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Percutaneous transluminal angioscopy is opening up exciting
possibilities for the interventional radiologist, since it can
picture vascular features with an accuracy and clarity that
previously has not been possible. Dr. Beck paves the way for the
use of this new tool in clinical diagnosis; he details the
technical prerequisites, gives step-by-step instructions for
applying the technique and discusses how to interprete the
resulting images. The amazing results of percutaneous angioscopy
are compared with the results of conventional angioscopy. This
approach introduces the new and unknown in perspective with the
tried and trusted of the past. Major advantages become obvious:
unclear or uncertain angiographical findings can be cleared up,
interventional procedures can be supported, and the effects of
interventional radiology can be seen before and after vascular
treatment. The author's unique insight and systematic approach to
the vascular system make this atlas a truly pioneering work.
In the past ten years, there have been significant advances in the
diagnosis and therapy of arterial vascular disease. While long-term
morbidity can only be improved by changing the patient's life-style
and removing any risk factors that may be present(hypertension,
hyperlipidemia, obesity, diabetesmellitus, nicotine abuse),
symptomatic relief may be obtained by various procedures. Besides
conservative treatment of arterial occlusive disease (physical
therapy, medical treatment) and surgical vascular interventions
(thromboendarterectomy, bypass procedures), balloon catheters
introduced percutaneously under local anesthesia have found
increased application in virtually all areas for the dilatation and
recanalization of obstructive lesions in the past few years. The
technique of balloon dilatation, as introduced by Griintzig as a
further development of the percutaneous interventions by Dotter and
Judkins, is no longer the decisive issue. The main objective of
present clinical research is to de termine the proper indications
and patient selection for this procedure, which has found its place
between conservative treatment and surgery. The contents of this
Symposium should provide some guidelines for the indi cations and
postprocedural therapy for the referring physician, the
angiologist, and for the radiologist and cardiologist performing
the dilatation. We owe our thanks to all the specialists involved,
who have provided us with the benefits of their experience. Mrs. H.
Beilmann and Dr. M. Wojtowycz con tributed substantially to the
preparation of the text. I would like to thank them and the staff
of Springer-Verlag for their conscientious work in the interest of
composition and publication quality."
It is not surprising that so much investigation has been undertaken
to establish the cause of childlessness, especially when the
potentia coeundi of the male is not impaired. As long ago as 1957
the German Society for the Study of Fertility and Sterility was
founded, embracing gynecology, andrology, and veterinary medicine.
After its inception, meetings conducted in the spirit of its
foundation were held every 2 years. This interdisciplinary,
coordinated scientific work in the field of human reproduction
achieved its value as a result of the stimuli provided by the
permanent involvement of veterinary scientists. After about 20
years of activity, the Society adopted a highly differentiated
pattern of work-directions in the field of human and veterinary
medicine. Since 1976 annual meetings have been held on the topic of
animal and human reproduction. These meetings have proved of great
value, especially in the area of comparative medicine, and have led
to excellent interdisciplinary associations. One of the most
evident successes was the first extracorporal fertilization in
humans with subsequent embryo transfer and full-term pregnancy.
Gynecologists have found that in 40% of cases the cause of
undesired childlessness rests with the male, and it is therefore no
surprise that also in the field of andrology certain factors
concerned with infertility have received great attention.
Applications of angiography have expanded to include not only
diagnostic proce- dures but also therapeutic interventions. The
introduction of regional administra- tion of vasoactive drugs
through percutaneously placed angiographic catheters was soon
followed by methods of transcatheter vessel occlusion using
temporary or permanent embolic materials. At the same time methods
of opening up nar- rowed or completely obstructed blood vessels
with percutaneously introduced balloon catheters were being
perfected. Thus, regional blood flow reduction or regional blood
flow increase can now be accomplished with percutaneous
angiographic methods in lieu of major surgical interventions. The
advantages in terms of reduced morbidity, length of hospital stay
and cost are evident. Therapeutic angiography is a rapidly
advancing and therefore changing field. This monograph aims at
capturing some of the most recent advances and also at presenting
some of the controversies. In order to accomplish this task the
editors invited a selected group of cardiovascular radiologists, to
contribute in their respective fields of therapeutic angiography.
For a balanced view other experts - usually nonradiologists - were
also asked to present their views, com- ments, and criticisms.
Whenever opinions were far apart an opportunity was given for reply
or rebuttal. Thus, up-to-date information with supporting or oppos-
ing expert views is presented on the topics of transluminal
angioplasty, transcath- eter vessel occlusion, regional drug
infusions, and radiologic interventions in thromboembolic disease.
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Cardiac Nuclear Medicine (Paperback)
B.Leonard Holman; Contributions by W. E. Adam, Francis Bitter; Edited by H. L. Abrams, E Zeitler; Contributions by …
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R2,927
Discovery Miles 29 270
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Ships in 10 - 15 working days
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Cardiac nuclear medicine has grown dramatically over the past
decade to the point where it is now an integral part of the routine
diagnostic workup in patients with heart disease, particularly
coro- nary artery disease. In no small part, this is the result of
dramatic improvements in technology and the application of these
improve- of diagnostic techniques. ments to the development and
refinement In this book, authorities on cardiac imaging techniques
provide an up-to-date description of the field, covering the
clinical appli- cability, efficacy, and future potential of
myocardial perfusion scinti- graphy, quantitation of regional blood
flow, assessment of ventricu- lar performance, and detection of
acute infarction using radio- tracers. This book provides the
physician involved in cardiac diag- nosis with the background
necessary to integrate the radiotracer method into his diagnostic
armamentarium. Boston, August 1979 B.L. HOLMAN Contents Cardiac
Nuclear Medicine: An Overview By B.L. HOLMAN ...1 Assessment of
Ventricular Function with First-Pass Angio- cardiography By N.
ScHAD and 0. NICKEL With 7 Figures ...9 Equilibrium (Gated)
Radionuclide Ventriculography By W.E. ADAM, A. TARKOWSKA, F.
BITTER, M. STAUCH, and H. GEFFERS With 15 Figures ...21
...Myocardial Scintigraphy with Infarct-Avid Tracers By B.L. HOLMAN
and J. WYNNE With 3 Figures ...35 ...Quantitative Assessment of
Thallium-201 Images By U. BuELL, E. KLEINHANS, M. SEIDERER, and
B.E. STRADER With 10 Figures ...43 ...Thallium-201 Myocardial
Perfusion Scintigraphy during Rest and Exercise By A. LENAERS ...55
...
The number of patients with occlusive peripheral vascular disease
of the lower ex- tremities is still growing as rapidly as the
number of patients with coronary heart disease and cerebrovascular
disease. Due to the increase in average life expectancy during the
last few decades, more patients now need surgical vascular
reconstruc- tion. This actually means a demand for more centers
specializing in vascular surgery and equipped with intensive care
facilities, since the number of patients with cardio- vascular and
bronchopulmonary complications is increasing as well. In addition,
the number of patients needing repeated vascular surgery has been
growing. Therefore, the search for simple procedures to recanalize
the arterial lumen which could be performed under local anesthesia
is no surprise. Unfortunately peripheral vascular disease is still
frequently treated by amputations. In 1967, the fIrst report in
German on percutaneous recanalization of arteries with thrombotic
occlusions and stenoses appeared in Rontgenfortschritte. The meth-
od described in this report had been published by Dotter and
Judkins in 1964. Today, 10 years after their report, more data have
been systematically collected on this method in Europe than in the
United States, where it was developed. Possibly an explanation of
this state of affairs is that nonsurgical treatment is favored more
in Europe than in the United States. The scientifIcally based
angiology established by Ratschow served as the foun- dation for
the development of diagnostic work-up and therapy in other
directions beyond the questions of operability and surgical
results.
Die Strukturierung der speziellen Skeletbande muBte von der Aufgabe
ausgehen, daB fur jeden einzelnen Skeletteil nach der
Einstellungstechnik die Anatomie, die normale Entwicklung, die
Variationen und Mif3bildungen, die traumatischen Veranderungen und
die Begutachtungsfragen getrennt abgehandelt werden, wahrend
generalisierte oder systematische Erkrankungen, Strahlenschaden und
Entzundungen, Geschwiilste und Erbkrankheiten - um nur einige zu
nennen - wegen ihres die einzelnen Skeletteile ubergreifenden
Charakters oder ihrer grundsatzlichen Erscheinungsbilder zusammen-
gefaBt werden, weil sich nur auf diese Weise unertragliche
Uberschneidungen und Wieder- holungen vermeiden lassen. Dieser
Aufgabe entsprechend bildet dieser Band eine Zusammenfassung un
seres heutigen Wissens auf einem Gebiet, auf welchem vor den
Radiologen schon viele Anatomen- Generationen wissenschaftlich
erfolgreich tatig waren, eines Wissens, zu dem neb en den Anatomen,
Pathologen und Radiologen auch Chirurgen, Orthopaden und Padiater
intensiv beigetragen haben. Das dadurch zwangslaufig sehr breit
gestreute Schrifttum muBte ausgewertet und dem wissenschaftlich
Tatigen in einer noch praktikablen Form zuganglich gemacht werden.
Hier die richtige Auswahl zu treffen, durfte zu den schwierig- sten
Aufgaben eines Autors gehoren. Dariiber hinaus solI dieser Band
jedoch auch fur die tagliche Praxis ein nutzlicher Helfer und in
schwierigen Fragen ein zuverliissiger Ratgeber sein.
Das Buch befa t sich mit Problemen der Qualit{tssicherung bei der
Herstellung und Anwendung von Kontrastmitteln. Nach einf}hrenden
Beitr{gen zur Fertigung und Lagerung wird die klinische Anwendung
von Kontrastmitteln f}r R-ntgen-, CT- und MRT-Untersuchungen
ausf}hrlich er-rtert.
Mit der Einfuhrung der nichtionischen Rontgenkontrastmittel hat ein
mehrere Jahrzehnte wahrender Prozess der pharmakologischen
Entwicklung zum Erfolg gefuhrt. In dem vorliegenden Buch werden die
Ruckwirkungen von Rontgenkontrastmitteln auf die Gefasswand, auf
Herz, Kreislauf und Lungenstrombahn, Nieren- und
Schilddrusenfunktion sowie ihre Toxikologie und Pharmakologie
ubersichtlich dargestellt. Weitere Beitrage befassen sich mit der
klinischen Wertigkeit der Rontgenkontrastmittel im Rahmen der
Angiographie und Computertomographie sowie mit den nichtvaskularen
Applikationen. Die hohe Sicherheit nichtionischer
Rontgenkontrastmittel bei Arthrographie, Sialographie,
Pankreatikographie und indirekter Lymphographie wird belegt. Ein
besonderer Abschnitt ist medikolegalen Fragen im Zusammenhang mit
der Patientenaufklarung gewidmet. Forschungsergebnisse der letzten
Jahre zur Kontrastmittelvertraglichkeit und zur Vermeidung von
Kontrastmittelnebenwirkungen schliessen das Buch ab.
1. Der Dosisvergleich zwischen Angiographiefilm auf
hochverstarkender Seltener-Erde-Folie (Quanta 3) und digitalem
BV-TV-Bild im "pulsed mode" fallt eindeutig zu ungunsten des
digitalen BV-TV-Bildes aus. Zumindestens beim DVI-II-System (Fa.
PHI LIPS) und DIGITRON-II-System (Fa. SIEMENS) liegen die Dosen an
den 3 MeBorten Oberfiache, Kor permitte und Austrittsseite bei
Verwendung der auto matischen Belichtungsregelung und eines 25 cm
Bild verstarkerformates urn den Faktor 2 hoher als bei der
hochverstarkenden Angiographie-Film -F olien-Kom bination (Quanta
3). Diese Aussage gilt unabhangig yom entgegengesetzten Strahl en
gang bei Filmangio graphie und DSA. 2. Durch Wahl einer niedrigeren
Dosisleistungsstufe oder Manipulation der kV-Zahl und Videokamera
apertur laBt sich die Dosis bei digitalen BV-TV-Bild in die
GroBenordnung der Filmdosis bringen. Die zuge horigen
Qualitatsvergleiche stehen noch aus. 3. Es besteht eine Diskrepanz
mind est ens urn den Faktor 10 zwischen yom Hersteller angegebener
"Eingangs dosis" am Bildverstarker und der yom Anwender tat
sachlich zu messenden Dosis vor der Bildverstarker abdeckung. Diese
Diskrepanz erkHirt sich zum Teil durch unterschiedliche
MeBbedingungen und den zwi schengeschalteten Streustrahlenraster
und Abstand. Fiir die Praxis ist jedoch mit realen Dosiswerten zwi
schen 3 und 5 mR pro Bild im "pulsed mode" vor der
Bildverstarkerabdeckung zu rechnen. Diese Werte werden von mehreren
Arbeitsgruppen bestatigt 1, 5-8]."
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