Imaging techniques: metastases and tumor extension in the abdomen.
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Biomedical subjects
Publications and source records attributed to J Winter.
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Forty-five computerized tomographic (CT) chest studies were performed on workers suspected of having pleural disease after being exposed to asbestos material. Ten of the 45 reviewed were court cases, and 32 workers acutely exposed at University of California-Los Angeles (UCLA) were studied with routine four views of the chest. CT confirmed the initial interpretation of chest films obtained at UCLA.
In 10 to 66% blunt chest traumata lead to cardiac traumata. As it is shown in our special collective (n = 12) injuries of the pericardial sac of the myocardium, of the myocardial septum, of the coronary arteries and of the cardiac valves have occurred. Therefore clinical symptoms are various and the diagnosis remains difficult with regard to the causative polytrauma. Bleedings and/or pericardial tamponade caused by rupture of the atrial or ventricular wall, injury of main coronary vessels or cardiac dislocation after pericardial rupture urgently require a surgical intervention. Aneurysms caused by blunt trauma, ventricular septal defects, valve insufficiencies may be mostly treated in the interval.
From 1972 to 1985 158 patients (pts.) were operated because of a mediastinal tumor at the Dept. of Thoracic and Cardiovascular Surgery at Düsseldorf. The tumor led to hemodynamic effects in 11 pts. (8 female, 3 male). In 6 pts. occurred a passive congestion of the upper caval vein (malignant teratoma 2 X, malignant thymoma 2 X, Boeck's disease 1 X, Non Hodgkin's disease 1 X), 4 pts. had a functional stenosis of pulmonary artery (dermoid 2 X, benign thymoma 2 X) and 1 pt. had pericardial effusion by a neurinoma. Being operated all pts. with 'pulmonary stenosis' were free of complaints, while all other pts. had infaust prognoses.
A radioimmunoassay of 21-deoxytetrahydroaldosterone was developed. Normal daily excretion of the unconjugated metabolite was 1.2 +/- 1.3 micrograms and of the glucuronized metabolite, 11.9 +/- 7 micrograms. The tetrahydroaldosterone/21-deoxytetrahydroaldosterone ratio varied more in patients with primary aldosteronism than in control subjects. Thus, measurements of the urinary excretion of the tetrahydroaldosterone or 21-deoxytetrahydroaldosterone alone did not provide an accurate expression for aldosterone production. Their sum correlated well with the clinical condition, i.e. clear-cut elevation in patients with primary aldosteronism. The diminished tetrahydroaldosterone/21-deoxytetrahydroaldosterone ratio found in patients with 21-hydroxylase deficiency may be attributed to increased bacterial conversion of tetrahydroaldosterone to 21-deoxytetrahydroaldosterone but could also stem from a deficiency implicating zona glomerulosa (aldosterone biosynthesis) regardless of the stage and clinical presentation of the disease.
The bacteriological investigation of an outbreak of Legionnaires' disease in Glasgow Royal Infirmary affecting 16 patients is described. Most of the patients had been treated in high-dependency areas on two floors of the hospital supplied by the same two air-conditioned ventilation systems. The source of infection was traced to contamination of a cooling tower from which a plume of spray discharged into the intake vents of the two ventilation systems. Rubber grommets within the cooling tower probably provided a nidus of infection there. The control and management of the outbreak are discussed: a policy of frankness about the course and progress of the investigations was adopted and helped to allay anxiety on the part of both staff and media.
In synchronized Euglena gracilis (light-dark regime of 14:10 hours) the successive formation of the photosynthetic apparatus during cell ontogeny is correlated with large changes in photosynthetic efficiency (P Brandt, B von Kessel 1983 Plant Physiol 72: 616-619; B Kohnke, P Brandt 1984 Biochim Biophys Acta 766: 156-160). This observation led us to investigate the functional association of the chlorophyll a/b light-harvesting protein complex (LHCP) with photosystem I or II, because changes in energy flow to photosystem I or II and in energy transfer between the two photosystems can be a reason for these alterations. As criterion for the association of the LHCP with photosystem I or II, state transitions were determined after 15 minutes preillumination using wave-lengths of 725 or 620 nanometers. The state transitions were determined from measurements of fluorescence induction at room temperature, and fluorescence kinetics at 77 K. According to the obtained data (a) mobile LHCP is present only between the 6th and the 10th hour of the light-time of the cell cycle and (b) this functional relation of the LHCP to photosystem I only at this stage of Euglena chloroplast development is not accompanied by a decrease in stacking. A model for the organization of the newly inserted LHCP within the photosynthetic apparatus of E. gracilis is discussed.
The synthesis of a steroid desmolase was demonstrated in two obligate anaerobes: a new bacterial species, Eubacterium desmolans, isolated from cat fecal flora, and Clostridium cadavaris, recovered from sewage of New York City. The enzyme cleaves the C-17-C-20 bond of corticoids possessing hydroxyl functions at C-17 and C-21. The conversion is quantitative, provided the substrate concentration is less than 100 micrograms/ml and the organisms are in the log phase. The velocity of transformation parallels the bacterial growth curve and in the log phase is higher for E. desmolans than for C. cadavaris. In addition, both organisms synthesize a 20 beta-hydroxysteroid dehydrogenase.
Cold-lesion contrast resolution was measured as a function of photopeak window position, photon energy, and scatter configuration using a clinical scintillation camera capable of asymmetric photopeak imaging. Two radionuclide solutions, technetium-99m and thallium-201, were studied at five photopeak window positions: the symmetric setting and window settings that were 5%, 10%, 20%, and 30% asymmetrically high (asymmetry was defined here by the intrinsic percentage of count loss relative to the symmetric window setting). Low contrast was examined with small cold-sphere phantoms and large cold-cube phantoms to produce high- and low-scatter conditions, respectively. High contrast was examined with a Hine cylindrical step phantom. Lesion contrast improved markedly with small degrees of window asymmetry but showed less dramatic improvement when positions at the higher degrees of asymmetry were studied. For the high-scatter and low-contrast situations, the maximum improvement in lesion contrast tended to be inversely proportional to lesion size. The maximum improvement in contrast resolution ranged from 10% to 45%, depending on lesion size, scatter configuration, and the radionuclide solution used.
Multiple-angle, variable-interval, nonorthogonal (MAVIN) MRI is a new, time-saving technique that allows for the independent choice of slice angle and position for each slice in a multiangle pulse sequence. By appropriate adjustment of the slice-select radiofrequency pulse and the slice-select and readout magnetic-field gradients, the interval and angle of each slice may be individually chosen. MAVIN can reduce examination time in studies of the lumbar spine, orbits, knees, and heart, where nonparallel oblique scanning may be necessary and would otherwise require the use of additional pulse sequences. Loss of signal in the region of intersection of multiple planes due to local changes in effective repetition time is a practical limitation. For this reason, scan planes are chosen so that the intersection does not overlie the region of interest.
In 10 patients with supratentorial ependymomas, the tumors exhibited hyperdensity on computerized tomography (CT) scanning prior to contrast infusion and, with one exception, all tumors were mixed lesions with the low densities suggesting cystic or necrotic portions. Eighty percent of the tumors contained small calcifications. Characteristically, the tumors were well demarcated and demonstrated moderate to marked enhancement after the intravenous administration of contrast material. Angiograms obtained in some patients showed mild hypervascular tumor staining and absence of large feeding arteries. The degree of contrast enhancement, angiographic vascularity, and tumor stain was compared to the pathological anaplasia of the tumors. No correlation was observed. Of four patients who were still alive during a follow-up period of 4 years or longer, three had recurrences with inoperable tumors; the remaining patient is without recurrence after craniospinal radiation. This same patient belonged to a group of five patients with a diagnosis of high-grade ependymoma, four of whom had recurrence. Follow-up CT accurately recorded the clinical course of each patient. Annual routine follow-up examinations are proposed for patients with low-grade ependymomas, and for those with high-grade ependymomas follow-up CT should be performed every 6 months. The characteristic appearance and behavior of these tumors include several distinctive features on angiographic and CT images.
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A plasma membrane protein common to non-myelin-forming peripheral glia, including non-myelin-forming Schwann cells, satellite cells and enteric glia, is recognized and defined by monoclonal antibody A5E3. It is not detectable immunohistochemically on myelin-forming Schwann cells. The antigen is also present in large amounts on smooth muscle cells and perineurial cells, on some PNS neurons, and at lower levels on astrocytes of adult rat. In neonatal but not adult animals, the antigen is present on skeletal muscle fibres and myoblasts. In immunoblots and immune precipitation experiments on smooth muscle and Schwann cell extracts the antigen is a polypeptide with an apparent molecular weight of 130 kd. In being present in some non-neural tissues, albeit very highly restricted in cell type, this antigen resembles several other cell surface glycoproteins found in large amounts in the nervous system.
Microcomputers have great potential in therapeutic environments, but, if they are to achieve this potential, they need appropriate software (programs). This paper examines the ideas behind games software and the relevance of commercially available software to therapy. It recommends that specially designed programs are needed and lays down some guidelines for the design and development of such software.
A rabbit brain tumor model using transplanted VX-2 carcinoma had an 85% rate of successful implantation. Rabbits lived 8.5 +/- 1.3 days. The tumor doubling time was 0.5 to 2.6 days. Some tumors were shown as early as four days after implantation and all tumors were seen by ten days after implantation. Two of three rabbits receiving radiation therapy to the tumor had significant extension of life. This model is a useful radiologic research tool.