardiographic abnormality. Positive exercise stress resulted in mild chest discomfort and 1.5 mm ST depression in II.III.aVF leads. Myocardial imaging perfusion with thallium-201 was normal and an anomalous origin of the left circumflex coronary artery from the right aortic sinus was observed by coronary angiography. MRI showed that the vessel running behind the aorta was connected to the right Valsalva's sinus. Furthermore, transesophageal echocardiography revealed that the vessel connected to the lateral wall of the left ventricle was running from the right Valsalva's sinus between the aorta and left atrium. The above results indicated that this vessel was the left circumflex artery. Although myocardial infarction or sudden death in patients with coronary anomaly has been discussed, the mechanism is still unknown. The present case is a rare one in which the anatomical relation between the anomalous coronary and the great vessels was directly detectable by transesophageal echocardiography. Transesophageal echocardiography is useful for the assessment of this type of coronary anomaly.
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PMID:[A case of anomalous origin of circumflex artery from right sinus of valsalva recognized by transesophageal echocardiography]. 174 70

The combined stereotactic-microsurgical approach has been used mainly to allow the removal of small subcortical lesions, determining their location and the route to be followed. In our experience, this approach has been most useful in 5 cases of small paraventricular AVMs and another 6 small deep-seated tumoural lesions. Since the availability of MRI, we have systematically applied Yasargil's proposal to perform dissection of the cisterns or sulci to reach a lesion with minimal or no injury to normal neuroanatomy. Assisted by Computer Aided Design software, we can superimpose the MR images with those provided by conventional or digital angiography (mainly the venous phase). MRI allows us to select a route or pathway through a sulcus, and angiography helps us in locating it on the brain surface. We have applied this technique systematically during the past year, and can report 20 cases (1 AVM, 12 tumoural lesions, 1 abscess and 6 haematomas). This trans-fissural or trans-sulcal approach has allowed us resection with minimal surgical damage, after a prompt and precise location. We think that both methods are not mutually exclusive, although the trans-sulcal approach is more adequate because of less discomfort for the patient, the smaller cerebral parenchyma injury and greater anatomofunctional information for the surgeon.
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PMID:Trans-fissural or trans-sulcal approach versus combined stereotactic-microsurgical approach. 179 60

Presented are real-time ultrasound findings in partially and completely denervated muscles of 30 patients with focal neuropathy and various other disorders of the second motor neuron. Sonographic scans of affected muscles are analyzed in conjunction with unaffected muscles of the same individual, under identical examination conditions. Initial pathological ultrasound changes could be detected as soon as 2 weeks after an acute neurogenic lesion. In denervation, the echodensity of the muscle was high and the normal intramuscular pattern was decomposed. Findings were more intense in severe and longstanding denervation. Ultrasound-indicated pathology correlated highly (chi-square: P less than 0.001) with pathological spontaneous activity detected by electromyography. Focal and systemic neuropathies showed no differences in ultrasound pathology. Six cases with central motor palsy had normal sonograms. Poor spatial resolution of real-time ultrasonography--as compared with CT and MRI--is compensated by its bedside availability, frequent repeatability without patient risk and discomfort, and its in vivo correlation of muscle morphology with muscle function.
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PMID:Real-time sonography of acute and chronic muscle denervation. 192 72

A 12-year-old male case of reflex epilepsy with visual field defects attack induced by a family computer game was reported. This patient showed binasal visual field defects attack when he was playing a family computer game. Neurological findings and ophthalmological examinations were normal. EEG showed spike and slow wave complex distributed on right occipital region. These paroxysmal waves were activated by checkerboard pattern reversal stimuli. Stimulus intensity was closely related with these activations, but not stimulus ratio was. Examinations of brain CT and brain MRI were normal. This patient complained of discomfort without visual symptoms when he suffered checkerboard pattern stimuli. A family computer game needs mental concentration, recognition, decision, alert state of consciousness and complex finger movement. Integration of these factors may have induced visual field defects attack. It is interesting that a family computer game is the inducer of reflex epilepsy with visual symptoms. The number of reflex epilepsy is thought to increase because of prevalence of family computer games.
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PMID:[A case of reflex epilepsy with binasal visual field defects attack induced by family computer game]. 240 Nov 14

Twenty-eight consecutive patients with multiple sclerosis (MS) were clinically evaluated to determine the presence of sleep-related disorders. There were 12 males and 16 females aged between 22 and 67 with disability ranging between 1.5 and 8.5 on Kurtzke extended disability status score (EDSS). Fifteen patients (54%) reported sleep-related problems. These included difficulties initiating sleep and/or frequent awakenings due to spasms or discomfort in the legs (8 patients), difficulty in initiating or maintaining sleep (3), habitual snoring (4) and nocturia (1). All-night oximetry was performed and the tracings analysed for the number of dips in oxygen saturation (SaO2) or more than 4%. Three patients showed significant sleep-related oxygen desaturation (> 5 dips of > 4% SaO2/h). Subsequent polysomnography performed in 2 of the 3 patients with significant oxygen desaturation confirmed the presence of sleep apnoea. MRI analysis of brain stem regions showed abnormalities in 20/22 cases. The 3 patients showing nocturnal oxygen desaturation had MRI brain stem lesions, but their locations were variable and their general appearance not different from that seen in the 17 without sleep apnoea. Sleep disturbance in MS is common but poorly recognised. It is usually due to leg spasms, pain, immobility, nocturia or medication. It is much less commonly associated with nocturnal respiratory insufficiency.
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PMID:Sleep problems in multiple sclerosis. 785 52

Because its function is related to its bony anatomy, ligamentous structures and integrated muscle groups, the knee is one of the most complex joints in the human body. Not surprisingly, knee injuries rank as one of the major causes of physical disability. Prior to the introduction of magnetic resonance imaging, prompt and accurate diagnosis of knee injuries was a challenge. Now, using MRI, a highly accurate diagnosis can be made in 30 minutes or less without patient discomfort. This article reviews knee anatomy, discusses common injuries and describes magnetic resonance techniques for imaging the knee.
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PMID:MRI's role in evaluating knee anatomy and injuries. 785 39


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