Biomedical subjects

M Vermess

Publications and source records attributed to M Vermess.

At least 37 records · Page 2Linked to original sources

PubMed1982

A prospective analysis of laboratory tests and imaging studies to detect hepatic lesions.

A prospective study of the ability of laboratory tests and liver imaging tests to detect hepatic metastases was performed. Eighty patients at risk for hepatic metastases but without clinical evidence of disease were tested with 13 laboratory tests and three liver imaging tests. No single laboratory test had greater than 65% accuracy in the detection of hepatic lesions. No combination of the laboratory tests increased this accuracy. If the laboratory tests were used with one of the liver imaging tests, the accuracy was improved in some combinations to 76%. The CEA assay when analyzed in patients with colorectal primaries had an accuracy of 79%. The results show that the laboratory tests alone are not sufficiently accurate to detect liver metastases. Additional accuracy can be obtained by the combined use of a single liver imaging test and selected laboratory tests. Use of all the liver imaging tests and laboratory tests lowers the accuracy and increases the expense and thus is unnecessary.

Carcinoembryonic Antigen↗

PubMed1982

A prospective study of hepatic imaging in the detection of metastatic disease.

This prospective study of 80 patients compared the results of liver scintiscan, ultrasound, and CT scan to the objective findings recorded at laparotomy. Analysis of these data revealed no significant differences in sensitivity, specificity, or accuracy among these three imaging procedures, although a trend toward increased accuracy of the CT scan was noted. In a composite analysis, the accuracy was not improved by combining two or all three of these examinations. A lesion by lesion analysis revealed the inability of any of the three currently used techniques to accurately detect lesions less than 3 cm in diameter.

Biopsy↗

PubMed1982

Biodistribution study of Ethiodized Oil Emulsion 13 for computed tomography of the liver and spleen.

Biodistribution studies were conducted with a new intravenous lipoid contrast material currently undergoing clinical trials in four hospitals. The contrast material selectively opacifies the liver and spleen for computed tomographic examination. The experiments were performed on rats with 125I-labeled ethiodized oil emulsion. The study showed that the liver accumulates nearly 80% of the injected iodine within 15 min of the injection and retains a high concentration over 3 h. The second highest concentration was found in the spleen. More than 99% of the iodine is eliminated from the liver and spleen within 48 h, primarily through the kidneys.

Animals↗

PubMed1982

The risk of hepatic artery embolization in the presence of obstructive jaundice.

Rhesus and cynomolgus monkeys were used as experimental subjects to determine the extend to which the presence of biliary obstruction increases the risk of hepatic necrosis following hepatic artery embolization. It was found that peripheral hepatic artery embolization without biliary obstruction resulted in acute hepatic swelling and dysfunction and chronic focal infarction with bile cyst formation. However, massive hepatic necrosis and bile lakes were not seen. Distal common bile duct obstruction unaccompanied by arterial occlusion did not seriously damage the liver, although it was found that distal common duct obstruction in monkeys is not strictly comparable to distal common duct obstruction in humans. When peripheral hepatic artery embolization was performed following ligation of the right or left hepatic ducts at the point of their emergence from the porta hepatis, total infarction of the obstructed segment occurred and a massive bile lake formed. The pathophysiologic explanation is probably the decreased portal venous inflow that accompanies biliary obstruction; hepatic artery inflow reciprocally increases and the liver become critically dependent upon an intact arterial system. Clinical evidence suggests that a liver with a recently decompressed biliary tree may also be more susceptible to infarction and abscess formation following hepatic artery ligation or embolization.

Animals↗

PubMed1982

EOE-13 in the detection of hepatosplenic lymphoma.

Thirty-nine patients with lymphoma were evaluated prospectively to determine the usefulness of Ethiodol-Oil-Emulsion-13 (EOE-13) in the detection of hepatosplenic lymphoma by computed tomography. The detection rate in the spleen increased from 8% (before EOE-13 infusion) to 92% (after EOE-13 infusion). In ten of 39 patients (25%) in this series, lymphomatous disease was recognized only on the postinfusion computed tomographic scan. The postinfusion EOE-13 study demonstrated additional visceral abnormalities in 38% of the patients. The potential usefulness, limitations, and toxicity of this hepatosplenic-specific imaging agent are discussed.

Ethiodized Oil↗

PubMed1982

Computed tomography of the liver and spleen with intravenous lipoid contrast material: review of 60 examinations.

In 60 computed tomographic examinations of the liver and spleen in 55 patients, a new intravenous lipoid contrast material, Ethiodized Oil Emulsion 13, was used. This organ-specific contrast material, retained by the reticuloendothelial cells of the liver and spleen, caused marked increase in the attenuation of the liver and spleen, but did not appreciably change the attenuation of the tumor involving these organs, thereby significantly increasing the density differential between normal and abnormal tissue. Toxicity was considered to be well within tolerable limits with the most frequently noted untoward side effects of chills, fever, headaches, and foul metallic taste. Ethiodized Oil Emulsion 13 holds the promise to become a valuable clinical tool by which hepatic and splenic imaging may be significantly improved and lesions less than 1 cm in diameter demonstrated in the liver and spleen.

Adult↗

PubMed1981

Post-splenectomy demonstration of splenic tissue by computed tomography with liposoluble contrast material.

The significance of localizing accessory spleens in patients with hematologic disorders as well as demonstrating splenic regeneration following splenectomy is well recognized. An experimental contrast material has been developed that, after intravenous injection, selectively opacifies the liver and spleen on computed tomograms. The contrast material was primarily developed to detect small avascular liver lesions (metastases). Its value in detecting accessory or recurrent spleen was recognized incidentally when a patient with testicular carcinoma and a previous splenectomy showed opacification of splenic tissue in the left upper abdomen.

Adult↗

PubMed1981

Use of intravenous liposoluble contrast material for the examination of the liver and spleen in lymphoma.

An experimental contrast material has been developed that, after intravenous injection, selectively opacifies the spleen and liver on computed tomography (CT). The contrast material contains iodinated ester of poppy seed oil in an emulsified form. Clinical trials were recently initiated to test the value of this contrast agent in Hodgkin's and non-Hodgkin's lymphomas. We present here two of our initial patients in whom we found lesions in the spleen or liver following the infusion of the experimental contrast material that were not visualized on the precontrast and urographic contrast material enhanced CT scans.

Adult↗

PubMed1980

Use of liposoluble contrast material to separate left renal and splenic parenchyma on computed tomography.

A lobulated or accessory spleen lying against the upper pole of the left kidney may simulate renal tumor on computed tomograms. Water soluble contrast material is usually of little help in the differential diagnosis, since it increases the attenuation of both the kidney and the spleen. Intravenous liposoluble contrast material preferentially increases the attenuation of the liver and spleen and thus permits clear separation of the enhanced lobulated or accessory spleen from the unopacified renal parenchyma.

Adult↗

PubMed1980

Clinical trials with a new intravenous liposoluble contrast material for computed tomography of the liver and spleen.

Ten patients with disseminated cancer were given intravenous injections of 0.2 ml/kg (40 mg l/kg) of the experimental contrast material EOE 13. Ct scans of the liver and spleen were taken prior to and 30 minutes after contrast infusion. Visualization of the liver was significantly improved in 5, moderately improved in 3, and not appreciably improved in 2. The spleen showed an obvious increase in density in all cases. No significant toxicity was encountered: untoward side effects consisted of fever, headaches, foul metallic taste, and weakness for a short period. Four patients had no side effects, and 2 experienced only abnormal taste sensation. Further experimental and clinical work is needed before the advantages and safety of this contrast material can be documented.

Autopsy↗

PubMed1979

Formulation and evaluation of ethiodized oil emulsion for intravenous hepatography.

A study was conducted to prepare and evaluate an ethiodized oil emulsion for intravenous administration that would selectively opacify the liver. Several formulations with differing globule size were prepared and compared for their in vivo activity (degree of liver opacification obtained) and stability. Results of studies conducted in rabbits and monkeys revealed that the oil globules that concentrate most in liver were 2.0--3.0 micrometer in diameter. The formulation of choice was stable for 6 months at refrigeration temperature (2--6 degree). In monkeys, this formulation produced an improved diagnostic image of the liver using computerized tomography at a dose of 0.2 ml/kg. The potential use of such emulsions in diagnostic radiology is briefly discussed.

Animals↗

PubMed1979

Development and experimental evaluation of a contrast medium for computed tomographic examination of the liver and spleen.

A lipoid based contrast material containing 53% of ethiodized oil in emulsion form was developed for computed tomography (CT) of the liver and spleen and tested in rabbits and monkeys. An intravenous dose of 0.2 ml/kg selectively opacified the liver and spleen, resulting in an average increase of 23 EMI units (500 scales) in the attenuation of the liver and a higher increase in the attenuation of the spleen. When injected into rhesus monkeys with carcinogen induced hepatomas there was a significant improvement in the visualization of the tumor, and small lesions, undetectable on the preliminary CT scan, became visible. Toxicity studies are in progress.

Animals↗

PubMed1978

Computer assisted tomography of orbital lesions in Wegener's granulomatosis.

The orbital lesions in six patients with Wegener's granulomatosis were studied by computer assisted tomography (CAT). Four patients had active orbital disease and proptosis, and each was found to have orbital masses accompanied by varying degrees of bone and sinus destruction. Two additional patients with histories of proptosis had no orbital lesions at the time of CAT study.

Adult↗

PubMed1977

Computer assisted tomography in methotrexate encephalopathy.

Five children with acute lymphocytic leukemia (ALL) developed encephalopathy following treatment with intrathecal or intraventricular methotrexate (MTX). In these patients computer assisted tomography was informative by revealing areas of decreased attenuation coefficient located periventricularly and in each centrum semiovale (three cases) and calcifications, mostly in the deep and cortical gray matter (two cases), as well as ventricular dilatation (four cases). Contrast injection used in one of these five patients, as well as in another child (not affected by ALL) with MTX encephalopathy, failed to reveal enhancement.

Acute Disease↗

PubMed1977

Computed tomographic demonstration of hepatic tumor with the aid of intravenous iodinated fat emulsion. An experimental study.

Computed tomography showed improved visualization of carcinogen-induced hepatoma in monkeys following intravenous injection of an experimental contrast material AG 60-99; selective opacification of the liver and spleen was accomplished with a dose of greater than or equal to 0.1 ml/kg, a fraction of the dose used in conventional x-ray tomography. This marked reduction was made possible by the improved density resolution of the CT scanner. This may be the first organ-specific contrast material intended primarily for use with CT scanners.

Animals↗

PubMed1977

Detection of orbital and intraocular foreign bodies by computerized tomography.

Localization of intraocular and orbital foreign bodies with computerized tomography (CT) was evaluated in eight patients and an experimental model. CT examination was particularly helpful in cases with multiple similar foreign bodies and in identifying foreign bodies too radiolucent to be seen by standard skull x-rays. Limitations of CT technique included insufficient resolution to localize a foreign body immediately adjacent to the sclera as either intraocular or extraocular, and obscuration of a small foreign body by artifacts from an adjacent, larger foreign body.

Adolescent↗

PubMed1976

Positional shift of intraventricular blood clots demonstrated by computed tomography.

Computed tomography with the patient in the prone position was employed to obtain information in a case of intraventricular hematoma secondary to arteriovenous maliformation. A gravitational shift in the position of the intraventricular blood clots was demonstrated by a scan obtained with the patient in the brow-down position. Consideration is given to the possible use of the "prone EMI scan" for other intracranial problems of differential diagnosis.

Adolescent↗

PubMed1976

Intravenous hepatosplenography. Experiment evaluation of a new contrast material.

A new, lipoid-based experimental contrast material (AG 60-99) was intravenously infused into 29 rhesus monkeys. The injections resulted in dense hepatosplenograms, preserving diagnostic quality for over 24 hours, and enabling routine utilization of tomography. This technique is capable of demonstrating simulated hepatic masses as small as 5 mm in diameter in vivo. Limited histopathologic and toxicity studies showed no serious or lasting toxic manifestations from AG 60-99 and none of the animals died from it. AG 60-99 is felt to be potentially useful in the radiographic detection of early metastic or lymphomatous involvement of the liver and spleen.

Animals↗