V článku autoři popisují způsob zavedení postmortem CT angiografie do praxe na Ústavu soudního lékařství Fakultní nemocnice Ostrava v případech bodnořezných poranění končetin. Detailně je popsána nezbytná příprava cévního řečiště před provedením samotné angiografie, způsob aplikace kontrastní látky do cévního řečiště i praktické tipy usnadňující následné provedení konvenční pitvy. Stručně je uveden rovněž souhrn publikovaných prací zabývající se problematikou postmortem CT angiografie, popisující nejen její nesporné výhody, ale také limity a úskalí, která s sebou tato metoda přináší. Adresa pro korespondenci: MUDr. Bc. Jana Mertová Ústav soudního lékařství FN Ostrava 17. listopadu 1790/5, 708 52 Ostrava-Poruba Tel.: +420 597 371 713 Fax: +420 597 371 706 E-mail: jana.mertova@fno.cz Delivered: June 24, 2024 Accepted: July 24, 2024
This article describes a method of introducing postmortem CT angiography into daily forensic medicine practice involving cases of limb stab wounds investigated at the Department of Forensic Medicine, University Hospital Ostrava. The essential preparation of the vessels as well as practical tips facilitating the subsequent performance of a classic autopsy are described in detail. Article also includes brief review of published papers dealing with PMCT angiography related issues, advantages which brings CT angiography into forensic routine work, but also its limits and pitfalls.
- MeSH
- Agar MeSH
- Biomedical Research methods MeSH
- Computed Tomography Angiography methods instrumentation MeSH
- Forensic Imaging methods instrumentation MeSH
- Extremities diagnostic imaging injuries MeSH
- Contrast Media MeSH
- Humans MeSH
- Wounds, Penetrating * diagnostic imaging MeSH
- Autopsy MeSH
- Postmortem Imaging * methods instrumentation MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Chronic Limb-Threatening Ischemia diagnostic imaging diagnosis nursing MeSH
- Extremities diagnostic imaging blood supply pathology MeSH
- Oxygen MeSH
- Peripheral Arterial Disease diagnostic imaging MeSH
- Ankle Brachial Index methods nursing instrumentation MeSH
- Blood Gas Monitoring, Transcutaneous methods nursing instrumentation MeSH
Bioimpedance is the ability of biological tissues to impede the flow of electrical current. It is often measured as a means of detecting volume and structural changes in various biological tissues. The purpose of this work was to design a two-channel portable device for measuring multifrequency bioimpedance of human limbs. The device was constructed specifically for evaluation of the bioimpedance measurement as a possible tool for aiding in diagnosis of soft-tissue structural changes in the muscles of human limbs by continuously comparing bioimpedance of one limb to the other. The proposed device is based on impedance converter AD5933. It is designed for noninvasive measurements on the human body with low amplitude alternating current at frequencies between 1 kHz and 100 kHz. The device was tested for electromagnetic compatibility, accuracy and used in laboratory measurements for detection of muscle edema on a bioimpedance model. It is capable of measuring impedance up to 100 kΩ with a relative measurement error below 1.84%.
- Keywords
- zátěž, farmakologická zátěž, indikace, viabilita myokardu, infekce cévních náhrad,
- MeSH
- Blood Vessels diagnostic imaging pathology MeSH
- Radiation Dosage MeSH
- Endocarditis diagnostic imaging MeSH
- Image Interpretation, Computer-Assisted MeSH
- Myocardial Ischemia diagnostic imaging MeSH
- Tomography, Emission-Computed, Single-Photon MeSH
- Cardiac Imaging Techniques classification methods instrumentation MeSH
- Cardiology * methods instrumentation MeSH
- Cardiovascular Infections diagnostic imaging MeSH
- Extremities diagnostic imaging pathology MeSH
- Humans MeSH
- Lymphoscintigraphy MeSH
- Neoplasms diagnostic imaging pathology MeSH
- Vascular Diseases diagnostic imaging pathology MeSH
- Heart Diseases diagnostic imaging classification MeSH
- Nuclear Medicine * methods instrumentation MeSH
- Perfusion Imaging methods MeSH
- Lung diagnostic imaging pathology MeSH
- Positron-Emission Tomography methods nursing MeSH
- Prognosis MeSH
- Radiopharmaceuticals classification MeSH
- Radioisotopes pharmacokinetics MeSH
- Risk MeSH
- Gated Blood-Pool Imaging classification MeSH
- Heart diagnostic imaging physiopathology MeSH
- Vasculitis diagnostic imaging MeSH
- Vasodilator Agents classification MeSH
- Ventilation-Perfusion Scan methods MeSH
- Inflammation diagnostic imaging classification pathology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- Keywords
- laloková plastika,
- MeSH
- Achilles Tendon surgery pathology MeSH
- Leg surgery diagnostic imaging pathology MeSH
- Surgical Flaps * surgery adverse effects MeSH
- Lower Extremity anatomy & histology surgery diagnostic imaging blood supply pathology injuries MeSH
- Femur surgery diagnostic imaging pathology injuries MeSH
- Fractures, Bone surgery diagnostic imaging pathology MeSH
- Upper Extremity anatomy & histology surgery diagnostic imaging blood supply pathology injuries MeSH
- Humerus anatomy & histology surgery diagnostic imaging blood supply MeSH
- Clavicle surgery MeSH
- Extremities anatomy & histology surgery diagnostic imaging blood supply pathology injuries MeSH
- Muscle, Skeletal surgery MeSH
- Foot Bones anatomy & histology surgery diagnostic imaging blood supply injuries MeSH
- Humans MeSH
- Metacarpal Bones surgery diagnostic imaging MeSH
- Metacarpus surgery diagnostic imaging MeSH
- Metatarsophalangeal Joint surgery MeSH
- Foot anatomy & histology surgery diagnostic imaging blood supply pathology MeSH
- Orthopedic Procedures methods adverse effects MeSH
- Osteomyelitis surgery MeSH
- Calcaneus anatomy & histology surgery diagnostic imaging blood supply pathology injuries MeSH
- Surgery, Plastic methods adverse effects MeSH
- Lunate Bone surgery diagnostic imaging MeSH
- Leg Injuries surgery diagnostic imaging pathology MeSH
- Foot Injuries surgery diagnostic imaging pathology MeSH
- Forearm Injuries surgery diagnostic imaging MeSH
- Finger Injuries surgery diagnostic imaging pathology MeSH
- Hand Injuries surgery diagnostic imaging pathology MeSH
- Fingers surgery diagnostic imaging blood supply pathology transplantation MeSH
- Pseudarthrosis surgery diagnostic imaging MeSH
- Hand surgery diagnostic imaging pathology MeSH
- Thigh surgery diagnostic imaging pathology injuries MeSH
- Talus anatomy & histology surgery diagnostic imaging injuries MeSH
- Tarsal Bones surgery diagnostic imaging pathology MeSH
- Plastic Surgery Procedures methods adverse effects MeSH
- Wrist anatomy & histology diagnostic imaging innervation MeSH
- Check Tag
- Humans MeSH
- Publication type
- Case Reports MeSH
- Review MeSH
An unknown intense signal (Pun ) with a mean chemical shift of 5.3 ppm was observed in 31 P MR spectra from the calf muscles of patients with the diabetic foot syndrome. The aim of the study was to identify the origin of this signal and its potential as a biomarker of muscle injury. Calf muscles of 68 diabetic patients (66.3 ± 8.6 years; body mass index = 28.2 ± 4.3 kg/m2 ) and 12 age-matched healthy controls were examined by (dynamic) 31 P MRS (3 T system, 31 P/1 H coil). Phantoms (glucose-1-phosphate, Pi and PCr) were measured at pH values of 7.05 and 7.51. At rest, Pun signals with intensities higher than 50% of the Pi intensity were observed in 10 of the 68 examined diabetic subjects. We tested two hypothetical origins of the Pun signal: (1) phosphorus from phosphoesters and (2) phosphorus from extra- and intracellular alkaline phosphate pools. 2,3-diphosphoglycerate and glucose-1-phosphate are the only phosphoesters with signals in the chemical shift region close to 5.3 ppm. Both compounds can be excluded: 2,3-diphosphoglycerate due to the missing second signal component at 6.31 ppm; glucose-1-phosphate because its chemical shifts are about 0.2 ppm downfield from the Pi signal (4.9 ppm). If the Pun signal is from phosphate, it represents a pH value of 7.54 ± 0.05. Therefore, it could correspond to signals of Pi in mitochondria. However, patients with critical limb ischemia have rather few mitochondria and so the Pun signal probably originates from interstitia. Our data suggest that the increased Pun signal observed in patients with the diabetic foot syndrome is a biomarker of severe muscular damage.
- MeSH
- Phantoms, Imaging MeSH
- Phosphorus chemistry MeSH
- Ischemia diagnostic imaging MeSH
- Hydrogen-Ion Concentration MeSH
- Extremities diagnostic imaging pathology MeSH
- Humans MeSH
- Magnetic Resonance Spectroscopy * MeSH
- Rest MeSH
- Signal Processing, Computer-Assisted * MeSH
- Aged MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Flexibook
2nd ed. ix, 480 s. : il ; 19 cm
Computer tomography provides valuable information for differentiating some cases of extremity edemas of acute and chronic venostatic origin and lymphedema--primary and secondary, in malignant processes. The paper presents graphic representation of individual kinds of changes and observed densities in 33 patients.
- MeSH
- Extremities diagnostic imaging MeSH
- Humans MeSH
- Lymphedema diagnostic imaging etiology MeSH
- Tomography, X-Ray Computed * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
