Biomedical subjects
Publications and source records attributed to D J Quint.
The myelographic, CT, and MR findings of a rare localized primary bone amyloidoma causing upper thoracic spinal cord compression are presented. Imaging showed a large, calcified mass centered in the posteromedial portion of the left second rib that invaded the second thoracic vertebra and the spinal canal.
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Peripheral blood mononuclear cell proliferative responses and interferon-gamma production to anti-CD3, cat fur extract, betalactoglobulin and ovalbumin were determined at birth in a group of 34 babies born to families where at least one parent was atopic. The development of atopic eczema with positive allergy skin-prick tests to cows' milk and egg at 1 year of age, where the symptoms improved on an egg and milk-free diet, was significantly associated with raised proliferative responses and defective IFN-gamma production to stimulation with betalactoglobulin with a trend for similar responses to ovalbumin. This was not observed in those who did not develop atopic eczema or those with atopic eczema not associated with foods. Responses to cat fur extract were not significantly different between those with and without atopic eczema. This has important implications for the prediction at birth, not only of the probability of being allergic, but also of the specific allergens which will cause problems. The implementation of specific targeted allergen avoidance during the critical period in infancy, therefore, should be more easily applied and should facilitate attempts to prevent disease.
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Thoracic spinal epidural lipomatosis, a rare cause of myelopathy, is most commonly associated with exogenous corticosteroid use. The authors present the clinical, magnetic resonance imaging, computed tomography, and surgical findings for two patients with idiopathic epidural lipomatosis, successfully treated with decompressive laminectomy accompanied by fatty debulking, followed for > 3 postoperative years. They review the literature on idiopathic spinal epidural lipomatosis as well as cases associated with exogenous steroid use.
Local leptomeningeal enhancement adjacent to a dural-based mass, observed in magnetic resonance images, has been called a "dural tail" and was initially considered a sign specific for meningioma. Recent work has shown that the dural tail (or "flare") sign may also be seen in association with other dural-based lesions. The authors present a case of a dural-based mass in the cerebellopontine angle that had a dural tail; at surgery, the mass proved to be a metastatic lesion. The authors stress that the dural tail sign is not specific for meningioma or neoplastic invasion; it sometimes simply reflects reactive changes. Furthermore, it is not even specific for dural-based masses, as it may be seen in association with both intra-axial and extra-axial lesions.
The preoperative diagnosis for an unusual skull base lesion was chordoma. The combination of imaging, pathologic, and surgical findings suggests the diagnosis of Rathke cyst.
Granulocytic sarcoma (chloroma) is a rare solid tumor of myelogenous stem cells, usually appearing in patients with acute myelogenous leukemia and less commonly in patients with chronic myelogenous leukemia or myeloproliferative disorders. We present a spinal epidural granulocytic sarcoma causing thoracic spinal cord compression in a patient with chronic anemia secondary to myelofibrosis.
Synovial cysts are a common complication of osteoarthritis in the lumbar spine, causing pain and neurological symptoms. However with early diagnosis a good clinical result can be expected. This report describes a documented case of hemorrhage into a synovial cyst demonstrated on both MR and CT imaging and summarizes the relevant diagnostic features. The sites of origin of such a synovial hemorrhagic cyst are described and its relationship to an arthritic facet joint is stressed.
Two new cases of alexia without agraphia are presented. Pertinent clinical findings, anatomy, pathophysiology and differential diagnoses are reviewed. The importance of carefully examining the inferior portion of the left side of the splenium of the corpus callosum on CT and/or MR scans in patients who present with this clinical syndrome is stressed.
Quantitative 3-D volumetric comparisons were made of composite CT-MRI macroscopic and microscopic tumor and target volumes to their independently defined constituents. Volumetric comparisons were also made between volumes derived from coronal and axial MRI data sets, and between CT and MRI volumes redefined at a repeat session in comparison to their original definitions. The degree of 3-D dose coverage obtained from use of CT data only or MRI data only in terms of coverage of composite CT-MRI volumes was also analyzed. On average, MRI defined larger volumes as well as a greater share of composite CT-MRI volumes. On average, increases in block margin on the order of 0.5 cm would have ensured coverage of volumes derived from use of both imaging modalities had only MRI data been used. However, the degree of inter-observer variation in volume definition is on the order of the magnitude of differences in volume definition seen between the modalities, and the question of which imaging modality best describes tumor volumes remains unanswered until detailed histologic studies are performed. Given that tumor volumes independently apparent on CT and MRI have equal validity, composite CT-MRI input should be considered for planning to ensure precise dose coverage for conformal treatments.
In routine computed tomography (CT) of scoliotic patients, multiple scans through each intervertebral disk level must be made, which can make interpretation of disks and neural foramina difficult. Use of lateral decubitus positioning for postmyelography CT allows use of gantry angulation to achieve true axial scans through disks, which permits easier evaluation of individual disks and foramina.
Congenital absence of one or both internal carotid arteries (ICAs) has a high association with circle of Willis aneurysm formation. Since the carotid canals in the skull base form secondary to the presence of the embryonic ICA, absence or hypoplasia of a carotid canal on a computed tomographic (CT) scan through the skull base should suggest a congenital ICA abnormality and prompt a search for associated intracranial vascular abnormalities. Of four patients with carotid canal underdevelopment evident at CT, two had associated circle of Willis aneurysms and a third had an extensive skull base rete mirabile supplying an abnormal tangle of vessels in the basal cisterns. Only two patients (one with an aneurysm, one with the skull base rete mirabile) presented with subarachnoid hemorrhage. One patient presented with monocular decreasing vision due to an enlarging aneurysm, and one patient was essentially asymptomatic. If asymmetry or absence of the carotid canals is evident on CT scans of the head, further evaluation to rule out a potentially life-threatening intracranial vascular abnormality such as those found in these patients should be seriously considered, even in a young or asymptomatic patient.
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Explore the source record for details and available documents.