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Biomedical subjects

E Steiner

Publications and source records attributed to E Steiner.

At least 127 records · Page 7Linked to original sources
PubMed1989

Clinical use of a nonferromagnetic needle for magnetic resonance-guided biopsy.

Five patients who had liver lesions detected by magnetic resonance (MR) and/or computed tomography (CT) were biopsied using MR guidance with a specially designed nonferromagnetic needle. The 20-gauge needle was constructed from Type 316 stainless steel in order to maximize needle visibility and minimize needle-tip artifact. In all cases adequate tissue was obtained for diagnosis and no side effects were observed during the biopsy or on clinical follow-up despite the fact that the needle was within the patient in MR for an average of 30 min.

Biopsy, Needle↗
PubMed1989

Digital videofluorography for direct digital spot filming of gastrointestinal studies.

Digital videofluorography (DVF) refers to a new computer-aided televised fluoroscopy technique that uses short (10-20 ms) intense pulses of radiation to produce a motion-free latent image, which is then transferred into digital storage. Because gastrointestinal imaging has lagged behind other body systems in the evaluation of digital acquisition, we investigated the potential utility of this technique for direct digital fluoroscopic spot filming of gastrointestinal examinations. In order to assess the level of clinical image quality achieved by this technique, we conducted an observer performance comparison study of digitally acquired and conventional analog 100 mm spot films. Sequentially acquired spot films and digital radiographs of 111 anatomic regions in 60 patients undergoing routine barium and cholangiographic examinations were compared. Evaluation was made of on-line interactive performance as well as side-by-side analysis of digital and analog hard copy images. Parameters evaluated include detection of normal and pathologic features, image contrast, image resolution, and image sharpness. Direct digital and analog spot films were of comparable diagnostic quality in all parameters studied. Added benefits of the digital mode included postprocessing to enhance detail in regions of low contrast and accommodation of a large field of view (14 inch) image intensifier format.

Bile Duct Diseases↗
PubMed1989

[The intraperitoneal installation of gamma interferon for the treatment of refractory ovarian carcinoma].

Patients with refractory ovarian cancer were treated intra-peritoneally with interferon-gamma. The maximum tolerated dose was achieved at 2 mg/m2. The substance was administered 3 times per week every second week. Interferon-gamma treatment activated locally the macrophages and induced a rise in neopterin urine, serum, and ascites levels. The tumor marker CA-125 showed marked fluctuations of more than 100% during interferon treatment and this was not correlated with neopterin. A flu-like syndrome and especially fatigue were the dose limiting side effects. Two of 3 evaluable patients died on tumor progression whereas one is now 18 months clinically free of disease.

Aged↗
PubMed1989

[Standardized sonographic measurement of the width of the extrahepatic bile ducts].

As there are no exact data available which part of the bile duct should be measured, the hepatoduodenal ligament was examined in 20 cadavers. The constant anatomic relationship between the right hepatic artery and the common hepatic duct is shown. A right hepatic artery properly originating from the hepatic artery passes to 85% dorsally and to 15% ventrally of the common hepatic duct, but remains ventrally to the portal vein. If the right hepatic artery is shown dorsal to the portal vein (20%), an accessory right hepatic artery should be suggested. To maintain uniformity of measurement, the size of the common hepatic duct should be recorded immediately caudal to the right hepatic artery.

Arteries↗
PubMed1989

[Gd-DTPA in the MR diagnosis of pituitary adenomas].

25 patients with surgically (n = 14) and/or biochemically (n = 20) confirmed pituitary adenomas were examined on a 1.5 T superconducting MR system by means of multislice spin-echo technique, 3 mm thick sections and a 256 x 256 matrix. T1-weighted sagittal and coronal sections were obtained before and after administration of Gd-DTPA (0.1 mmol./kg. BW). 13 microadenomas and 12 macroadenomas were found. In unenhanced T1-weighted images 48% of the adenomas were isointense, 48% were hypointense and 4% were hyperintense. 58% of the adenomas enhanced to a lesser degree, 15% enhanced to a higher degree than the normal pituitary gland. 12% showed equal enhancement and 15% showed hypointense and hyperintense areas simultaneously. In 3 patients (12%) there was evidence of adenoma only in the enhanced images. The delineation of the adenoma from the cavernous sinus was possible in 95% of the enhanced, but only in 25% of the native scans.

Adenoma↗
PubMed1989

Gd-DTPA enhanced high resolution MR imaging of pituitary adenomas.

Thirty-eight patients with surgically or biochemically confirmed pituitary adenomas were examined on a 1.5 T MRI system by means of spin echo technique with 3 mm slice thickness. T1 weighted sagittal and coronal sections were obtained before and after the administration of Gd-DTPA. Compared with the normal pituitary anterior lobe, 8% of the adenomas were hyperintense, 45% were isointense, 42% were hypointense and 5% were inhomogeneously intense. After Gd-DTPA administration, 13% enhanced to a greater degree, 10% to the same, and 57% to a lesser degree than the normal pituitary tissue. Twenty percent showed inhomogeneous enhancement. In 10%, there was evidence of adenoma only in the enhanced images. The delineation of the adenoma from the cavernous sinus was improved from 47% in unenhanced scans to 91% after Gd-DTPA administration.

Adenoma↗
PubMed1989

Imaging of pancreatic neoplasms: comparison of MR and CT.

Thirty-two patients with pathologically proved pancreatic carcinomas or cystadenomas were evaluated with MR images obtained with T1-weighted spin echo (short TR/short TE), inversion recovery, and T2-weighted spin-echo (long TR/long TE) pulse sequences. CT was used as the reference standard to determine the ability of MR to delineate normal and abnormal pancreatic anatomy and thereby to exclude or detect pancreatic malignancy. Short TR/short TE spin-echo sequences were significantly better (p less than .05) than inversion recovery or T2-weighted spin-echo sequences in resolution of both normal and abnormal anatomy. Resolution of pancreatic anatomy correlated (r = .9) with the image signal-to-noise ratio. In seven (22%) of 32 cases, MR visualized pancreatic tumors better than CT did because it showed a signal intensity difference between the tumor and normal pancreatic tissue. Overall, the slight superiority of MR over CT for tumor visualization tended to occur in larger tumors and was not statistically significant. On T1-weighted images, 63% (20 of 32) of pancreatic tumors studied had lower signal intensities than normal pancreatic tissue, whereas on T2-weighted sequences (TE = 60, 120, and 180 msec) only 41% (13 of 32) of tumors had increased signal intensities. Currently available MR imaging techniques offer no significant advantages over CT for evaluating the pancreas for neoplasia.

Adult↗
PubMed1989

Do donor age and cold-ischemia time have a detrimental effect on early pancreas-allograft function?

To study the impact of donor age and cold-ischemia time (CIT) on early graft function, we retrospectively divided the donors of 51 pancreas transplants performed between 1979 and 1987 at Innsbruck University Hospital into four groups according to donor age (greater than 45 yr and less than 15 yr) and CIT (greater than 8 h and less than 3 h). All organs were perfused with Eurocollins solution and stored at 4 degrees C. Fasting blood glucose levels and total amount of pancreatic juice produced over the first 3 postoperative days were recorded to assess graft function. No statistically significant difference was found between groups 1 and 2 and between groups 3 and 4. From these data, it is concluded that with the preservation method used, CIT can without a doubt be extended to at least 12 h, and a maximum donor age similar to that for the kidney can be adopted. This might not only enlarge the donor pool but also facilitate distant organ procurement.

Age Factors↗
PubMed1989

Rejection of kidney and pancreas after pancreas-kidney transplantation.

On the basis of 26 combined pancreas-kidney transplants we questioned whether both organs undergo rejection simultaneously. Reliable diagnosis of pancreas-graft rejection was made possible by monitoring exocrine graft function, including quantitative measurements of pancreatic juice, its amylase content, and pancreatic juice cytology. In addition, diagnosis of pancreas rejection was based on regular flow studies, daily urinary neopterin excretion, and a retrospective analysis of the clinical course. Clinical symptoms, blood chemistry, and, primarily, histology were used to assess rejection of the kidney allograft. In 18 cases the kidney and pancreas were rejected together; in 8 cases the kidney or the pancreas was rejected. Although both organs were rejected at the same time in most cases, either organ can be rejected alone. Thus, the kidney cannot be used to monitor the pancreas allograft in every case.

Adult↗
PubMed1989

Induction of theophylline metabolism by pentobarbital.

Theophylline concentrations in plasma and urine were determined during maintenance treatment in nine healthy volunteers during one dosage interval before and after 10 days of simultaneous treatment with pentobarbital (100 mg each night). During the pentobarbital period, total plasma clearance of theophylline increased by 40% (range -4-79%), whereas renal clearance remained unchanged. It is concluded that therapeutic doses of pentobarbital induce the metabolism of theophylline with marked interindividual variation.

Adult↗
PubMed1989

[Chondrosarcoma of the soft parts of the thoracic wall. Apropos of a case after surgery and irradiation of breast adenocarcinoma].

We are reporting here a case of chondrosarcoma of the soft tissues of the thoracic wall. As far as we can tell it is the first case published in the world. The tumour appeared 13 years after radical mastectomy and radiotherapy for an adenocarcinoma of the breast. The tumor was greyish-white in appearance and hard, but friable and haemorrhagic. Clinically and biologically it looked like an inflammatory mass. This disappeared when the tumour had been removed but recurred 6 days post-operatively when nodules showing that it had permeated the tissues appeared. Histological and immunohistochemical examination confirmed the diagnosis. We discuss the clinical and histological aspects of the case and state what we found in the literature about other sarcomas that have followed adenocarcinomata of the breast that had been irradiated and operated on. The role of radiotherapy in bringing about this tumour is discussed, including the relationship between the site of the tumour and the dose and field of irradiation. The prognosis is particularly bad in this type of sarcoma which was induced by irradiation.

Adenocarcinoma↗
PubMed1988

[Our therapy concept in nonresectable liver metastases].

Cytotoxic chemotherapy was performed in a total of 18 patients (12 men, 6 women): 5 patients with colonic carcinoma and 1 patient with unknown primary lesion received 5 x 1000 mg 5-Fluorouracil (5-FU) at 4 week interval. The 5 following patients primarily suffering from colonic carcinoma were treated with 0.5 mg/kg BW FUDR continuously at 2 week interval. 5 further patients with colonic carcinoma sequential received Mitomycin C (8 mg/m2) and 4 x 1000 mg 5-FU. 2 patients with breast cancer were treated with 500 mg/m2 Cyclophosphamide, the same amount of 5-FU and 40 mg/m2 Methotrexate every 4 weeks. Chemotherapy was well tolerated by all patients. A clinically significant response, however, was seen in only 2 patients with breast cancer. In 8 patients a liver transplantat was performed, which was followed in 3 cases by ultra-high dose Cyclosphosphamide, lethal total body irradiation and autologous bone marrow transplantation. 1 further patient received polychemotherapy. At the time of this analysis only 3 patients were still alive at 61, 30 and 26 months with only 1 perioperative death. All 3 had meanwhile developed recurrent or metastatic disease. Because of these sobering results, liver transplantation for the treatment of non-resectable liver metastases has been abandoned, and regional chemotherapy is now only applied in patients with liver metastases from breast cancer and after resection of metastases in an adjuvant setting.

Adult↗
PubMed1988

[Experiences with kidney transplantation in elderly patients].

Despite a significant increase in the number of elderly patients with end stage renal disease, these patients still represent a minority of renal transplant recipients in many countries. Roughly the recipients in the present study were older than 50 years of age. Infection was a more common complication in these patients than in the younger patients. However, the incidence of cerebrovascular and cardiovascular complications was found to be lower than expected. Patient-graft survival in 110 renal transplants in 106 patients aged 50 years or older were 87% and 76% respectively. These results suggest that cadaveric renal transplantation represents a relatively safe form of therapy also for older patients.

Aged↗