Estimates for Assessment of Lymphedema: Reliability and Validity of Extremity Measurements.

Measuring lymphedema with high accuracy is important for several reasons. The aim of this study was to assess the reliability and validity of three routinely used methods to estimate limb volumes. Inverse water displacement, girth measurements, and Perometer measurements were executed.

Compositional modelling and crushing behaviour of MSWI bottom ash material classes.

At present, in Europe, 18 million tonnes of MSWI Bottom Ash (BA) is annually stockpiled or used in low-grade applications (e.g. in road bases).

Paradoxical gas embolism by transpulmonary passage of venous emboli during hysteroscopic surgery: a case report and discussion.

After an episode of apparent venous gas embolism in a patient undergoing surgical hysteroscopy, transoesophageal echocardiography revealed air in the left but not in the right heart. Contrast echocardiography failed to demonstrate anatomical right-to-left shunts, making it likely that venous emboli overwhelmed the capacity of lungs to filter emboli, resulting in paradoxical embolization.

Qualitative observation of left ventricular multiphasic septal motion and septal-to-lateral apical shuffle predicts left ventricular reverse remodeling after cardiac resynchronization therapy.

A multiphasic septal motion and typical septal-to-lateral apical shuffle of the left ventricle can be observed echocardiographically in some patients with left branch bundle block. The relation of both with left ventricular (LV) dyssynchrony according to tissue Doppler and LV reverse remodeling after cardiac resynchronization therapy was investigated. Fifty-three patients (37 men; age 68+/-8 years) with ischemic (n=26) or idiopathic (n=27) cardiomyopathy, baseline QRS duration 171+/-30 ms, LV ejection fraction 21+/-7%, and LV end-diastolic volume 257+/-91 ml were studied.

Myocardial contrast echocardiography for the detection of coronary artery stenosis: a prospective multicenter study in comparison with single-photon emission computed tomography.

Objectives: The purpose of this study was to compare myocardial contrast echocardiography (MCE) with single-photon emission computed tomography (SPECT) for the detection of significant coronary artery disease (CAD) in patients with symptoms suggestive of CAD.

Background: Single-photon emission computed tomography is a well-established method of assessing patients with CAD. Myocardial contrast echocardiography is a new technique allowing bedside assessment of myocardial perfusion.

Early discharge is feasible following primary percutaneous coronary intervention with transradial stent implantation under platelet glycoprotein IIb/IIIa receptor blockade. Results of the AGGRASTENT Trial.

Background: Primary percutaneous coronary intervention (PCI) with stent implantation demonstrated to be superior to both PCI with balloon angioplasty and to thrombolysis for acute ST-elevation myocardial infarction (STEMI). The use of glycoprotein (GP) IIb-IIIa blockers in this setting may be beneficial. However, GP IIb-IIIa receptor blocker treatment is frequently accompanied by femoral entry site-related bleeding complications, resulting in additional morbidity and prolonged hospitalization.

An unusual presentation and way to diagnose hepatocellular carcinoma.

A 67-year-old man with a history of chronic obstructive pulmonary disease (COPD) was admitted with acute progression of dyspnoea, productive cough, fever, elevated central venous pressure, oedema and liver enzyme abnormalities. Pneumonia with secondary right-sided congestive heart failure was considered. Additional abdominal ultrasound examination confirmed by a CT scan showed a mass in the inferior vena cava (VCI) extending into the right atrium.

Transesophageal echocardiography-guided transvenous biopsy of an intracardiac tumor.

Transesophageal echocardiography with simultaneous fluoroscopic guidance during a transvenous biopsy of an intracardiac tumor is a valuable technique. We present the case of a 67-year-old man with a metastasis in the right atrium from which histological examination of the tumor was indicated. The inaccessible location of the primary tumor in the liver and impaired hemostasis due to cirrhosis necessitated a transvenous biopsy of the metastasis.

Cardiac disease in young adult patients with end-stage renal disease since childhood: a Dutch cohort study.

Background: Cardiovascular disease is the most important cause of death in patients with pediatric end-stage renal disease (ESRD). Yet, few data exist on cardiac function in these patients. We assessed the extent of cardiac abnormality and analyzed its association with potential determinants in young adult patients with pediatric ESRD in a long-term follow-up study.

[Dyspnea after pneumonectomy due to atrial septum defect].

A 55-year-old woman presented with complaints of recurrent dyspnoea one year after pneumonectomy carried out as treatment for a tumour of the left lung. During several months her symptoms progressed and eventually mechanical ventilation became necessary. On admission a patent foramen ovale was found with transoesophageal ultrasound but this was judged not to be the cause of her symptoms.

Premature ventricular contractions during triggered imaging with ultrasound contrast.

Background: Premature ventricular contractions (PVCs) were observed during triggered second harmonic imaging of a contrast agent for myocardial perfusion assessment, with continuous infusion of the contrast agent. Further investigation into the relation of this phenomenon to both ultrasound energy and the contrast agent was carried out during a subsequent bolus-versus-infusion study.

Methods And Results: Two open-label studies in healthy male volunteers were performed.

Cardiac involvement in carriers of Duchenne and Becker muscular dystrophy.

A cross-sectional study in a cohort of DNA proven carriers of Duchenne (DMD) and Becker (BMD) muscular dystrophy was undertaken with the following objectives: (1) to estimate the frequency of electrocardiographic (ECG) and echocardiographic abnormalities; (2) to establish the proportion of carriers with dilated cardiomyopathy and (3) to assess possible associations between dilated cardiomyopathy and genotype. One hundred and twenty nine DMD and BMD carriers, aged 18-60 years, were traced through the files of the central register kept at the department of Human Genetics in Leiden. Investigations included full medical history, physical examination, ECG and two-dimensional and M-mode echocardiographic examination.

Signs and symptoms of Duchenne muscular dystrophy and Becker muscular dystrophy among carriers in The Netherlands: a cohort study.

Background: Carriers of Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) may show muscle weakness or dilated cardiomyopathy. Studies focusing on skeletal-muscle involvement were done before DNA analysis was possible. We undertook a cross-sectional study in a population of definite carriers to estimate the proportion and to assess the clinical profile of carriers with symptoms.

In-hospital cardiopulmonary resuscitation: prearrest morbidity and outcome.

Background: Considerations about the application of cardiopulmonary resuscitation (CPR) should include the expected probability of survival. The survival probability after CPR may be more accurately estimated by the occurrence in time of the prearrest morbidity of patients.

Objective: To identify risk factors for poor survival after CPR in relation to the dynamics of prearrest morbidity.

NC100100, a new echo contrast agent for the assessment of myocardial perfusion--safety and comparison with technetium-99m sestamibi single-photon emission computed tomography in a randomized multicenter study.

Background And Hypothesis: Myocardial contrast echocardiography using second-generation agents has been proposed to study myocardial perfusion. A placebo-controlled, multicenter trial was conducted to evaluate the safety, optimal dose, and imaging mode for NC100100, a novel intravenous second-generation echo contrast agent, and to compare this technique with technetium-99m sestamibi (MIBI) single-photon emission computed tomography (SPECT).

Methods: In a placebo-controlled, multicenter trial, 203 patients with myocardial infarction > 5 days and < 1 year previously underwent rest SPECT and MCE.

Accuracy and feasibility of contrast echocardiography for detection of perfusion defects in routine practice: comparison with wall motion and technetium-99m sestamibi single-photon emission computed tomography. The Nycomed NC100100 Investigators.

Objectives: We sought to assess the feasibility and accuracy of myocardial contrast echocardiography (MCE) using standard imaging approaches for the detection of perfusion defects in patients who had a myocardial infarction (MI).

Background: Myocardial contrast echocardiography may be more versatile than perfusion scintigraphy for identifying the presence and extent of perfusion defects after MI. However, its reliability in routine practice is unclear.

Transmyocardial laser channels.

We present 2-dimensional echocardiographic images of laser-made channels in the myocardium in an experimental model and in a patient treated with transmyocardial laser revascularization.

Evolution of cardiac abnormalities in Becker muscular dystrophy over a 13-year period.

We evaluated the course of cardiac involvement in 27 previously reported patients with Becker muscular dystrophy (BMD) originating from nine kindreds. Since almost all affected individuals of each kindred were included, intrafamilial variability could be studied. We also attempted to identify associations between cardiac involvement, functional ability and mutations at DNA level.

Diagnostic accuracy of transesophageal echocardiography during cardiopulmonary resuscitation.

Objectives: We sought to establish the diagnostic accuracy of transesophageal echocardiography (TEE) during cardiopulmonary resuscitation.

Background: Because of its bedside diagnostic capabilities, excellent cardiac images and lack of interference with resuscitation efforts, TEE is ideally suited to determine the cause of a circulatory arrest that is not due to severe arrhythmia. However, the diagnostic accuracy of TEE during resuscitation is unknown.