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Biomedical subjects

Andrew Grainger

Publications and source records attributed to Andrew Grainger.

5 recordsLinked to original sources
PubMed2005

Subacute posteromedial impingement of the ankle in athletes: MR imaging evaluation and ultrasound guided therapy.

OBJECTIVE: To describe the use of MR imaging and efficacy of ultrasound-guided steroid injection in the diagnosis and management of athletes with clinical posteromedial impingement of the ankle. DESIGN AND PATIENTS: A retrospective analysis of imaging findings on MR was undertaken in nine elite athletes with clinical posteromedial ankle impingement. MR studies from six professional athletes with posterolateral pain were also reviewed as an imaging control group. The two reviewing radiologists were blinded to the clinical details and the proportion of control and study subjects. The nine study athletes also underwent diagnostic ultrasound and ultrasound-guided injection of steroid and anaesthetic into the posteromedial capsular abnormality. Follow-up was by telephone interview. RESULTS: Posteromedial capsular thickening was seen only in athletes with posteromedial impingement (7/9). Posteromedial synovitis was present in all athletes with posteromedial impingement; however, posterior and posterolateral synovitis was also seen in these athletes. Mild posteromedial synovitis was present in two control athletes. Ultrasound identified abnormal posteromedial soft tissue thickening deep to tibialis posterior between the medial malleolus and talus in all nine athletes. After injection all athletes returned to their previous level of sport, with eight of the nine not experiencing any residual or recurrent symptoms. CONCLUSION: If MR imaging excludes significant coexistent abnormality, ultrasound can localise posteromedial soft tissue abnormality and guide injection therapy, allowing return to athletic activity without surgical intervention.

Adult↗
PubMed2004

Combination immunotherapy of B-cell non-Hodgkin's lymphoma with rituximab and interleukin-2: a preclinical and phase I study.

PURPOSE: Cytokine-induced modulation of innate immunity is being explored to enhance the activity of monoclonal antibodies. Severe combined immunodeficient (SCID) mice engrafted with peripheral blood leukocytes (PBLs) from Epstein Barr virus-seropositive donors develop human B-cell non-Hodgkin's lymphomas [B-NHLs (hu-PBL-SCID mouse model)]. We used this hu-PBL-SCID mouse model to study the synergism between interleukin (IL)-2 and rituximab. We also conducted a phase I trial of IL-2 and rituximab in relapsed B-NHL to study whether expansion of natural killer (NK) cells and enhanced cellular cytotoxicity could be safely accomplished in vivo. EXPERIMENTAL DESIGN: Hu-PBL-SCID mice were treated with various schedules of rituximab and IL-2, with survival as the end point. Patients with relapsed B-NHL received rituximab (375 mg/m2 weekly x 4) followed by daily low-dose IL-2 (1 MIU/m2/day x 4 weeks) with pulses of intermediate-dose IL-2 (3-15 MIU/m2). Toxicity, NK cell numbers, and cellular cytotoxicity were measured. RESULTS: In the hu-PBL-SCID mouse, the combination of rituximab and IL-2 showed greater activity against B-NHL than either agent alone. Treatment was most effective when IL-2 was given before rituximab. Twelve patients with heavily pretreated B-NHL entered the phase I trial. Toxicity was manageable, and responses were observed. NK cell expansion and enhanced cellular cytotoxicity against a B-cell lymphoma target were observed but did not correlate with response. CONCLUSIONS: The combination of IL-2 and rituximab is synergistic against B-NHL in the hu-PBL-SCID model. In the phase I trial, a sequential combination of rituximab and IL-2 was well tolerated and achieved biological end points. Responses were observed.

Adult↗
PubMed2003

Modified Larsen scoring of digitized radiographs in rheumatoid arthritis.

OBJECTIVE: To facilitate storage, retrieval, and analysis of radiographic images we assessed the validity of a film digitizer and computer based system. METHODS: A total of 101 sets of radiographs of hands and feet from patients with early rheumatoid arthritis were digitized according to standards defined by the American College of Radiology. Two blinded observers applied the modified Larsen score to the digitized images and the original radiographs. RESULTS: There was good concordance between the scoring of digitized images and radiographic films; intraclass correlation coefficient was 0.89. Regression analysis of a Bland-Altman plot revealed that there was no significant systematic bias. It was noted that scoring the digital images took more than twice as long as scoring the radiographic films. CONCLUSION: Our results indicate that modified Larsen scoring of adequately digitized films on standard computer displays is valid and shows good agreement with conventional techniques. Scoring digitized images appears to require more time, but this may be outweighed by the considerable advantages of computer storage and retrieval of radiographic images.

Arthritis, Rheumatoid↗