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Biomedical subjects

M Laniado

Publications and source records attributed to M Laniado.

At least 37 records · Page 2Linked to original sources

Inverted papilloma of the nasal cavity and the paranasal sinuses: using CT for primary diagnosis and follow-up.

OBJECTIVE: Morphologic criteria for the diagnosis of primary and recurrent inverted papilloma as revealed on CT were evaluated in a large series. MATERIALS AND METHODS: Findings of 121 CT examinations that had been performed in 32 patients with histologically proven inverted papilloma were retrospectively analyzed using the following morphologic criteria: localization, size, surface configuration, and bony changes. RESULTS: Unilateral tumor localization involving the lateral nasal wall and the middle meatus was the feature that best correlated with the finding of primary inverted papilloma. A lobulated surface pattern was another typical sign, which was revealed on 19 of the 29 CT scans of patients with primary inverted papilloma. Although tumor localization and the finding of a newly grown soft-tissue mass were less reliable criteria to differentiate between recurrent inverted papilloma and postoperative complications or concomitant inflammatory disease, a lobulated surface pattern was seen on 26 of the 28 CT scans of patients with tumor recurrence but on only three of the 64 follow-up CT scans of patients without recurrent inverted papilloma. CONCLUSION: A unilateral mass within the nasal cavity or paranasal sinuses with a surface configuration that appears lobulated on CT is, to our knowledge, a new sign that strongly suggests inverted papilloma as a primary diagnosis and also suggests inverted papilloma in patients with tumor recurrence.

Adult↗

Perianal complications of Crohn disease: MR imaging findings.

The aim of this study was to revisit anal anatomy, to explain surgical terminology in perianal complications of Crohn disease, and to show the MR imaging findings of perianal fistulas and abscesses. To this end more than 200 patients were studied using surface coils (Helmholtz; phased array) at 1.0 and 1.5 T. Transverse and coronal T1- and T2-weighted images were obtained. Parks' classification was used to describe perianal abscesses and fistulas. This pictorial essay shows the normal anal anatomy and pathologic findings such as subcutaneous, para-anal, ischiorectal, intersphincteric, and supralevatoric abscesses and fistulas. MR imaging with surface coils is well suited to showing the anal anatomy and to reliably describing perianal abscesses and fistulas according to surgical terminology.

Abscess↗

[Current status of the clinical development of MR contrast media].

The paramagnetic extracellular Gd contrast media (Gd-CM) Magnevist, Dotarem, Omniscan, and ProHance are on the market, whereas Gadovist, Optimark, and MultiHance (also used as a hepatobiliary CM) are undergoing clinical trials (phase III). Among other indications, Gd-CM are applied in tumours, inflammation, vascular pathologies, and MR-angiography. The paramagnetic hepatobiliary CM Teslascan, Eovist and MultiHance are in clinical trials (phase II and III). They improve tumour detection and characterisation. The Mn-CM Teslascan is also suited for pancreatic imaging, the Gd-CM MultiHance for imaging of myocardial infarction and the brain, and the Gd-CM Eovist has been used in liver CT. The superparamagnetic reticuloendothelial CM Endorem is on the market whereas Resovist is undergoing phase-III trials. Both agents have the same indications as the hepatobiliary CM. Sinerem is another superparamagnetic CM. However, it acts as a blood pool agent and accumulates in lymph nodes (MR lymphography). Gastrointestinal CM are divided into paramagnetic, superparamagnetic and diamagnetic agents acting either as positive or negative CM. Some are on the market, but their clinical value is limited.

Adult↗

Expression of bcl-2 in bladder neoplasms is a cell lineage associated and p53-independent event.

AIMS: To investigate bcl-2 and p53 protein expression in hyperplastic, metaplastic and neoplastic epithelia of the urinary bladder in relation to cell lineages (transitional versus glandular epithelia). METHODS: Formalin fixed, paraffin wax embedded archival tissue blocks of 29 transitional cell carcinomas (TCC), 11 adenocarcinomas, five specimens of cystitis glandularis, four papillomas, and seven samples of morphologically normal bladder mucosa were examined immunohistochemically with antibodies specific to bcl-2 and p53. Consecutive sections were used to assess co-expression of the two proteins. RESULTS: bcl-2 protein was expressed heterogeneously in basal cells of the normal transitional epithelium, whereas p53 was rarely detectable in either normal or hyperplastic epithelium. Of the 29 TCCs, 20 (69%) expressed immunodetectable p53 which was positively associated with grade. In contrast, bcl-2 was detected in four (14%) TCCs and its expression was not associated with grade. bcl-2 was expressed constitutively in all five specimens of cystitis glandularis and in all adenocarcinomas; p53 was co-expressed in most of the latter. There was no association between bcl-2 and p53 protein expression in the TCCs. Expression of bcl-2 protein correlated negatively with grade of adenocarcinoma. CONCLUSION: In bladder adenocarcinomas, bcl-2 expression correlated negatively with tumour grade whereas p53 was associated positively with tumour grade. The association of bcl-2 with cystitis glandularis and adenocarcinoma but not TCC suggests that it may be involved in triggering a lineage switch converting transitional epithelium to a glandular phenotype.

Adenocarcinoma↗

MR imaging of the liver with Resovist: safety, efficacy, and pharmacodynamic properties.

PURPOSE: To evaluate the safety, efficacy, and pharmacodynamic properties of a new superparamagnetic parenteral iron oxide contrast agent for magnetic resonance (MR) imaging. MATERIALS AND METHODS: Thirty-six patients with liver lesions received a bolus injection of Resovist (SH U 555 A; Schering, Berlin, Germany) at a dose of 4, 8, or 16 micromol iron per kilogram body weight (micromol Fe/kg). Fast low-angle shot, spin-echo, and turbo gradient spin-echo MR images were obtained before and 10, 40, and 70 minutes after injection. Blood samples were obtained, vital signs were monitored, and adverse events were recorded. Lesion detection was assessed by two independent, blinded readers. RESULTS: No drug-related adverse events occurred. Serum iron and ferritin levels were increased at all dose levels. Partial thromboplastin time increased and factor XI level decreased 4 hours after injection of 16 micromol Fe/kg. Lesion detection and diagnostic confidence were increased in patients who received 4 or 8 micromol Fe/kg, with no further increase with a 16-micromol dose. CONCLUSION: Resovist is safe and effective. The best MR imaging results were obtained 40 minutes after injection of 8 micromol Fe/kg.

Adult↗

Desmoplastic fibroma of the bone. A report of two patients, review of the literature, and therapeutic implications.

BACKGROUND: Desmoplastic fibroma (DF) is an extremely rare bone tumor. The recommendations for therapy are often based on limited personal experience, and the rate of local recurrence in the published cases is very high. Therefore, an analysis of treatment results of published cases was performed. Furthermore, DNA analysis of the tumors from two patients was also performed. METHODS: The clinical, radiologic, and histologic data of two patients with DF of the long bones are presented. DNA flow cytometry was performed on both DFs, three cases of abdominal fibromatosis, and three cases of extraabdominal fibromatosis. One hundred eighty-nine patients analyzed in the literature and our own 2 patients were evaluated with regard to epidemiologic, clinical, and histologic data, with particular emphasis on treatment results. RESULTS: DNA analysis of the locally infiltrating tumors revealed indices of proliferation between 21.5% and 24%, noticeably elevated values in comparison with extraosseous desmoid tumors (8.04%). Magnetic resonance imaging (MRI) was most valuable for imaging the intraosseous and extraosseous extent of DF. The evaluation of 191 patients (189 from the literature, 2 of the authors) showed the numbers of males and females to be equivalent, with a mean age of 23 years. DF has been reported in almost all bones, with a tendency to occur in the mandible and the long bones. Approximately 12% of patients presented with a pathologic fracture (20 of 161 patients). Infiltrative growth in the soft tissue was documented in 48% of patients. Three patients developed metastases after local recurrence. Analyzing the treatment results, the authors found a recurrence rate of 55-72% after nonresection procedures, and 17% after resection. No recurrences are reported after resection with wide surgical margins. The recurrence rate of tumors of the extremities was 55%, and 25% of these patients eventually required an amputation. CONCLUSIONS: Considering the "semimalignant" character of this entity and the poor treatment results in patients with recurrent tumors, marginal or wide resection for primary treatment is recommended. The superior imaging quality of MRI greatly facilitates preoperative planning.

Adolescent↗

Oral magnetic particles (ferristene) as a contrast medium in abdominal magnetic resonance imaging.

RATIONALE AND OBJECTIVES: In this phase III study, we evaluated the efficacy and safety of a negative contrast medium, ferristene (oral magnetic particles), among 277 patients undergoing magnetic resonance (MR) imaging of the abdomen. METHODS: Enhanced (800 ml ferristene) MR images were compared with unenhanced MR images in an intraindividual-patient control design. Adverse events were recorded. The examinations were performed on 1.5-T MR systems (T1- and T2-weighted sequences). RESULTS: Ferristene increased the diagnostic information in 50.9% of the patients, particularly in those with abdominal masses, lymphoma, or pancreatic disease. Distribution of ferristene in the stomach, duodenum, jejunum, and ileum was complete or sufficient in 70.5-85% of the studies. In 64% of the patients, we were confident in the MR findings after the use of ferristene, and ferristene disclosed additional findings in 22% of the patients. The incidence of adverse events was 9.0%, but only 3.6% of all patients experienced ferristene-related adverse events (e.g., nausea, vomiting). Most events were mild or moderate in intensity. CONCLUSION: Ferristene was well tolerated, and for 50% of the patients it added useful diagnostic information.

Administration, Oral↗

How to present research data consistently in a scientific paper.

The paper analyzes, on a subjective basis, aspects of how to write scientific papers that will be accepted for publication in peer review journals. For each individual section of the manuscript, i.e. Introduction, Materials and methods, Results, Discussion, Abstract, and References, general comments and examples are given. It is concluded that writing scientific articles is a form of mental exercise that has to be practised to be successful.

Europe↗

How to present research data consistently in a scientific paper.

The paper analyzes, on a subjective basis, aspects of how to write scientific papers that will be accepted for publication in peer review journals. For each individual section of the manuscript, i.e. Introduction, Materials and methods, Results, Discussion, Abstract, and References, general comments and examples are given. It is concluded that writing scientific articles is a form of mental exercise that has to be practised to be successful.

Peer Review↗

[Echo contrast agents for the color Doppler sonographic diagnosis of deep femoral venous thrombosis].

PURPOSE: Evaluation of an echo contrast medium (Echovist) for color-coded duplex sonography of deep venous thrombosis of the thigh. MATERIAL AND METHODS: In 19 patients with deep vein thrombosis of the thigh, diagnosed by contrast phlebography, 22 color-coded duplex sonography studies were performed for flow analysis at the top of the thrombus. During the studies 8.5 ml echo contrast medium were injected in an ipsilateral vein at the back of the foot. The flow signals of the non-enhanced color coded duplex sonography were compared with those of the echo enhanced study for differentiation between floating thrombi from those adherent to the vein wall. RESULTS: The echo-enhanced color-coded duplex sonography showed a significant increase in detection of perfusion at the top of the thrombus in comparison with non-enhanced color-coded duplex sonography (p < 0.01). 9 thrombi were regarded as wall adherent after the native study, 7 of these could be identified as floating thrombi by echo-enhanced color-coded duplex sonography. CONCLUSION: Echo-enhanced color-coded duplex sonography yields a significant increase of diagnostic information in certain findings of the non-enhanced color-coded duplex sonography differentiating between floating thrombi and wall adherent thrombi in the deep venous system of the thigh.

Adult↗

Normal bone marrow in the sacrum of young adults: differences between the sexes seen on chemical-shift MR imaging.

OBJECTIVE: Age-related changes in the distribution of fatty and nonfatty bone marrow in the pelvis and femur are well recognized. However, mapping not only of age-related MR appearance of normal bone marrow but also of potential variations in females versus males is necessary to differentiate normal findings from marrow disease. Accordingly, we studied possible sex-related differences in the MR imaging appearance of sacral bone marrow in young adults. SUBJECTS AND METHODS: A population of 21 healthy men and 21 healthy women (17-42 years old) was prospectively studied with chemical-shift pulse sequences. MR imaging (1.5 T) of the sacrum was done with frequency-selective fat images (SENEX [selective nonexcitation] 300/27) and water images (SENEX 1000/27) by using an elliptical surface coil. Two independent observers compared the signal intensity of sacral marrow with the signal of fatty tissue planes adjacent to the sacrum (fat images) and the signal of gluteus muscle (water images). T2 relaxation times were estimated by using a two-parametric monoexponential fit on SENEX 1000/27 and SENEX 1000/54 images. RESULTS: In both sexes, fat MR images showed a higher fat content and greater heterogeneity in the bone marrow of the lateral masses than in the vertebral bodies of the sacrum (p < .05). Yellow marrow in the lateral masses of the sacrum appeared brighter in men than in women (p < .05). The heterogeneity of fatty marrow did not differ significantly between the sexes. On water MR images, the signal intensity of the sacrum was higher in women (p < .05). T2 relaxation times were longer in nonfatty marrow with a high water signal intensity (41.8 +/- 5.5 msec versus 33.4 +/- 2.6 msec p < .01). CONCLUSION: Our findings show that the normal appearance of the sacral bone marrow depicted on chemical-shift MR imaging differs between young men and women. Awareness of these differences is important to avoid misinterpretation of normal MR findings seen in patients in this age group.

Adolescent↗

[The endorem tolerance profile].

ENDOREM (Guerbet, Sulzbach) is a superparamagnetic contrast agent for magnetic resonance imaging of the liver and spleen. The contrast agent consists of dextran-coated iron oxide particles with a size distribution between 120 and 180 nm and an iron concentration of 0.2 mol/l. Before ENDOREM received approval in Germany and other European countries, clinical trials were performed in Japan, the USA, and Europe. At a dose of 10 micromol Fe/kg (Japan, USA) and 15 micromol Fe/kg (Europe). ENDOREM was slowly infused in 100 ml of glucose 5% over approximately 30 min in 163 (Japan), 213 (USA), and 467 patients (Europe). The rate of side effects ranged between 6.1% (Japan) and 10.3% (Europe). The most frequent side effect was lower back pain. However, infusion was stopped or medication was necessary because of lower back pain in only very few cases. Transient increases of serum iron and ferritin and decreases of iron binding capacity occurred. No clinically relevant changes of heart rate and arterial blood pressure were observed. With the recommended biphasic infusion (2 ml/min over 10 min and 4 ml/min over 20 min) and at a dose of 15 micromol Fe/kg in 100 ml of glucose 5% ENDOREM is a well tolerated contrast agent

Adult↗

[The color-coded duplex sonography and contrast-enhanced magnetic resonance tomography of scintigraphically cold thyroid nodules].

In order to establish diagnostic criteria, colour-coded duplex sonography was performed on 40 patients who had a total of 43 operatively confirmed thyroid lesions which were scintigraphically "cold" (28 adenomas, 8 carcinomas, 4 cases of thyroiditis and 3 cysts). 32 of these patients also had MRT with T2- and T1-weighted images before and after injection of Gd-DTPA (0.1 mmol/kg). Adenomatous nodules and adenomas showed a peripheral vascular halo on colour-coded duplex sonography with a sensitivity of 96% and a specificity of 93%. Malignant lesions showed marked central vascularisation and on B-images irregular marginal structures. Adenomas and adenomatous nodules showed hyperintense areas on T1-weighted unenhanced MR images and/or homogeneous uptake in the lesion (sensitivity 100%, specificity 77%). Malignant lesions typically showed an irregular margin with increased contrast uptake on MRT. If sonography and colour-coded duplex sonography is unable to classify a lesion with any degree of assurance then MRT with Gd-DTPA enhancement should be performed.

Adult↗