Fibrin sheaths in central venous port catheters: treatment with low-dose, single injection of urokinase on an outpatient basis

De-Hua Chang,1 Kamal Mammadov,1 Tilman Hickethier,1 Jan Borggrefe,1 Martin Hellmich,2 David Maintz,1 Christoph Kabbasch1 1Department of Diagnostic and Interventional Radiology, University Hospital of Cologne, NRW, Germany; 2Institute of Medical Statistics, Informatics and Epidemiology, University Hospital of Cologne, NRW, Germany Purpose: Evaluation of the efficacy of single-shot, low-dose urokinase administration for the treatment of port catheter-associated fibrin sheaths. Methods: Forty-six patients were retrospectively evaluated for 54 episodes of port catheter dysfunction. The presence of a fibrin sheath was detected by angiographic contrast examinations. On an outpatient basis, patients subsequently received thrombolysis consisting of a single injection of urokinase (15.000 IU in 1.5 mL normal saline) through the port system. A second attempt was made in cases of treatment failure. Patients were followed up for technical success, complications and long-term outcome. Results: Port dysfunction occurred at a median of 117 days after implantation (range: 7–825 days). The technical success after first port dysfunction by thrombolysis was 87% (40/46); thereof, initial thrombolysis was effective in 78% (36/46). Nine patients (20%) received a second dose of urokinase after previous treatment failure. Follow-up was available for 26 of 40 patients after successful thrombolysis. In 8 of these, rethrombosis occurred after a median of 98 days (range: 21–354 days), whereby rethrombolysis was effective in 5 of 7 (63%) patients. The overall success of all thrombolyses performed was 70% (45/64). No procedure-related technical or clinical complications occurred. After first favorable thrombolysis, a Kaplan–Meier analysis yielded a 30-, 90- and 180-day probability of patency of 96%, 87% and 81%. Conclusion: Thrombolytic therapy on an outpatient basis appears to be a safe and efficient. Three-month patency rates are comparable to more invasive treatment options, including catheter exchange over a guide wire and percutaneous fibrin sheath stripping. Keywords: central venous port catheter, thrombolysis, urokinase, angiography, port dysfunction, catheter occlusio

Fashion show films

Due to technological developments, fashion show films provide fashion brands the opportunity to communicate their brand concepts, to attract attention and to gain more brand awareness by publishing them in the Internet. The purpose of this research paper is to investigate how fashion brands communicate their brand concept and personality through fashion show films. For this purpose, ten fashion show films of brands from the categories luxury, premium, high-street and active wear are investigated. The results indicate that the investigated brands use different ways to attract attention and to communicate their brand concept and personality. The design of the setting, the presentation of the collection as well as the visualization of the brand concept through the brand name, logo, colors or symbols and camera work play an important role to create an effective and exciting fashion show film in order to communicate the brand concept and to promote their brand image. Mostly luxury and premium brands use fashion show films for branding. For high-street and active wear brands the analysis indicates less importance of fashion show films. The limitations of this research are related to the fact that the restricted number of ten fashion show films is analyzed. This gives an overview but cannot provide a comprehensive breakdown of this topic

Whole-body computed tomography in trauma patients: optimization of the patient scanning position significantly shortens examination time while maintaining diagnostic image quality

Tilman Hickethier,1,* Kamal Mammadov,1,* Bettina Baeßler,1 Thorsten Lichtenstein,1 Jochen Hinkelbein,2 Lucy Smith,3 Patrick Sven Plum,4 Seung-Hun Chon,4 David Maintz,1 De-Hua Chang1 1Department of Radiology, University Hospital of Cologne, Cologne, Germany; 2Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany; 3Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Canada; 4Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany *These authors contributed equally to this work Background: The study was conducted to compare examination time and artifact vulnerability of whole-body computed tomographies (wbCTs) for trauma patients using conventional or optimized patient positioning. Patients and methods: Examination time was measured in 100 patients scanned with conventional protocol (Group A: arms positioned alongside the body for head and neck imaging and over the head for trunk imaging) and 100 patients scanned with optimized protocol (Group B: arms flexed on a chest pillow without repositioning). Additionally, influence of two different scanning protocols on image quality in the most relevant body regions was assessed by two blinded readers. Results: Total wbCT duration was about 35% or 3:46 min shorter in B than in A. Artifacts in aorta (27 vs 6%), liver (40 vs 8%) and spleen (27 vs 5%) occurred significantly more often in B than in A. No incident of non-diagnostic image quality was reported, and no significant differences for lungs and spine were found. Conclusion: An optimized wbCT positioning protocol for trauma patients allows a significant reduction of examination time while still maintaining diagnostic image quality. Keywords: CT scan, polytrauma, acute care, time requirement, positionin