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Biomedical subjects

A Alavi

Publications and source records attributed to A Alavi.

420 records · Page 24Linked to original sources
PubMedDate not supplied

Sentinel lymph node biopsy in the management of breast cancer.

Sentinel node localization is the second most important development in this century after conservative lumpectomy for the treatment of early breast cancer. The sentinel node mapping is a new multidisciplinary approach for staging of axilla in an accurate and less morbid way as compared to axillary node dissection. Sentinel lymph node biopsy in patients with breast cancer has been adopted rapidly into clinical practice. The accuracy of sentinel lymph node biopsy is more than 95%, when performed meticulously (by an experienced multidisciplinary team) with proper patient selection. Sentinel lymph node biopsy is most widely used for both palpable and non-palpable T1 and T2 tumors. Recent studies show application of sentinel lymph node technique in patients with locally advanced breast cancer and after neoadjuvant chemotherapy. Therefore, sentinel lymph node biopsy technique has application in developing countries and other countries where screening for breast cancer is not common and most patients present relatively in advanced stage of the disease. Several aspects of the sentinel lymph node biopsy including technique, case selection, pathologic analysis and accuracy with supportive important studies published in the literature will be discussed in this review.

Breast Neoplasms↗
PubMedDate not supplied

Acute renal allograft rejection: difficulty in diagnosis of histologically mild cases by MR imaging.

To determine the ability of magnetic resonance (MR) imaging to diagnose various degrees of acute allograft rejection (AR), 33 MR examinations in 28 patients were obtained. Surface coils were used in 21 examinations. Seventeen examinations were correlated with biopsy results, which were graded as absent (n = 7), mild (n = 6), or severe (n = 4) AR. Corticomedullary differentiation (CMD) on T1 weighted images was graded as absent/poor versus distinct, and images were also evaluated for visibility of intrarenal vessels. For serial examinations, renal volume was measured and compared. The MR results were correlated with radionuclide interpretations in 22 cases. Diminished CMD was most common with AR (7 of 12) but was also seen with acute tubular necrosis (2 of 6) and cyclosporin toxicity (2 of 3). All four cases of severe AR had diminished CMD. In contrast, only one of six cases of mild AR had diminished CMD (p less than 0.05). Four of five cases of mild AR by radionuclide scan were correctly diagnosed. Visualization of intrarenal vessels was best with surface coils, but this did not contribute to differential diagnosis. Renal volume was increased in rejecting allografts. Magnetic resonance is a promising modality for investigation of renal allografts but is not a sensitive or specific modality for the diagnosis of mild AR.

Graft Rejection↗
PubMedDate not supplied

Management of osteonecrosis in sickle-cell anemia and its genetic variants.

Osteonecrosis secondary to sickling disorders differs from most other forms of osteonecrosis, because vaso-occlusive episodes generally involve many other organs. For this reason optimum management and care of these patients requires a team approach. The spectrum of clinical symptoms and bone involvement varies widely from one patient to another, even among patients with the same abnormal hemoglobin patterns. Although the efficacy of conservative therapeutic measures has not been definitely established, these may be all that can be offered because of the patient's other problems. Before contemplating surgery, the surgical and anesthetic risks should be evaluated and measures taken to prevent complications. The varus osteotomy, Chiari pelvic osteotomy, prosthetic or total hip replacement, and the Neer shoulder prosthesis may benefit a limited number of carefully selected patients.

Adolescent↗
PubMedDate not supplied

Detection of synovial pseudarthrosis by 99mTc scintigraphy: application to treatment of traumatic nonunion with constant direct current.

A prospective study utilizing technetium scintigraphy to evaluate nonunion patients prior to the electrical stimulation of osteogenesis is reported. Roentgenographic evaluation and scintigraphy must include four views (anteroposterior, lateral and both obliques). Although all nonunion technetium scans showed increased uptake of the radionuclide at the fracture site, three bone scan patterns were identified: (1) intense, uniformly increased uptake at the nonunion site (69.5%); (2) photon deficient (cold) cleft between two intense areas of uptake (23.4%); and (3) indeterminate pattern (7.1%). The presence of a cold cleft between two intense areas of uptake on scintigraphy correlated closely with the presence of a synovial pseudarthrosis at surgery. Nonunions of the humerus were most frequently associated with synovial pseudarthrosis (57.1%). The presence of a synovial pseudarthrosis as suggested by technetium scintigraphy mandates open excision of the lining membrane at the time of electrode insertion.

Diphosphonates↗