Volvulus in childhood

Summary Gastric volvulus or volvulus of the small-bowel can occasionally be found in neonates and small infants. Since volvulus is an emergency case, the radiologist must know the characteristic radiological findings and the ultrasound signs in correlation to the clinical symptoms. Two forms of gastric volvulus can be distinguished: the organoaxial type and a mesenterioaxial form. Besides an idiopathic etiology, diaphragmatic alterations can be observed in children with volvulus of the stomach. Volvulus of the small-bowel occurs in children with malrotation type I or II or with nonrotation. Bile-stained vomiting starts within the first days of life and is followed by the clinical signs of high bowel obstruction and peritonitis. Primarily in cases of gastric volvulus, an ultrasound examination can show the wrong position of the stomach or the pyloric region. In cases of small-bowel volvulus, abnormal localization of the superior mesenteric artery can be demonstrated. The plain film features an upper small-bowel obstruction. Upper intestinal contrast studies may reveal the level of small-intestine obstruction. A contrast enema can rule out a concomitant colon nonrotation or malrotation. A rare form which can be misdiagnosed easily, is volvulus of the sigmoid with pathological elongation and positioning of the sigma. It appears mostly in school children with less urgent symptoms and can disappear spontaneously. A typical feature is pain in the left lower abdomen and complete obstruction in an opaque enema. Eingegangen am 30. Dezember 1996 Angenommen am 3. Januar 1997     

Epicondylitis in the athlete

Epicondylitis plagues a significant proportion of athletes and can result in prolonged symptoms and suboptimal athletic performance. The diagnosis can be confused with many other pathologic entities affecting the elbow, some of which can occur concurrently. Most patients will respond favorably to a well-guided nonsurgical treatment protocol. A minority of patients will have persistent problems and will require surgical intervention that can relieve pain effectively and return patients to their preinjury level of activity.     

Emergencies in sports

Sports-related acute nail trauma brief can cause subungual hematoma and pain, which can be alleviated by fluid evacuation; the differential diagnosis includes subungual melanoma. A careful history will help distinguish splinter hemorrhages related to systemic disease from those caused by trauma. Chronic trauma can damage the nail matrix, leading to longitudinal splits or ridging, pigmentary changes, pterygium, or dystrophy. Mildly ingrown toenails can be treated with cotton placed under the lateral nail edges and proper trimming; severe cases may require surgery. Treatment of acute paronychia includes systemic antibiotics, while chronic paronychia may require topical or systemic antifungal agents.     

颞骨CT影像检查技术

本文综述了颞骨的现代影像学检查技术，HRCT是颞骨首选的影像学检查方法，对于颞骨解剖及病变的显示有很大优势。螺旋CT有多种后处理技术可应用于颞骨检查：MPR能对颞骨进行多方位观察，CPR对面神经等结构全貌显示，SSD、CTVE能够立体全方位显示解剖及病变并可进行模拟手术，VR显示内耳膜迷路及神经。MRI能够在一定程度上区分病变的病理性质，水成像技术清晰显示膜迷路。     

E-mail use in the radiology workplace

E-mail is a wonderful tool. But, like any tool, it can be misused. The proper use of e-mail by an administrator, manager, or technologist can provide a wonderful communication tool not just for customers and colleagues. Bulk e-mail-especially those developed in HTML, which can include visually appealing fonts and graphics-has an unrealized potential in radiology. Just be sure it doesn't qualify as the hated "spam," or important colleagues and customers will feel abused rather than helped. Finally, use words and phrases in an e-mail that can enhance collaboration and build positive relationships. E-mail can help win friends and influence others in meaningful and positive ways. It can be a useful strategy to facilitate positive interactions and gain support.     

胸腔镜在胸部创伤中应用的研究进展

创伤患者经常出现严重的胸部损伤,如血胸、肋骨骨折、肺损伤,食管、气管及胸导管损伤虽然少见但常常是患者死亡的主要原因,如果上述胸部创伤没有及时的诊断和治疗,会导致高病死率及远期不良预后。视频辅助胸腔镜(VATS)是外科手术中成熟的技术,在胸部损伤中,VATS可以提供胸腔内结构最大可视化,不但可作为胸部损伤的诊断方法而且能同时进行治疗,本文对VATS在胸部各类创伤中的应用及其优缺点进行综述,并讨论在胸部创伤中使用VATS的禁忌证及注意事项。     

Sickle cell trait in sports

Sickle cell trait (SCT) can pose a grave risk for some athletes. In the past decade in NCAA Division I football, no deaths have occurred from the play or practice of the game, but 16 deaths have occurred from conditioning for the game, and 10 (63%) of these deaths are tied to SCT, an excess of up to 21-fold. Research shows how and why, during intense exercise bouts, sickle cells can accumulate and "logjam" blood vessels, causing explosive rhabdomyolysis that can kill. Sickling can begin in 2 to 5 min of all-out exertion and can reach grave levels soon thereafter if the athlete struggles on or is urged on by coaches despite warning signs. Sickling collapse is an intensity syndrome that differs from other common causes of collapse. Tailored precautions can prevent sickling collapse and enable athletes with SCT to thrive. Irrationally intense conditioning for a game puts the lives of healthy athletes with SCT at risk.     

Radiotracer development in psychiatry

Over the last 20 years a number of radiotracers that target various neurotransmitter systems have been developed for use in imaging studies in psychiatry, but there are many more targets still to be investigated. The development of a radiotracer for clinical positron emission tomography (PET) or single photon emission computed tomography (SPECT) neuroimaging studies can be a complex and lengthy process with few imaging agents successfully progressing into clinical human studies. One of the most challenging aspects in the procedure is the development of a rapid and simple radiosynthesis protocol to obtain the potential radiotracer with adequate specific activity, isolated radiochemical yield and radiochemical purity for human imaging. Once a candidate has been radiolabelled, full characterization of the radiotracer is required before it can be used in clinical human studies. Pre-clinical studies include investigation into the binding distribution, pharmacokinetics, metabolism, toxicology and dosimetry of a radiotracer. There are many points during the development procedure where a potential radiotracer can be rejected. Due to interspecies differences the development of a radiotracer can either go too far with an unsuccessful candidate or can potentially lead to rejection of a candidate too soon. It is only when the radiotracer has been used in humans can we be certain that a radiotracer is a useful imaging agent for clinical research studies. The development of new technologies, such as micro-PET or SPECT can only improve our ability to predict the success of a radiotracer.     

Experiences in the field of elemental analysis in vivo

In this paper some radioanalytical methods will be described for assessing the contents of various elements in the human body. In vivo methods are necessary for this problem. Protein content can be estimated by means of in vivo measurements of nitrogen, bone minerals by means of the total body content of calcium. Fat contains a high concentration of carbon. Carbon in fat can be estimated and from this the total body fat can be calculated. Toxic elements such as lead, cadmium and mercury are assessed by in vivo measurements, both related to occupationally exposed workers and to members of the public.     

甲状腺相关眼病活动性的影像评估

影像检查可以无创地显示眼眶结构,定量分析眼内病变,在评估甲状腺相关眼病(TAO)活动性及指导治疗方案制订中具有重要意义。A超、B超可测量眼外肌的形态变化。彩色多普勒成像实时显示眶内重要血管的血流信号。CT可显示眼眶结构形态学改变,在评估眼部损害和临床分级方面已经取得了较好的效果。MRI能更准确地评价眼外肌和脂肪的炎症反应。而核素显像技术从分子水平评判TAO的活动度,具有良好的应用前景。     

模型病毒在光化学灭活血液制品中病毒中的应用

光化学方法灭活血液制品中的病毒是近几年发展较快、应用前景的灭活方法。它高效灭活病毒、并确保血液或血液制品的完整性和功能活性。选择合适的病毒模型不仅能评价灭活效果,还能替代尚未建立系统培养的病毒株考察灭活效果。     

Emergencies in sports

Activity can cause or exacerbate certain skin conditions. Sweaty skin is a warm, moist environment for fungi and yeasts, and sports participation may transmit or worsen a viral condition such as herpes simplex. Specialized medication regimens and topical treatments can sometimes prevent a flare-up or minimize activity interruptions.     

Sonography in the diagnosis of lymphogranulomatosis

With a rate of 87.7% of exact diagnoses, sonography is a proven method to find intraperitoneal and retroperitoneal manifestations of malignant system diseases. It is not stressing or invasive and can be frequently repeated; needing less expenditure and involving no risks, it can bear comparison with lymphographic methods and is important in the classification of stages of lymphatic system diseases. During one examination, enlarged organs and infiltrations in form of focuses in the parenchymatous organs can be diagnosed, and vessels and formations of lymphomas can be seen within their topographic connection. Independently from their drainage ways, all enlarged lymph nodes, also those situated in areas not accessible by lymphography like the hilus of liver, spleen, kidney, and retrohepatic, mesenteric, and intraperitoneal regions, can be visualized even without administration of a contrast medium. The method offers the possibility of frequent control examinations during radiotherapy or chemotherapy; possible recurrences can be early detected. However, manifestations of a malignant system disease in the lymph nodes can be hardly discerned from metastases of a primary tumor localized in another region. Despite this disadvantage, sonography keeps the first rank in the gradual application of image-producing diagnostic methods (sonography, CT, lymphography).     

Mitral Valve Prolapse in Active Youth

In brief Mitral valve prolapse (MVP) often brief manifests among active children and adolescents. Techniques for detecting clicks and systolic nonejection murmurs can help physicians identify MVP, and diagnostic tests can help confirm the findings. Tracking the patient's chest pain, palpitations, shortness of breath, and other symptoms can help clinicians decide if treatment should include medication—and if medication helps symptoms. Sometimes, simple reassurance will be enough to ease symptoms. With annual follow-up, patients can lead normal lives, which includes reaping the benefits of physical activity.     

Clinical decision rules in radiology

Clinical decision rules to guide physicians in the appropriate use of diagnostic imaging studies need to be developed, in part, to control the overutilization of imaging studies. These rules need to be evidence based. Randomized control trials can be designed to assess the value of imaging studies and interventional procedures at levels five and six, patient outcome and societal efficacies, in Fryback and Thornbury's hierarchical model of efficacy. Results of these trials can be used to develop clinical decision rules. However, the efficacy of most diagnostic imaging studies can be assessed better at levels three and four, diagnostic thinking and therapeutic efficacies. Studies can be designed to determine clinical situations in which imaging studies will be of no value or to determine clinical criteria for the use of imaging studies. Systematic reviews of the literature and other techniques of analysis of evidence, such as decision trees, also can be used to develop evidence-based clinical decision rules for the use of diagnostic imaging procedures.     

Application of multinuclear in vivo magnetic resonance spectroscopy in oncology

Cell metabolism and the metabolism of drugs can be monitored noninvasively and in vivo by magnetic resonance spectroscopy (MRS). At present, tumors cannot be differentiated by means of 31P MRS. This method can be used in tumor therapy follow-up for early detection of metabolic tumor response. 31P MRS is not helpful in determining whether patients respond to therapy or not. The first clinical results have been obtained using 1H MRS; however, no clinically relevant results have been obtained as yet. Preliminary experiments demonstrate that 19F MRS can be used to observe the metabolism of drugs.     

Joint innervation in joint injury

When considering joint innervation, it is important to appreciate that the joint receptors and the muscle tendon units about the joint interact in a complimentary manner forming a single afferent system. This system remains complex, and its overall function is still relatively unclear. Although the role of joint afferents can not be explicitly described, it is important to appreciate that alterations in joint innervation caused by athletic trauma can occur and can markedly affect joint function.     

Bildzeichen in der Thoraxdiagnostik

Signs in chest imaging are defined as typical findings which can be easily recognized on x?ray photographs or computed tomography (CT) scans of the chest. They are caused by different typical pathophysiological processes. Due to the association of a certain pathophysiological cause with a given sign, knowledge and use of these signs can allow the possible differential diagnoses to be narrowed down. If other imaging findings and clinical data are additionally taken into account, the diagnosis can be made with a high degree of confidence in many cases.     

Spinal injury in sport

Spinal injuries are very common among professional or amateur athletes. Spinal sport lesions can be classified in overuse and acute injuries. Overuse injuries can be found after years of repetitive spinal load during sport activity; however specific overuse injuries can also be found in adolescents. Acute traumas are common in contact sports. Most of the acute injuries are minor and self-healing, but severe and catastrophic events are possible. The aim of this article is to review the wide spectrum of spinal injuries related to sport activity, with special regard to imaging finding.     

Managing blisters in competitive athletes

Friction blisters can have a negative effect on an individual’s ability to perform his or her sport or duties. In a recent study, 69% of soldiers participating in a 20-km road march were found to have blisters, 10% of whom required medical intervention. Blistering of the feet is one of the most common injuries sustained by runners while training and racing. Although most blisters are minor and can be treated conservatively, others can lead to intense pain, cellulitis, and even sepsis. The best way to treat friction blisters is to prevent them; however, if they do occur, timely and effective treatment will help prevent the complications that can impede athletic performance.