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Biomedical subjects

J Metzger

Publications and source records attributed to J Metzger.

At least 163 records · Page 9Linked to original sources
PubMed1979

Malignant gliomas treated after surgery by combination chemotherapy and delayed radiation therapy. Part II. Tolerance to irradiation after chemotherapy.

34 patients operated on for malignant gliomas were successively treated by combination chemotherapy with VM26 and CCNU and conventional radiation therapy with an average dosage of 5,800 Rads, six months after surgery. The general and haematological tolerance of delayed irradiation after chemotherapy was satisfactory. Twelve patients developed neurological complications during or after irradiation. The complications were early in 10 cases, and delayed in 2. They were probably due to tumour growth in five cases, and secondary to irradiation in seven. In four of the seven cases the preradiation chemotherapy seemed to potentiate the radiation effect on the central nervous system.

Brain↗
PubMed1979

CT follow-up studies in postoperative craniopharyngiomas.

Thirty patients with histologically proved craniopharyngiomas were controlled by CT after surgical excisions. Recurrence occurred in 70%. Of these tumours 33% were cystic, 30% were solid, and 12% were calcified. The ventricles were dilated in 67%, and postoperative cavities were found in 33%. The effectiveness of various forms of therapy has been monitored by CT. The purpose of our study is to investigate the value of early and long term CT scanning in craniopharyngiomas after surgical excision.

Adolescent↗
PubMed1979

[Preoperative diagnosis of posterior fossa tumors (author's transl)].

The wide-scale use of the CT Scanner has completely modified the radiological approach in the diagnosis of infratorial tumors. In the cerebello pontine angle tumors, computerized tomography offers enough information for surgery (at least in those cases where enlargement of porus is noticeable on the skull film). On the other hand, if clinical picture is incomplete or CT scann atypical (spontaneous hyperdensity), a vertebral angiography is necessary to recognize a meningioma or a neurinoma of the firth nerve. A low density suggesting a cyst (epidermoid or other) is a good indication for pneumoencephalography. In cerebellar tumors of the hemispheres, vertebral angiography should be performed in the case of multiple tumors (except if there is a good chance of metastases) and also with a single tumor showing a high enhancement with contrast; in a solitary cyst, angiography is recommanded when clinical signs suggest hemangioblastoma. Isotopic scanning is only indicated when there is a suspicion of metastases. In midline tumors, one has to consider the relationship with the 4th ventricle; no other radiological exams are necessary if tumor is likely located in the cerebellar vermis; on the contrary, if the ventricular cavity is barely visible positive ventriculography is helpful. In the anteriorly located neoplasms, pneumoencephalography with tomography may precise the exact situation in relation with the brain stem. Regardless of the anteroposterior location, a highly contrasted tumor should be explored by angiography.

Adult↗
PubMed1979

[Computerized tomography of craniopharyngiomas. Therapeutic consequences].

An analysis was made of the results of C.T. scanning in 43 patients with craniopharyngiomas. Filling of the suprasellar cisternae was observed in most cases, together with dilatation of the lateral ventricles. The appearances of the tumor before and after intravenous injection of the contrast medium are described and the frequency with wich calcification, cysts, and lipid densities were noted is reported. Regular C.T. scanning can define operative indications for craniopharyngiomas as a function of the results obtained.

Calcinosis↗
PubMed1979

[Computerized tomography in post-traumatic cerebral lesions (author's transl)].

A review of 108 cases of cranial injury, dating back for more than three months, and having had computerized tomography examinations, revealed 96 abnormalities in the results. These included overall, 65 times, and localized, 20 times, ventricular dilatations, generalized atrophy 27 times, porencephaly 27 times, enlargement of the sylvian fossa 28 times, chronic subdural hematomas 8 times, intracranial calcification 3 times, meningiomas 3 times, and a cerebral abscess in 1 patient. The computerized tomography results were normal in 12 patients. Very good correlations were found between clinical and computerized tomography results in patients with psychic disturbances and disorders of the higher centers. They were variable in cases of epilepsy and neurological deficiency states. The greatest number of normal results was found in so-called subjective syndromes.

Brain Diseases↗
PubMed1979

[C.T. scan appearances of acute necrotizing herpes encephalitis (7 cases). Preliminary therapeutic results after isoprinosine (author's transl)].

Seven cases of confirmed or probable acute necrotizing herpes encephalitis (ANE) were studied using computer tomography during the various acute or chronic stages of the disease. They were bilateral, or in some rare patients, asymmetrical pseudofocal cases of ANE. Computer tomography appearances are described from the morphological and topographical point of view, before and after intravenous injection of a contrast medium. Analogous data reported in the published literature is used to describe the findings and to emphasize the problem of differential diagnosis. Computer tomography appears to be an essential examination for establishing the diagnosis and prognosis in herpes encephalitis, but it must be correlated with the results of an electro-encephalogram, and biological and immunological tests of the cerebrospinal fluid. It can also be of value for choosing the optimal site for urgent cerebral biopsy with immunofluorescence. Treatment must be given very early, whether Ara A antiviral DNA or Isoprinosine (Inosiplex) which stimulates cellular immunity, as soon after diagnosis has been established as possible. The authors chose the latter medication for 6 of the 7 cases reported, as well as in 12 other cases of acute primary viral encephalitis, and 3 cases of subacute sclerozing panencephalitis, and obtained very positive results.

Adolescent↗
PubMed1978

[Comparison of CT, scintigraphy, and angiography in the topographic and pathological diagnosis of 300 supratentorial tumors (author's transl)].

The results of CT, scintigraphy (CSS), and angiography in 300 supratentorial cerebral tumors were compared with regard to the topographic and pathological diagnosis proposed in the initial reports. CT elucidated the topography in 98% of the cases and the pathology in variable percentages, depending on the type of tumor. The use of scintigraphy provided a high accuracy of pathological diagnosis. Except for meningiomas, arteriography was less accurate than the two other methods of examination. A radiological management of supratentorial cerebral tumors is proposed based on clinical and CT data.

Astrocytoma↗
PubMed1978

Bismuth encephalopathy and cerebral computed tomography.

Five cases of severe encephalopathy due to chronic ingestion of bismuth have been studied by cerebral computed tomography (CT). In every case, areas of increased attenuation coefficient in the basal ganglia and the cortex of the cerebral hemispheres were demonstrated. These regions of increased attenuation were diffuse with irregular, patchy denser areas. The increased attenuation in the gray matter territories contrasted with decreased attenuation of the white matter, particularly evident in the centrum semiovale of each hemisphere and probably related to edema. Some ventricular dilatation was also present in three cases. In one patient, areas of increased attenuation were demonstrated in the cerebellum. Follow-up CT studies of one patient revealed regression of the pathological findings. This regression accompanied the clinical improvement, which, in every case, followed the termination of the bismuth intake.

Adult↗
PubMed1978

Differential effects of Pitressin on blood flow and oxygen extraction in canine vascular beds.

Physiologic studies in dogs have been performed with an intravascular flow/diameter sensor which can be introduced directly into the aorta or its branch vessels through a percutaneous radiologic catheter. These studies have focused upon attempts to devise a clinically practical means to protect the small intestine from radiation damage during therapy of abdominal and pelvic malignant tumors. The effects on superior mesenteric, renal, and lower extremity blood flows of controlled infusions of Pitressin given directly into the superior mesenteric artery or into a peripheral vein have been measured. In addition, using these regional flow measurements and arteriovenous differences in oxygen content, regional tissue oxygen extraction rates during Pitressin infusions have also been estimated. The data show that intravenous Pitressin at an infusion rate of 0.0124 U/kg/min may be almost as effective as Pitressin given directly into the superior mesenteric artery in lowering superior mesenteric blood flow (40%-70% reduction for intravenous, 50%-70% for direct arterial infusions) and intestinal oxygen extraction (20%-40% reduction for intravenous, 40%-50% for direct arterial infusions). The effects of Pitressin at similar dose rates on the kidney and the lower extremity are less reproducible, and it is possible that relatively selective radiation protection of the intestine using systemic (intravenous) infusions of Pitressin during abdominopelvic radiotherapy might be achievable.

Animals↗
PubMed1978

[Tomodensitometric aspects of 3 cases of acute bismuth encephalopathy (author's transl)].

A study of 3 cases of acute bismuth encephalopathy by C. T. scanner revealed indisputable evidence of abnormal hyperdensity in certain brain regions. These hyperdensities, or rather hyperattenuations, are very typical in case no. 1, where the central grey nuclei, especially the caudate nuclei and cerebral cortex, have an important hyperdence appearance. The images are heterogenous, sometimes granular, and are not modified by the injection of a contrast medium. There are also ventricular and cisternal dilatations which are even more remarkable when the age of the patients (less than 45 years) is considered. Cases Nos. 2 and 3 showed hyperdensity which was mainly in the cortical hemispheres. Blood bismuth levels vary according to the date of bismuth stoppage, lying between 850 and 1.350 microgram p. 1.000 ml. The pathogenesis of these tomodensitometric images are discussed as a function the of atomic number of bismuth metal and its unequal distribution in the cerebral parenchyma and the meninges.

Adult↗
PubMed1977

[Cerebral tomodensitometry (scanner) and accident sequelae: its medico-legal value].

The authors report their experience of one years use of a cerebral scanner in the investigation of the sequelae of head injuries, and the medico-legal interest of this discovery. It permits one to visualise the pathological processes responsible for the symptoms following head injuries and its is thus of major intetrest in legal medicine where the subjective factor in these symptoms is difficult to assess. Increasing considerably the proportion of definite etiologies in this pathology, the authors believe that this new method will become standard in the medico-legal assessment of head injuries.

Adolescent↗