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Biomedical subjects

D Ling

Publications and source records attributed to D Ling.

At least 19 recordsLinked to original sources

Oral cancer progression and c-erbB-2/neu proto-oncogene expression.

Monoclonal antibody PAb3 to c-erbB-2/neu protein was utilized in the immunoperoxidase staining of 86 human specimens from oral mucosa. These tissue specimens represented a spectrum from 7 normal to 9 simple hyperplasia, 15 mild dysplasia, 14 moderate dysplasia, 20 severe dysplasia and 21 squamous cell carcinoma. Our study indicated that as the cells acquire a more malignant phenotype, there was a progressive increase in neu expression. It also suggested that neu may be involved in the development of oral cancers and that its evaluation in the early stages may assist in the diagnosis and management of oral cancers.

Carcinoma, Squamous Cell

Perceptual-oral training of two hearing-impaired children in the recognition and production of /s/ and /z/.

Two hearing-impaired children were tested and trained in the utilization of an artificial acoustic cue that signalled the presence of /s/ and /z/ in verbal stimuli. These sounds, chosen because they are among the most important morphemes in English, were both perceived and produced significantly better by the subjects following only seven training sessions when the cue, automatically signalled by a specially designed laboratory device, was presented at a 20 dB sensation level in a frequency range immediately above the subjects' upper limits of hearing for amplified speech. The implications of the study are briefly discussed in relation to testing and training procedures involving sensory aids.

Auditory Threshold

Clinical stage B prostate carcinoma: staging with MR imaging.

Magnetic resonance (MR) imaging studies were performed in 29 patients with clinical findings of stage B prostatic carcinoma with use of both T1 and T2-weighted spin echo sequences. MR imaging findings were correlated with surgical/pathologic results in 18 patients who underwent an operation. Periprostatic fat, periprostatic venous plexus, seminal vesicles, and lymph nodes were assessed from MR imaging studies. When each was assessed independently, the periprostatic fat signal had a sensitivity of 29%, specificity of 100%, and accuracy of 85% in detecting extracapsular tumor extension, whereas the periprostatic venous plexus had a sensitivity of 57%, specificity of 86%, and accuracy of 80%. MR imaging had a sensitivity of 50%, specificity of 97%, and accuracy of 89% for detecting seminal vesicular involvement. When all four anatomic features were taken into consideration, MR imaging had an accuracy of 89% (16 of 18 patients) in differentiating stage B from stage C or D disease (sensitivity 87%, specificity 90%). Our data indicate that MR imaging is a promising method for staging prostatic carcinoma.

Adipose Tissue

MR imaging of the scrotum with a high-resolution surface coil.

Magnetic resonance (MR) imaging of the scrotum with a high-resolution surface coil was performed in ten healthy volunteers and 20 patients with scrotal abnormalities demonstrated by high-resolution real-time ultrasound (US). Four patients had an abnormal testis (two tumors, one cyst, one testicular atrophy), and 16 patients had extratesticular abnormalities (four hydroceles, five epididymal cysts, one hernia, and six cases of epididymitis). The normal structures of the scrotum were depicted clearly on MR images. In all cases, the tunica albuginea was easily differentiated from the testis and epididymis. MR imaging enabled one to distinguish intratesticular from extratesticular lesions and to determine whether a lesion was solid or cystic. Complicated and simple fluid collections could also be differentiated. In general, MR imaging and US scanning provided similar information. A potential advantage of MR imaging is in the evaluation of patients with painful scrotal lesions that may limit US evaluation.

Adult

Primary bladder carcinoma: evaluation with MR imaging.

Magnetic resonance (MR) imaging was performed in 23 patients (25 tumors) with proved bladder neoplasms. MR studies were retrospectively evaluated and compared with computed tomographic (CT) and pathologic findings. Bladder neoplasms, having a signal intensity intermediate between those of urine and perivesical fat, were best seen on T1-weighted and proton-density images. MR imaging was as accurate as technically well-performed CT studies in detecting extravesical tumor extension. MR could additionally be used to assess the integrity of the bladder wall. On T2-weighted images the normal bladder wall appeared as a thin, linear, low-intensity structure. The disruption of this low-intensity line was indicative of deep muscle invasion, whereas preservation of this low intensity line implied a more localized lesion. Although chemical shift artifacts might cause apparent disruption of the bladder wall, knowledge of this artifact coupled with additional imaging along different planes helps avoid misinterpretation of this artifact as deep muscle invasion.

Carcinoma, Transitional Cell

Adrenal gland: MR imaging.

The authors investigated the utility of magnetic resonance (MR) imaging in identifying the normal adrenal gland in 100 patients as well as in distinguishing adrenal adenomas (n = 12) from malignant neoplasms (n = 14). The left adrenal gland was seen in 99 of 100 cases and the right in 91 of 100 cases. The adrenals were most easily seen with T1-weighted spin-echo pulse sequences. The ratio of the intensity of the adrenal mass to that of fat at 2,100/90 (repetition time msec/echo time msec) was most helpful in distinguishing adrenal adenomas from malignant neoplasms. In contrast to other studies, the adrenal mass/liver intensity ratios were not helpful. All ten lesions with adrenal mass/fat ratios at 2,100/90 of 0.8 or greater were malignant, whereas all eight adrenal masses with a ratio less than 0.6 were adrenal adenomas. However, eight (31%) of the masses (four adenomas and four malignant neoplasms) had ratios between 0.6 and 0.8. Although MR imaging has considerable potential in characterizing adrenal masses, larger studies are needed to determine its true sensitivity and specificity.

Adenoma

Diagnosis and staging of renal cell carcinoma: a comparison of MR imaging and CT.

MR studies were performed in 36 patients with proven renal cell carcinoma. In 27 patients in whom a radical nephrectomy was performed, MR studies were reviewed and compared with CT and pathologic findings. Renal cell carcinomas had a varied MR signal with the most common appearance being a mass with an intensity intermediate between the renal cortex and the medulla on T1-weighted images and hyperintense on T2-weighted images. MR was similar to CT in staging renal cell carcinomas (74% for MR vs 67% for CT). Neither CT nor MR was reliable in differentiating stage I from stage II lesions. MR clearly showed venous invasion without the use of IV contrast medium and was superior to CT in differentiating lymphadenopathy from small vascular structures. Because of the limited availability, longer imaging time, and more stringent patient requirements (patients with pacemakers, intracranial aneurysm clips, life-supporting systems, and severe claustrophobia need to be excluded), the authors recommend MR only for patients with known contraindications to iodinated contrast medium, patients with prior suboptimal bolus-contrast CT studies, or patients in whom the CT findings are equivocal.

Adult

[Staging of prostatic carcinoma. Accuracy of magnetic resonance].

Twenty-nine prostatic cancer patients were evaluated for staging purpose by Magnetic Resonance (MR). MR findings were correlated with the pathologic examination in 18/29 patients who underwent radical prostatectomy. Four MR staging parameters were evaluated individually: periprostatic fat; periprostatic venous plexus; seminal vesicles and pelvic adenopathy. MR correctly staged 16/18 patients, with one case of overstaging and one case of understaging. The diagnostic accuracy of MR in differentiating intracapsular stage B from extracapsular stage C was 87%, with a sensitivity of 90% and a specificity of 87%. MR and CT results agreed in 4 of the 7 operated patients who were examined with both techniques; in 3 cases there was disagreement, and MR was correct.

Aged

High resolution sonography in diagnosing testicular neoplasms: clinical significance of false positive scans.

We describe the use of high resolution real-time ultrasound to evaluate scrotal masses. From August 1980 to September 1984, 249 patients underwent scrotal ultrasound using high resolution real-time scanners with 10 mHz. transducers to evaluate scrotal abnormalities. The ultrasound diagnosis was consistent with a testicular neoplasm in 20 patients. Pathological and surgical confirmation was available in all 20 patients. Only 10 of 20 patients had malignant tumors, whereas 10 had benign lesions (false positive rate of 50 per cent). Testicular lesions producing false positive studies were principally hypoechoic in 8 patients and hyperechoic in 2. Testicular neoplasms characteristically were hypoechoic with or without focal hyperechoic areas. There was 1 false negative ultrasound study. Our results suggest that radical orchiectomy should not be performed indiscriminately in all patients with testicular lesions that are sonographically suspicious for neoplasm. In selected cases with hyperechoic sonographic features associated frequently with benign testis lesions open testicular biopsy and a testis-sparing operation may be indicated.

Dysgerminoma

Percutaneous drainage of prostatic abscesses.

Percutaneous catheter drainage of intra-abdominal abscesses currently is a well established technique. We report on 2 anuric patients on maintenance hemodialysis who presented with a prostatic abscess. We elected to use a transperineal, percutaneous drainage technique. Adequate drainage was documented by pelvic computerized tomography scans and followup confirmed satisfactory long-term results.

Abscess

Urography with a low osmolality contrast agent. Comparison of Hexabrix with Conray 325.

A double-blind, parallel group comparison study of Hexabrix and Conray 325 for adult intravenous urography was performed. Sixty patients with a mean age of 54 years were included. Doses of contrast ranged from 0.5-1.1 ml/kg for both groups with a mean of 0.7 ml/kg. Hematology, urinary and biochemical laboratory tests were performed prior to the study in all patients and at 24 hours afterward in nearly half the group. Biochemical laboratory tests were done at 72 to 96 hours in approximately one third of the patients. Hexabrix proved satisfactory for standard urography at a chosen dose of 16 g of iodine (50 ml). There were no statistically significant differences in the diagnostic quality of the urogram in the two groups except for bladder filling. The decreased osmotic diuresis associated with Hexabrix necessitated delayed bladder filming for optimal evaluation. Excellent patient tolerance was achieved with less pain on injection with Hexabrix. There was one death in the Hexabrix group in a patient with multiple medical problems. Although the patient's medical problems appeared well controlled and did not meet specific rejection criteria, they almost certainly played a role in his death. Hexabrix may be useful for adult urography at a lower dose range, eg, 16 g iodine, than is typically used, which also may be cost effective (competitive) given the higher projected cost of the new low osmolar agents.

Adolescent

Prostatic carcinoma and benign prostatic hyperplasia: inability of MR imaging to distinguish between the two diseases.

Forty patients with prostatic carcinoma or benign prostatic hyperplasia (BPH) underwent magnetic resonance (MR) imaging of the prostate. In vitro MR images of six prostate specimens were also obtained. The prostatic parenchyma was best evaluated by a T2-weighted spin-echo pulse sequence. The prostate both in patients with prostatic carcinoma and patients with BPH often had an inhomogeneous and nodular appearance on T2-weighted images. While most of the prostatic carcinomas appeared hyperintense relative to muscle and adjacent prostatic parenchyma, some of the hyperplastic nodules had a signal intensity similar to carcinoma. With current imaging techniques, MR imaging cannot differentiate prostatic carcinoma from BPH with certainty.

Adult

Uterine neoplasms: MR imaging.

Magnetic resonance (MR) studies were performed on 20 healthy volunteers and 41 patients with proved cervical and uterine neoplasms. MR imaging demonstrated normal uterine landmarks in all patients. On T2-weighted images, the normal uterine wall could be differentiated into three distinct layers: a central high-intensity zone, a junctional low-intensity band, and a peripheral medium-intensity area. While most of the normal cervices had only two distinct zones (central high-intensity zone and peripheral low-intensity zone), a small percentage had three layers of signal intensity, similar to the uterine body. Primary cervical and uterine neoplasms could be identified on MR images. In 18 of 22 patients with proved carcinoma, a mass with a signal intensity higher than that of normal cervical lips was seen on T2-weighted images. Endometrial carcinoma was most often identified as expansion of the central high-intensity area; discrete tumor nodules were visible in nine of 15 patients. Mixed müllerian sarcoma appeared as a large pelvic mass with complete obliteration of normal uterine landmarks. MR imaging delineates primary cervical and endometrial carcinoma better than computed tomography does.

Adenocarcinoma

Acute renal rejection versus acute tubular necrosis in a canine model: MR evaluation.

Findings of magnetic resonance (MR) imaging in acute renal rejection and acute tubular necrosis (ATN) were studied in dogs. On T1-weighted images, corticomedullary differentiation was absent in kidneys undergoing acute rejection. The loss of corticomedullary differentiation in these kidneys was secondary to a decrease in the relative signal intensity of the cortex, indicating prolongation of the T1 relaxation time of the cortex. In contrast, corticomedullary differentiation was preserved on T1-weighted images of autotransplanted kidneys and kidneys with ATN. MR imaging findings correlated with changes in water content in these three groups of kidneys. Kidneys undergoing acute rejection showed a marked increase in water content compared with kidneys in the other two groups. No change in fat content was found in any group.

Acute Kidney Injury

MRI of extracranial hematomas: preliminary observations.

Thirteen patients (16 examinations) with extracranial hematomas (four mediastinum, three pelvis, two calf, two psoas muscle, one liver, one abdominal wall) were examined with magnetic resonance imaging (MRI). With the exception of an acute hematoma (less than 48 hr), which did not have a distinctive MRI appearance, subacute and chronic hematomas (up to 10 months' duration) had areas of high signal intensity on both T1- (TR 500/TE 30) and T2- (TR 1500/TE 90) weighted pulse sequences. The hematomas in 10 of the patients were also evaluated by computed tomography (CT). The MRI findings complemented those seen on CT. Low-intensity parts of the hematoma on both T1- and T2-weighted images corresponded to areas of high attenuation on CT, whereas high-intensity zones correlated with regions of low attenuation. This observation was more apparent on the T1-weighted images. While older hematomas did not exhibit areas of hyperdensity that would allow a specific diagnosis on CT, MRI did demonstrate regions of high signal intensity indicative of hemorrhage.

Abdominal Muscles

Isolation and structure determination of crisamicin A, a new antibiotic from Micromonospora purpureochromogenes subsp. halotolerans.

A new antibiotic, crisamicin A, with in vitro activity against Gram-positive bacteria, B16 murine melanoma cells, and herpes simplex, vaccinia, and vesicular stomatitis viruses, has been isolated from Micromonospora purpureochromogenes subsp. halotolerans. On the basis of 1H and 13C NMR spectroscopic, high resolution field desorption mass spectrometric, and circular dichroism studies of the antibiotic and several of its derivatives, the structure of crisamicin A has been assigned.

Anti-Bacterial Agents

Hepatic metastases studied with MR and CT.

Examinations of the liver using magnetic resonance (MR) and computed tomography (CT) were performed on 50 patients with hepatic metastases. MR and CT were comparable in their ability to detect metastases, which generally appeared hypointense compared with normal liver parenchyma on T1-weighted MR images and hyperintense on T2-weighted images. The MR imaging techniques that were most reliable in detecting metastases were inversion recovery and a relatively T2-weighted, spin-echo technique (TR = 1,500 msec, TE = 60 msec). We conclude that CT, because of its shorter imaging time, greater spatial resolution, and lower cost, should remain the preferred screening test for hepatic metastases. MR imaging should be reserved for patients with equivocal CT findings and for patients in whom there is persistent clinical suspicion of hepatic metastases despite a negative CT examination.

Adult