bluuebunny/crossref_metadata_2025_split huggingface dataset:
Liver perfusion scintigraphy prior to and after transjugular intrahepatic portosystemic shunts (TIPS) in patients with portal hypertension
Authors: Schoniburg A. , Brensing K. A. , Reichmann K. , Bangard M. , Overbeck B. , Sauerbruch T. , Biersack H. J. , Willkomm P. 
Published: March 2018

Summary
Purpose: This investigation was performed to compare the hemodynamic results of the transjugular intrahepatic portosystemic shunt, a new interventional treatment for portal hypertension, with those observed after the established surgical shunt interventions. Methods: We examined 22 patients with portal hypertension due to liver cirrhosis before and after elective TIPS by liver perfusion scintigraphy. The relative portal perfusion was determined before and after the shunt procedure. Additionally, we measured the portal pressure gradient (PPG: portal-central venous pressure, mmHg). Results: Prior to TIPS, the relative portal perfusion was significantly reduced to 22 ± 9.1%. After the intervention we calculated values of 23.1 ± 10,7% in the TIPS-group (p = 0.67; not significant). In spite of unchanged portal perfusion, the portal pressure was significantly (p <0.001) reduced from 25.6 ± 5.3 to 14.8 ± 4 mm Hg. Conclusion: These results suggest that the reduction of portal hypertension by TIPS is effective. The portal perfusion is maintained by TIPS suggesting that liver perfusion is preserved to a higher degree.
Influence of single-photon-transmission scan duration measured with the ECAT ART PET-scanner
Authors: Kremp S. , Hellwig D. , Alexander Chr. , Kirsch C-M. , Schaefer A. 
Published: March 2018

Summary
Aim: The aim was to study the influence of singlephoton-transmission scan duration in 3D-PET on the quantitative values of attenuation coefficients and noise in transmission images and of activity concentrations and noise in attenuation corrected emission images of thorax phantom- and patient data. Method and material: Using dual collimated Cs-137 singles transmission sources (Eγ = 662 keV, A = 2* 614 MBq) on an ECAT ART tomograph series of transmission scans of a thorax phantom were acquired pre- and post-injection of 18F. 17 patients underwent two transmission scans. The scan time of the short transmission was chosen according to the results of the phantom studies (noise of Poisson statistics less than 4%). Transmission and attenuation corrected emission images were evaluated with respect to estimated linear attenuation coefficients, noise and specific activities in organs. Results: The phantom studies reveal little variation of the estimated linear attenuation coefficients as a function of scan duration. The estimates of the attenuation coefficients are found to be 1% lower than the expected values for pre- and up to 6.5% lower for post-injection transmissions. The noise level in the transmission images increases as expected for Poisson data. The noise level in the attenuation corrected emission images shows only little increase with decreasing transmission scan time whereas it is strongly influenced by a variation of emission scan time. In patient studies, less than 3% difference was found in the estimated linear attenuation coefficients as well as in the activity concentrations between short (pre or post-injection) and long transmission scans. The noise levels in transmission and emission images are 1% (pre-injection) and 4% (post-injection) higher for short transmission scans. Conclusion: Due to the high photon flux, single photon transmission offers good clinical performance with significantly reduced transmission scan durations (< 2 min/bed in pre-, < 4 min/bed in post-injection transmission).
Effect of N-butylscopolamine on intestinal uptake of fluorine-18-fluorodeoxyglucose in PET imaging of the abdomen
Authors: Weber W. A. , Avril N. , Schwaiger M. , Stahl A. 
Published: March 2018

Summary
Aim: Circumscribed or diffuse intestinal uptake of F-l 8-fluorodeoxyglucose (FDG) is a frequent finding in PET imaging of the abdomen often interfering with correct scan interpretation. The aim of the present study was to determine whether the antiperistaltic agent N-butylscopolamine reduces intestinal FDG-uptake. Methods: Whole body scans from 40 patients with malignant lymphoma and no evidence for intraabdominal tumor involvement were analyzed (6 bed positions; scan start 60 min post injection of approximately 350 MBq FDG; emission time 9 min per position; no attenuation correction). Twenty patients received 20 mg N-butylscopolamine in combination with an intravenous injection of FDG (test group) and 20 patients received only FDG (control group). For analysis, the intensity of bowel loops and diffuse abdominal background were compared to normal liver on a 4 point scale (0 = lowest intensity, 3 = highest) by two experienced nuclear medicine physicians. Furthermore, focal intestinal uptake was evaluated quantitatively by a R0I technique and bowel to liver ratios (b/l) were calculated. Results: Bowel loops had lower intensity and occupied less abdominal regions in the test group than in the control group (visual score 1 vs. 1.5, p = 0.01; abdominal regions 1 of 5 vs. 2.5 of 5, p = 0.04). The visual score for diffuse abdominal background was 0.5 in the test group and 1 in the control group (p = 0.04). Bowel uptake interfered with scan interpretation in 1 of 20 patients in the test group and 6 of 20 patients in the control group (p = 0.01 ). The b/l ratios were 1.5 ± 0.7 in the test group and 2.3 ± 1.4 in the control group (p = 0.08). Conclusion: Administration of N-butylscopolamine reduces intestinal uptake of FDG and may facilitate accurate interpretation of abdominal FDG-PET studies.
Klinische Relevanz der I-123/I-131-MIBGSzintigraphie bei intestinalen Karzinoiden
Authors: Frank T. , Laubenbacher C. , Fink U. , Bauer R. , Langhammer H. R. , Pabst H. W. , Flierdt E. van de 
Published: March 2018

Zusammenfassung
Ziel der retrospektiven Studie war es, die Wertigkeit der MIBG- Szintigraphie bei gastrointestinalen Karzinoiden in Abhängigkeit von histologischen, klinischen und biochemischen Parametern zu überprüfen. Methode: Bei 15 Patienten wurde das Speicherverhalten gastrointestinaler Karzinoide und ihrer Metastasen in Korrelation zur Lokalisation des Primärtumors, zur intra- und extrahepatischen Tumormasse, zum histologischen Wachstumsmuster, zu immunhistochemi- schen Befunden und neuroendokrinen Tumormarkern sowie zur klinischen Symptomatik untersucht. Ergebnisse: Eine hohe Speicherintensität im Szintigramm zeigte sich fast ausschließlich bei einer Primärlokalisation im terminalen Ileum. Eine positive Korrelation ergab sich auch mit einer Karzinoid-typischen klinischen Symptomatik und der 5-HIES-Ausscheidung. Keine Korrelation zum Speicherverhalten bestand bezüglich der Tumormasse, dem histologischen Wachstumsmuster sowie der Mehrzahl der immunhistochemischen Befunde und der neuroendokrinen Tumormarker. Schlußfolgerung: Es besteht eine eingeschränkte Indikation zum Einsatz der MIBG-Szintigraphie in der Nachsorge gastrointestinaler Karzinoide. Wenn die Speicherpotenz eines Tumors bewiesen ist, ist die mlBG-Szintigraphie für Langzeitnachsorge und Therapiemonitoring geeignet.
Paradoxical Hypotension during Dobutamine Infusion for Myocardial Perfusion Scintigraphy
Authors: Caner B. , Atalar E. , Karanfil A. , Tokgözoğlu L. , Ergün E. L. 
Published: March 2018

Summary
Aim: Dobutamine as a predominant beta-1 agonist increases heart rate and myocardial contractility and at sufficient high doses, it also increases systolic blood pressure. This study was undertaken to describe instances of paradoxical hypotension during dobutamine infusion for TI-201 myocardial perfusion SPECT study and the relationship between scintigraphic findings and hypotension occurred during dobutamine infusion. Methods: In 201 consecutive patients unable to perform adequate exercise, dobutamine TI-201 myocardial SPECT was performed. Dobutamine was infused starting from 10 μg/kg/min increasing to 40 μg/kg/min. Paradoxical hypotension was defined as a decrease in systolic blood pressure ≥ 20 mmHg compared with baseline study. Results: Paradoxical hypotension was observed in 40 patients (Group A) out of 201 (19.9%) while no significant change in systolic blood pressure was detected in the remaining 161 patients (Group B). Mean maximum fall in systolic blood pressure was 39 ± 18 mmHg (range: 20-90). In 33 of 40 patients (83%) with paradoxical hypotension, scintigraphy was normal compared to 131 (81%) of the remaining 161 patients. In patients of Group A, angiography, echocardiography and tilt table tests were performed in 13, 11 and 6 patients respectively. Nine of 13 angiographic evaluations (69%), 10 of 11 echocardiographic evaluations (91%), all of the tilt table tests were normal. Additionally, all of the patients of Group A were clinically followed up at least 6 months after the myocardial perfusion scintigraphy. None of the patients had a cardiac event except one patient during the follow-up period. Conclusion: Paradoxical hypotension during dobutamine infusion for myocardial scintigraphy is not an uncommon finding and up to 19.9% patients may develop such hypotension. To maximize test safety, precautions should be taken during dobutamine myocardial stress test, since remarkable decrease in systolic blood pressure may occur. Unlike hypotension occurring with exercise test, hypotension response to dobutamine is not always a marker for coronary artery disease.
Modified Transarticular External Skeletal Fixation for Support of Achilles Tenorrhaphy in Four Dogs
Authors: Goring R. L. , Renberg C. , Bertrand S. , de Haan J. J. 
Published: March 2018

SummaryAchilles tendon ruptures in four dogs were treated with tenorrhaphy using a modified Kessler locking loop suture pattern and postoperative immobilization in partial extension of the tibiotarsal joint. The temporary immobilization of the tibiotarsal joint was achieved with a modified transarticular external skeletal fixation (MTESF). After predrilling the bone, the first fixation pin was placed in the distal tibia and the second in the calcaneus; they were connected with medial and lateral connecting bars. This immobilization method was easy to apply and to maintain during the postoperative period. The modified transarticular external skeletal fixation was removed between five and eight weeks after the operation. All four tendons healed, and all of the dogs returned to normal function. Modified transarticular external skeletal fixation is an alternative method of immobilization of the tibiotarsal joint for support of healing Achilles tenorrhaphies in dogs.Achilles tendon ruptures in four dogs were treated with tenorrhaphy and postoperative temporary immobilization of the tibiotarsal joint. The immobilization was achieved using a modified bilateral transarticular external skeletal fixation connecting the distal tibia and the calcaneus. All four tendons healed, and all of the dogs returned to normal function.
Navicular Syndrome: Preliminary Assessment of Radiographic Scoring
Authors: Dobson H. , Bonnett B. , Field J. R. 
Published: March 2018

SummaryThe purpose of this preliminary study was to record observer agreement in the assessment of navicular bone radiographs. This was performed to assess whether a navicular lesion scoring system would augment tests currently available. Radiographs from both normal horses and horses affected with navicular disease were used in the study.The dorsoproximal-palmarodistal oblique (65°) view of both forefeet of 54 individuals were assessed in an independent and unprejudiced manner by two observers, six months apart. The total synovial fossae score and the total number of lesions seen were recorded and intra-class correlation coefficients determined. From this the level of intraobserver and inter-observer agreement was determined. Substantial intra-observer agreement (ICC 0.61–0.80) for total synovial fossae score and total number of lesions was attained by one observer (No. 2) whilst the other (No. 1) attained only poor to moderate aggreement (ICC 0.40–0.60). The interobserver agreement ranged from moderate to substantial.In view of the inconsistency seen, in this preliminary evaluation, it is our belief that a navicular scoring system would not augment currently available diagnostic tests.This preliminary study examines the consistency of observer agreement for evaluation of navicular bone radiographs. A low level of observer aggreement, and hence consistency, was seen. The results suggest that the use of a navicular scoring system to augment diagnostic tests may be of little value.
A Prospective Study Comparing Two Fascial Reconstruction Techniques to Stabilise the Cranial Cruciate Deficient Stifle in the Dog
Authors: Lubbe A. M. , Coetzee G. L. 
Published: March 2018

SummaryThe standard intra-articular “underand-over” (U & O) cranial cruciate ligament substitute technique, using autogenous fascia lata, was compared with a combined intra- and extracapsular U & O fascial reconstruction procedure. Medium, large and giant dog breeds (body weights ≥ 15 kg), presented with unilateral rupture of the cranial cruciate ligament, were included in the study. Functional usage of the operated limb was evaluated according to a clinical grading system within the first six weeks and again at 12 and 26 weeks after the operation.Dogs treated with the standard intraarticular U & O procedure were partly weight-bearing on the operated limb within three to five weeks postoperatively. Return to full use of the limb with no or only mild, occasional lameness was recorded in 20 of 24 dogs (83.3%) after 26 weeks. Those treated with the combined intra- and extracapsular U & O procedure, returned to partial weight-bearing within four to seven weeks after the operation. These dogs exhibited slightly more cranial drawer motion (± 1.0 - 2.0 mm) at the six- and 12-week follow-up examinations, when compared to the first group, but stifle stability improved between 12 and 26 weeks. The results obtained from 45 of 55 dogs (81.9%) treated with the combined intra- and extracapsular U & O technique were comparable with the standard intra-articular U & O procedure with return to full use of the limb after 26 weeks. Radiological evidence of peri-articular osteophyte formation showed no remarkable difference between the two techniques after 26 weeks. Results obtained from the standard intra-articular U & O technique indicated that it was an effective method for use in large dogs with body weights greater than 30 kg. This is in agreement with findings in other studies. The combined intra- and extracapsular U &O fascial reconstruction was a reliable alternative for use in the medium to large dog breeds with body weights ranging between 15 and 26 kg.The standard intra-articular “under-and-over” (U & O) replacement technique was effective for use in dogs with body weights (BW) >30 kg. Dogs treated with the combined intra- and extracapsular U & O method had slightly more cranial drawer motion at the six-week and 12-week examinations, but stifle stability improved between 12 and 26 weeks, especially in medium-sized to larger dogs with BW ranging between 15 and 26 kg.
A Self-Locking Knot for Lateral Fabellotibial Suture Stabilisation of the Cranial Cruciate Ligament Deficient Stifle in the Dog
Authors: Miller A. , McKee W. M. 
Published: March 2018

SummaryMaintaining adequate tension when knotting large diameter monofilament sutures can be challenging, especially without surgical assistance. A self-locking knot is described for lateral fabellotibial suture stabilisation of the canine cranial cruciate ligament deficient stifle. The self-locking knot enables maintenance of tension during tying and the knot can be tied by an unassisted surgeon. The inherent ability of the knot to maintain tension on the fabellotibial suture is due to the first throw of the knot creating a locking-loop effect. Increasing the tension on the suture material is readily achieved by applying traction on the free ends and tightening the first throw of the knot to remove the slack created. When the suture is tightened sufficiently four additional square throws are applied to the knot.A self-locking knot is described for lateral fabellotibial suture stabilisation of the canine cranial cruciate ligament deficient stifle. The inherent ability of the knot to maintain tension on the suture material is due to the first throw of the knot creating a locking-loop effect. Tension on the knot can be readily adjusted and the knot may be tied by an unassisted surgeon.
A Survey of Orthopaedic Conditions in Small Animal Veterinary Practice in Britain
Authors: Abercromby R. H. , May C. , Turner B. M. , Carmichael S. , Ness M. G. 
Published: March 2018

SummaryA two-month survey of small animal orthopaedic conditions was conducted by members of British Veterinary Orthopaedic association. Clinicians from 42 clinics participated from a variety of practice including referral, primary care and teaching institutions. A total of 1627 cases were recorded. The case load was dominated by dogs with evidence that in UK cats are underrepresented in veterinary orthopaedic practice. Evidence of breed predisposition to orthopaedic disease in dogs was not detected. The importance of trauma in younger patients and degenerative diseases in older dogs was confirmed. A strong similarity between the case loads seen at primary care and referral practices was recorded. The results of this survey may be useful to those planning clinical orthopaedic teaching and research programmes.Members of BVOA recorded and collated details of all orthopaedic cases seen during February and March 1994. The case load was dominated by dogs with evidence that cats are underrepresented in orthopaedic practice. There were striking similarities between the case loads of primary care and referral institutes. The findings of this survey may help those responsible for planning clinical orthopaedic teaching and research.
Closed Toggle Pinning for Canine Traumatic Coxofemoral Luxation
Authors: Serdy M. G. , Hornof W. , Koehler C. , Chiu D. , Vasseur P. B. , Schulz K. S. 
Published: March 2018

SummaryA method of closed implantation of a toggle pin bone anchor and prosthetic ligament was developed for the treatment of traumatic canine coxofemoral luxation. Radiographic and anatomical evaluation of the canine femur and acetabulum were performed in order to develop an imaging and instrumentation technique that would allow closed placement of a toggle pin bone anchor under fluoroscopic guidance, while at the same time minimizing, or eliminating, damage to the articular cartilage. The surgical technique was then performed in 14 canine cadaver coxofemoral joints, followed by gross evaluation of implant placement, and potential cartilage or soft tissue damage. The cervical canal radiographic view of the proximal femur allowed placement of the drill hole through the fovea capitis of the femoral head without damaging the articular cartilage. The acetabular fossa was readily distinguishable from the acetabular articular cartilage on both of the lateral and ventrodorsal radiographic views of the pelvis. The toggle pin apparatus was inserted without damage to the articular cartilage in nine out of the fourteen hips and the bone tunnels were situated within the cancellous bone of the femoral neck in each of the nine specimens evaluated. Complications encountered during the procedure included bending and/or breakage of the guide wire in three hips and damage to the articular cartilage in two hips. The success of technique modifications designed to diminish the incidence of these complications awaits investigation in a clinical trial. Closed toggle pinning for canine traumatic coxofemoral luxation has the potential advantage of achieving rapid stabilization of the coxofemoral joint without damage to the articular cartilage and the need for an open approach to the joint. The clinical application of the technique is reported in one patient.The equipment and methodology for closed implantation of a toggle pin bone anchor and prosthetic ligament was developed for the treatment of traumatic coxofemoral luxation. A cadaver study was performed to assess the viability of the technique. Clinical application in one case is described.
Fine Morphological Assessment of Stripped Screw Sites in Cortical Bone
Authors: Oliver J. L. , Hosgood G. , Moore R. M. , Fitch R. B. 
Published: March 2018

SummaryUnintentional over-tightening of orthopaedic screws resulting in loss of screw purchase (“screw stripping”) is a potential complication during fracture fixation. This report describes the microstructural and radiographic effects on bone caused by stripping a 2.7 mm orthopaedic screw, and subsequent replacement in these stripped screw sites with either a 3.5 mm cortical or a 4.0 mm cancellous orthopaedic screws in both tapped and untapped holes. Over-tightening of a 2.7 mm screw resulted in shearing of the bone directly engaged by the screw threads. Additional fractures occurred in surrounding bone, primarily superficial subperiosteal saucer fractures in the cis cortex and to a lesser degree, in the subendosteum of the trans cortex. Bone damage was consistently more severe in the cis cortex. Salvaging stripped screw sites by insertion of a 3.5 mm or 4.0 mm screw resulted in additional fracturing and displacement, which was more severe in the untapped sites. Decreased holding power of screws placed in stripped screw sites could be attributed to collateral structural bone damage occurring during screw stripping and replacement screw application.Over-tightening of orthopaedic screws until mechanical failure (“screw stripping”) results in damage to cortical bone which extends beyond the outer thread diameter of the screw. Damage, most often subperiosteal saucer fractures, was greater in the cis cortex. The subperiosteal saucer fractures decreased the functional length of screw engagement of the larger replacement screws in the cortical bone, which may account for decreases in expected holding power.