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R Heinz

Publications and source records attributed to R Heinz.

At least 55 records · Page 3Linked to original sources
PubMed1994

MR and positron emission tomography in the diagnosis of surgically correctable temporal lobe epilepsy.

PURPOSE: To determine the association of an MR abnormality and a positron emission tomography (PET) abnormality with a good outcome in patients with temporal lobe epilepsy after lobectomy, the association of combined PET and MR findings with good outcomes after lobectomy, and MR and PET pathologic correlation. METHODS: MR and PET were performed on 27 patients in a blinded study. Histologic studies were correlated with foci of increased T2 signal. RESULTS: Increased signal or decreased volume of the hippocampus was noted in 13 of 15 patients with mesial temporal sclerosis. Twelve of 15 had positive PET findings. MR identified 20 (83%) of the 24 patients with good outcomes. PET identified 71%. When MR and PET were combined, they detected 95% of the patients with good outcome. Region of interest measurements of the hippocampus in 11 study patients and 7 control subjects documented a significant increase in signal in the patients with seizures. Histologic correlative studies demonstrated that increased T2 signals related to astrocytosis in the hippocampus and adjacent white matter. CONCLUSIONS: MR (increased signal and decreased volume of the hippocampus) significantly improved the capability to identify those persons who would be helped by lobectomy. MR sensitivity exceeded that of PET.

Adolescent↗
PubMed1994

[Therapy of low-grade non-Hodgkin's lymphoma].

Untreated patients with low-grade non-Hodgkin's lymphoma (NHL) demonstrate a natural course of the disease differing from between a few months and decades. Prognostic factors to assess survival probability have recently been defined. Cure seems possible in the rare localized stages by irradiation. In advanced stages watchful waiting is still indicated. There is not enough evidence at present that aggressive induction prolongs survival. However, approaches such as autologous bone marrow transplantation or peripheral stem cell transfusion are currently being investigated in clinical trials but so far information is still lacking on the quality of life and the incidence of late complications such as the development of a second malignancy. Interferon alpha may have an influence on prolonging the duration of remission in follicular lymphoma. The poor prognosis of low-grade T-cell NHL and centrocytic lymphoma (CC) stresses the necessity for new therapeutic modalities. Purine analogues show efficacy in some subtypes of NHL and further investigations are warranted.

Combined Modality Therapy↗
PubMed1993

[Interferon therapy in Hodgkin's disease].

Though there are only limited reports interferon (IFN) seems an interesting substance for patients with Morbus Hodgkin. Overall response rate is about 20% in heavily pretreated patients. Even patients after bone marrow transplantation showed response. This suggests to treat patients in a earlier phase of their disease. Combination of interferon with radiotherapy or chemotherapy might be promising. Prospective studies investigate the value of IFN for maintenance. It seems that patients treated with IFN have less relapses and better immunorestorations. Whether IFN can prevent secondary malignancies is also topic of these investigations. As IFN has complex side effects it should be applied only in controlled studies.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

MACOP-B treatment in patients with Ki-1-positive large-cell anaplastic lymphoma.

Nine adult patients with Ki-1-positive large-cell anaplastic lymphoma were treated with MACOP-B. Two suffered from relapsed disease and had previously received chemotherapy; a third patient had received a single dose of 100 mg/m2 cisplatin before initiation of MACOP-B. The stage of lymphoma was determined according to the Ann Arbor Conference criteria and was II in one, III in two and IV in six patients. All patients had constitutional symptoms. Five patients had achieved complete remission 4 weeks after termination of the protocol and there were two partial remissions. One patient died of massive pulmonary embolism during the 4th week of treatment; another patient, who had received MACOP-B as salvage therapy, died of progressive lymphoma 1 month after completion of the regimen. Maximal observed toxicities according to WHO were mucositis grade 3 (n = 3) and there were three cases with thromboembolic complications, including a fatal pulmonary embolism in a young patient. However, MACOP-B appears an effective, fairly well-tolerated and feasible therapy for patients with Ki-1-positive large-cell anaplastic lymphoma.

Adult↗
PubMed1992

Exophytic syrinx, an extreme form of syringomyelia: CT, myelographic, and MR imaging features.

Magnetic resonance (MR) imaging and computed tomography (CT) were used to study severe syringomyelia, in which the syrinx was so eccentric relative to the center of the spinal cord that at initial examination it appeared to be an exophytic extramedullary mass, in five of six patients with type 2 Arnold-Chiari malformation and one patient with an intramedullary tumor. Sagittal and axial images were routinely obtained at 1.5 T; CT was performed after intrathecal injection of contrast material. On sagittal MR images, the exophytic component of the syrinx typically displaced the spinal cord peripherally and mimicked an extramedullary intradural lesion such as an arachnoid cyst or meningioma. On axial MR images, the gradual appearance and disappearance of this component could be traced as it compressed the spinal cord, which had a signet-ring appearance at the equator of the syrinx. It is concluded that both MR imaging and postmyelographic CT can reveal the characteristics of this lesion on axial images, but MR imaging is superior because it enables direct sagittal imaging.

Adolescent↗
PubMed1992

Evaluation of complex cystic masses of the brain: value of steady-state free-precession MR imaging.

OBJECTIVE: This study evaluated the effectiveness of steady-state free-precession (SSFP) MR imaging of complex cystic masses of the brain compared with that of conventional T1- and T2-weighted spin-echo imaging. Our hypothesis is that SSFP MR images provide better characterization of these masses and facilitate more appropriate preoperative diagnoses and planning. SUBJECT AND METHODS: Axial T1-weighted and SSFP MR images and specimens for pathologic examination were obtained in seven consecutive patients, 9-81 years old, with cystic mass lesions of the brain and neurologic symptoms and signs directly related to the masses. Axial contrast-enhanced T1-weighted images were obtained in six patients, surgical exploration was done in five patients, and stereotaxic biopsy was done in two. After examination of the routine spin-echo and SSFP images, the usefulness of SSFP images was determined by how well they facilitated correct preoperative diagnosis. RESULTS: On SSFP MR images, the solid or inhomogeneous components of a cystic mass had extremely low signals in contrast to the high signal of surrounding fluid. On routine spin-echo images, however, the signals of these components were masked by the signal of the surrounding fluid. SSFP MR images helped markedly in diagnosis of hemorrhagic, epidermoid, and arachnoid cysts. In cases of enhancing brain tumors, SSFP MR images provided the same information that contrast-enhanced images did. Overall, when SSFP MR imaging was used, more information about the texture and constituents of the cystic mass was obtained, and a more useful diagnosis was made. CONCLUSION: Initial results show that SSFP MR imaging is a more useful technique than conventional spin-echo imaging for characterizing complex cystic masses of the brain. SSFP MR imaging (1) allows distinction of edema from tumor, (2) helps establish where biopsy has the best chance of providing tissue that will show pathologic changes, and (3) helps distinguish simple cysts from tumors, tumor-cyst, or multicompartmental cyst and may be particularly helpful in detecting the contents of hemorrhagic cysts.

Adult↗
PubMed1990

[Malignant lymphomas of the thyroid gland].

In the period from 1957-1989 43 malignant lymphomas of the thyroid gland were treated in the surgical department of Kaiser Elisabeth hospital. 42 were classified as non-Hodgkin lymphomas and one as a Hodgkin lymphoma. The sex distribution was 32 women (mean age 70) to 11 men (mean age 72). The patients were divided into two groups according to postoperative management. First group (1957-1978): conventional irradiation. N = 24 patients, mean survival time 5 months (0-37 months). Second group (1979-1989): high voltage irradiation and/or chemotherapy. N = 19 patients, mean survival time 39 months (1-128 months). All patients in the first group died, whilst in the second group only 9 have died to date. Moreover, 9 of the 10 patients who are still alive are in full remission. Over the past 10 years we have achieved a clear improvement in survival time; this is a result of extended radicality of the surgical procedures, haematological staging and an improvement in the chemotherapy and irradiation regimens.

Adult↗
PubMed1990

Long-term follow-up of CHOP-treated non-Hodgkin lymphoma of high-grade malignancy.

The long-term outcome of 116 NHL patients (38 CB, 33 IB, 24 LB, 11 high-grade unclassified, 9 PTCL, 1 Ki-1 lymphoma - see list of abbreviations) treated with an age-adjusted CHOP regimen from 1980-85 was evaluated. The median age was 64 years. Of these patients 28% had significant comorbidity. CB patients had the best outcome; the median survival was not reached after 110 months. However, the differences in survival of all histological entities are not significant (P = 0.08). Fifty-six percent of the patients had clinical stages I-II. The CR rate of all 116 patients was 47%. After a median follow-up of 58 months, 30% of the patients are alive and disease-free. Of 14 relapses 11 occurred within 2 years. The median time period before relapse was 9 months. Salvage therapy failed, as none of the IB and LB patients achieved CR. Five CB patients had CR with second-line therapy, four had PR after induction therapy, one patient relapsed after 30 months. Of the CR patients 15% developed second or third neoplasms. Only one instance of acute myeloblastic leukemia was observed. These results indicate that age-adjusted CHOP is a well-tolerated therapy.

Aged↗
PubMed1990

Ki-1-positive large cell lymphoma. A clinicopathologic study of 41 cases.

We report the clinicopathologic findings of 41 patients with Ki-1 (CD30)-positive large cell lymphoma. The median age was 50 years; 13 patients were under 40 years of age. Ten patients presented with extranodal disease. Fifty-five percent of the patients presented with stage I or II disease, and bone marrow involvement was histologically documented in 30% and occurred exclusively in patients over 40 years of age. Two cytomorphologically distinct groups of Ki-1--positive large cell lymphomas could be separated. Group A lymphomas consisted of pleomorphic large cells, sometimes with wreathlike and embryo-like nuclei, whereas group B lymphomas displayed a rather monomorphic appearance. Clinically the two groups of lymphomas differed with respect to stage of disease, frequency of bone marrow involvement, and median survival. On paraffin sections, the Ki-1--related antibody Ber-H2 provided excellent staining results in all cases. Immunologic phenotyping disclosed a T cell type in the majority of cases, revealed marked loss of differentiation antigens, and frequent expression of HLA-DR and IL-2 receptor. The overall median survival was 13 months. Age below 40 years, limited stage of disease (I and II), and, although not statistically significant, lymphoma morphology were associated with longer survival. We conclude, that Ki-1--positive large cell lymphomas represent a morphologically and immunologically heterogeneous category of hematolymphoid neoplasms derived from dedifferentiated and activated lymphoid cells with marked age-dependent prognosis.

Adult↗