Ms. Cornelia De Riese Profile

Cornelia De Riese

at Texas Tech Univ

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Publications (4)

Proceedings Article | 22 February 2006 Paper

Osteoporosis: Are we measuring what we intend to measure? In search of the ideal bone strength study

Cornelia de Riese

Proceedings Volume 6078, 607825 (2006) https://doi.org/10.1117/12.646941

KEYWORDS: Bone, Dual energy x-ray absorptiometry, Magnetic resonance imaging, Minerals, X-rays, Ultrasonography, Diagnostics, Signal attenuation, Spine, Tissues

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In 1991 the World Health Organization (WHO) defined osteoporosis as a "loss of bone mass and micro architectural deterioration of the skeleton leading to increased risk of fracture."^1,2 Since microarchitecture can not be measured directly, a panel of the WHO recommended that the diagnosis be made according to a quantifiable surrogate marker, calcium mineral, in bone. Subsequently in 1994, the definition focused on the actual bone "density," giving densitometric technology a central place in establishing the diagnosis of osteoporosis.^3,4 But soon it became obvious that there was only limited correlation between bone mineral density (BMD) and actual occurrence of fractures and that decreases in bone mass account for only about 50% of the deterioration of bone strength with aging. In other words only about 60% of bone strength is related to BMD.⁵ Recent developments in bone research have shown that bone mineral density in itself is not sufficient to accurately predict fracture risk. Bone is composed of inorganic calcium apatite crystals that mineralize an organic type I collagen matrix. The degree of mineralization, the properties of the collagen matrix, crystal size, trabecular orientation, special distribution of the different components and many more factors are all impacting bone strength.^6-14 Human cadaver studies have confirmed the correlation between bone density and bone.²⁶ strength.^5,15-20 Changes in cancellous bone morphology appear to lead to a disproportionate decrease in bone strength.^21-26 When postmenopausal women are stratified by age, obvious differences between BMD and actual fracture risk are observed.²⁴ Felsenberg eloquently summarizes what he calls the "Bone Quality Framework." In great detail he talks about the geometry and micro- architecture of bone and how the different components are related to functional stability.²⁷ Are our current testing modalities appropriately addressing these structural factors? Are we keeping in mind that in screening for osteoporosis the key variable is fragility, not bone density itself? All currently FDA approved and commercially available equipments for the evaluation of bone status claim that they - at least indirectly - assess the biological fracture risk. This review summarizes an extensive current literature research covering FDA approved as well as experimental devices for the evaluation of bone. The pros and cons of the different techniques are discussed in the context of diagnostic accuracies and practical implications.

Proceedings Article | 25 April 2005 Paper

Cellulite treatment: evidence and ethics, brief history, and emphasis on current practices including liposuction

Cornelia de Riese

Proceedings Volume 5686, (2005) https://doi.org/10.1117/12.596505

KEYWORDS: Tissues, Surgery, Connective tissue, Skin, Ultrasonography, Magnetic resonance imaging, Blood, Associative arrays, Dual energy x-ray absorptiometry, Internet

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Proceedings Article | 13 July 2004 Paper

Laser treatment in gynecology

Cornelia de Riese

Proceedings Volume 5312, (2004) https://doi.org/10.1117/12.531631

KEYWORDS: Carbon dioxide lasers, Laser therapeutics, Laser ablation, Surgery, Nd:YAG lasers, Laparoscopy, Semiconductor lasers, Argon ion lasers, Vagina, Laser vision correction

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Proceedings Article | 12 September 2003 Paper

Female stress urinary incontinence: standard techniques revisited and critical evaluation of innovative techniques

Cornelia de Riese, Werner de Riese

Proceedings Volume 4949, (2003) https://doi.org/10.1117/12.504634

KEYWORDS: Bromine, Collagen, Surgery, Gold, Bladder, Medicine, Bone, Laparoscopy, Diagnostics and therapeutics, Laser therapeutics

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Objectives: The treatment of female urinary incontinence (UI) is a growing health care concern in our aging society. Publications of recent innovations and modifications are creating expectations. This brief review provides some insight and structure regarding indications and expected outcomes for the different approaches. Materials: Data extraction is part of a Medline data base search, which was performed for "female stress incontinence" from 1960 until 2000. Additional literature search was performed to cover 2001 and 2002. Outcome data were extracted. Results: (1) INJECTION OF BULKING AGENTS (collagen, synthetic agents): The indication for mucosal coaptation was more clearly defined and in the majority of articles limited to ISD. (2) OPEN COLPOSUSPENSION (Burch, MMK): Best long-term results of all operative procedures, to date considered the gold standard. (3) LAPAROSCOPIC COLPOSUSPENSION (different modifications): Long-term success rates appear dependent on operator skills. There are few long-term data. (4) NEEDLE SUSPENSION: (Stamey, Pareyra and modifications): Initial results were equal to Burch with less morbidity, but long-term success rates are worse. (5) SLING PROCEDURES (autologous, synthetic, allogenic graft materials, different modes of support and anchoring, free tapes): The suburethral sling has traditionally been considered a procedure for those in whom suspension had failed and for those with severe ISD. The most current trend shows its use as a primary procedure for SUI. Long-term data beyond 5 years are insufficient. (6) EXTERNAL OCCLUSIVE DEVICES (vaginal sponges and pessaries, urethral insert): Both vaginal and urethral insert devices can be effective in selected patients. (7) IMPLANTABLE ARTEFICIAL URETHRAL SPHINCTERS: Modifications and improvements of the devices resulted in improved clinical results regarding durability and efficacy. CONCLUSION: (1) The Burch colposuspension is still considered the gold standard in the treatment of female genuine SUI. There is a trend for the suburethral sling to be used as the primary procedure for this indication. Early outcome data are encouraging. New concepts such as use of metalic bone anchors and allograft material as well as the Tension free Vaginal Tape are under investigation. (2) Standardization of diagnostic and therapeutic interventions is prerequisite for any meaningful research. Randomized controlled prospective studies are essential to provide objectives regarding risks and benefits of new procedures and materials.

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