Fat distribution was assessed by computed tomography in normal volunteers (n = 42), patients on long-term dialysis (n = 18), and patients on glucocorticoids [renal transplant patients (n = 49), other diseases (n = 17)]. Patients on glucocorticoids had higher mediastinal (deep) and identical or increased posterior cervical, buccal, and midthigh (superficial) fat areas when compared with normal subjects. The pattern of fat distribution in dialysis patients mimicked the distribution observed in patients taking glucocorticoids. Healthy females had higher ratios of superficial to deep fat than healthy male subjects. Patients on prednisone or on dialysis lost this sex-associated difference in fat distribution. Since patients on prednisone exhibit increased or normal thigh fat depots in the presence of increased mediastinal fat, the current concept that glucocorticoids induce redistribution of body fat from peripheral to central fat compartments has to be revised. Furthermore, disease states and/or glucocorticoids abrogate sex-associated differences in body fat distribution.
A morphometric method to calculate liver volumes from transverse sections is evaluated (point-integrating method). In the first part of the study, 10 liver specimens were investigated by computed tomography (CT) and ultrasound (US); the calculated volumes were compared to the volumes obtained by water displacement of the organs. While CT showed an ideal agreement (r = 0.994), volumes calculated from US sections correlated less well (percentage differences from +12.5% to -9%, r = 0.915). In the second part of the study, the livers of 10 randomly selected patients were investigated by CT and US. Liver volumes were calculated using the point-integration method. Compared to the CT examination, US results show a good correlation with a correlation coefficient of r = 0.977. The point-integration method is very valuable to measure organ volumes from transverse sections. The method can be applied "offline" to photographic films, data do not have to be recorded electronically. The time required to calculate the volume of an organ is comparable to other methods.
KEYWORDSUltrasonography; Musculoskeletal ultrasound; Interventional ultrasound.Abstract In recent years ultrasonography (US) has emerged as the imaging technique of choice for guiding diagnostic and therapeutic procedures including those related to the musculoskeletal system. However, the absence of ionizing radiation and the elevated safety of the method must not lead us to forget that there are precautions and contraindications to keep in mind, which are crucial to the protection of both the patient and the physician.Among these precautions it is first of all essential to obtain the patient's accurate clinical history including current medication, particularly if it involves drugs influencing the blood clotting, and information related to possible allergies. The patient should furthermore receive detailed information concerning the procedure (sterile precautions as well as possible sideeffects of the drugs which will be injected). In addition to this, there must be a close contact between the radiologist and the patient's general physician (GP) in order to obtain the best possible result of the procedure.Sommario Negli anni recenti l'ecografia si è imposta come tecnica, spesso di elezione, per guidare interventi diagnostici e terapeutici, anche in ambito muscolo-scheletrico. L'assenza di radiazioni ionizzanti e la quasi innocuità delle procedure non devono, tuttavia, far dimenticare che esistono precauzioni da prendere e controindicazioni da conoscere, essenziali per la tutela del paziente e del medico.Tra le precauzioni sono punti fondamentali il rigore e l'accuratezza nell'ottenimento dell'anamnesi (conoscere eventuali assunzioni di farmaci, in particolare di quelli che interagiscono con la coagulazione, o allergie del paziente), informare dettagliatamente il paziente sulla modalità di realizzazione delle procedure (effetti collaterali dei farmaci che saranno iniettati) e la sterilità.A tutto questo deve sempre aggiungersi un corretto rapporto ecografista/medico curante che consenta di ottenere risultati ottimali. ª
Pain is one of the most common causes of reduced productivity. The annual cost of health-related reductions in productivity has been estimated at approximately 225 billion dollars in the United States alone. Ultrasound-guided locoregional infiltration procedures have frequently been shown to offer economical, effective, lasting relief of pain. In-depth familiarity with the equipment (probes and needles) and techniques used to perform these procedures are fundamental for safe, effective treatment. In fact, depending on the characteristics of the patient and the clinical problem, the approach and technique may have to be modified to simplify the procedure and ensure better results. Up-to-date knowledge of the drugs used for these infiltrations (indications, how they are used) is equally important. Our aim is to provide an update on the techniques and materials used in interventional musculoskeletal ultrasonography based on a review of the most recent literature as well as on our personal experience.
Ultrasound (US) is the most commonly used imaging method for studying urinary tract disorders in dogs, as it is easy to perform, inexpensive and provides excellent contrast resolution in real-time. However, US examination of dogs presents a series of technical difficulties, and the US operator must therefore have a longstanding experience and access to high-quality equipment including a range of different probes to achieve a correct diagnosis. The aim of this mini-pictorial essay is to describe US findings and patterns which permit identification of the most common pathologies of the urinary tract in dogs. The technical difficulties that may be encountered are also evaluated as well as integration with other imaging modalities (traditional X-ray, computed tomography, magnetic resonance imaging).
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