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Biomedical subjects

R J Herzog

Publications and source records attributed to R J Herzog.

At least 19 recordsLinked to original sources
PubMed2001

Megadose transplantation of purified peripheral blood CD34(+) progenitor cells from HLA-mismatched parental donors in children.

We performed HLA-mismatched stem cell transplantation with megadoses of purified positively selected mobilized peripheral blood CD34(+) progenitor cells (PBPC) from related adult donors in 39 children lacking an otherwise suitable donor. The patients received a mean number of 20.7 +/- 9.8 x 10(6)/kg purified CD34(+) and a mean number of 15.5 +/- 20.4 x 10(3)/kg CD3(+) T lymphocytes. The first seven patients received short term (<4 weeks) GVHD prophylaxis with cyclosporin A, whereas in all the following 32 patients no GVHD prophylaxis was used. In 38 evaluable patients, five patients experienced primary acute GVHD grade I and one patient grade II. In 32 patients, no signs of primary GVHD were seen and GVHD only occurred after T cell add backs. T cell reconstitution was more rapid if the number of transplanted CD34(+) cells exceeded 20 x 10(6)/kg. Of the 39 patients, 15 are alive and well, 13 died due to relapse and 10 transplant-related deaths occurred. We conclude that the HLA barrier can be overcome by transplantation of megadoses of highly purified mismatched CD34(+) stem cells. GVHD can be prevented without pharmacological immunosuppression by the efficient T cell depletion associated with the CD34(+) positive selection procedure. This approach offers a promising therapeutic option for every child without an otherwise suitable donor.

Adolescent↗
PubMed2000

Nonsurgical treatment for radicular of pain of zygoapophyseal joint cyst origin: therapeutic selective nerve root block.

We report the first case of zygoapophyseal joint cyst-induced radicular pain successfully treated with therapeutic selective nerve root block. A 56-year-old dentist presented with pain involving the lateral thigh, lateral calf, and foot dorsum that worsened with standing and walking. Magnetic resonance imaging of the lumbar spine showed a cyst emanating from the right L4-L5 zygoapophyseal joint, resulting in central canal and lateral recess stenosis. The patient was treated with two fluorscopically guided therapeutic L5 selective nerve root blocks. The patient remained pain free at 18-month follow-up.

Cysts↗
PubMed1999

Unknown case.

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1997

Changes in bone mineral content in obese dieting women.

Significant reductions in total-body bone mineral density (BMD) have been reported in obese women who consume very-low-calorie diets. A reduction in bone mass is highly correlated with an increased risk of osteoporosis. The present study investigated whether strength training would prevent such reductions in dieters. Twenty-one healthy obese women weighing (mean +/- SD) 91.1 +/- 9 kg and aged 38 +/- 9 years were randomly assigned to receive either diet alone or diet plus resistance training. Both groups consumed a 925-kcal/d portion-controlled diet for the first 16 of 17 weeks and a 1,000 to 1,500-kcal/d balanced deficit diet thereafter. Bone mineral content (BMC), BMD, fat-free mass (FFM), and fat mass were measured with dual-energy x-ray absorptiometry (DEXA) before and after 24 weeks of dieting. No significant changes in total-body or lumbar spine BMC and BMD were observed in either condition at the end of treatment. However, both groups demonstrated a significant loss of both BMC and BMD in the femoral neck and greater trochanter. Diet plus resistance training was not associated with a significantly better outcome on either of these measures versus diet alone. The results suggest that increasing the energy content of very-low-calorie diets to 925 kcal/d may prevent the loss of total BMD, but not the loss from the femoral neck and greater trochanter. These findings raise a concern in light of the high frequency of dieting in American women.

Adult↗
PubMed1996

The radiologic assessment for a lumbar disc herniation.

With magnetic resonance imaging and computed tomography, there now are two excellent diagnostic imaging modalities to detect noninvasively the presence of lumbar disc abnormalities and to follow the natural history of pathologic changes of a disc, with or without therapeutic interventions. The clinical significance of the information provided by these two imaging methods can be determined only by precise correlation of the results of a magnetic resonance imaging or computed tomography study to a patient's history, physical examination, and other diagnostic tests. With controlled prospective clinical studies, it may be possible to learn what type of abnormal changes detected on a magnetic resonance imaging or computed tomography study may have prognostic value in predicting patient outcome.

Humans↗
PubMed1996

Consensus summary of the diagnosis and treatment of lumbar disc herniation.

Clinicians must not simply decide that a patient with symptoms and a positive diagnostic test has a reason for a specific treatment, and likewise clinicians must not decide that a patient with symptoms and a negative test does not have a clinically important problem. We must also consider the sensitivity, specificity and predictive value of the diagnostic test and the individual characteristics of the patient. Treatment outcome depends on many factors. Point of service decisions vs population based decisions are obviously different. Each patient presents to the treating practitioner on a given day, at a given time, and it is this picture upon which a plan of care is formulated.

Humans↗
PubMed1996

Assessment of spinal fusion. Critical evaluation of imaging techniques.

Before any radiologic imaging modality is employed in an investigation study, its efficacy must be critically assessed. The purpose of this report is to demonstrate how the choice of computed tomography imaging parameters affects the information provided by a computed tomographic examination. It is apparent from these results that imaging parameters must be optimized before the results of an imaging technique can be compared to other modes of diagnostic evaluation, including surgical observations.

Data Collection↗
PubMed1995

Magnetic resonance imaging. Use in patients with low back or radicular pain.

With the current emphasis on cost containment, it is important to order the single best diagnostic test when clinical uncertainties must be resolved. Magnetic resonance imaging is currently the optimal imaging modality to provide the maximum amount of information when evaluating patients with suspected spinal disorders. A comprehensive magnetic resonance imaging study is needed along with a subspecialty interpretation to provide the greatest amount of useful clinical information.

Humans↗
PubMed1994

Efficacy of magnetic resonance imaging of the elbow.

Elbow dysfunction is usually related to acute or chronic injury to the soft tissue components of the elbow. Prior to the development and application of magnetic resonance imaging (MRI), radiologic evaluation of the elbow was primarily limited to the detection of osseous abnormalities. The value of MRI to accurately determine the nature and extent of the pathologic changes in ligaments, tendons, muscles, and the osseous structures of the elbow joint is presented in the following discussion.

Humans↗
PubMed1993

Magnetic resonance imaging of the elbow.

With the current popularity of racket and throwing sports, the number of individuals seeking medical care for elbow pain and dysfunction has increased rapidly. Before the development and implementation of magnetic resonance imaging (MRI), radiologic imaging examinations provided the treating physician limited information to determine the precise etiology of elbow disorders, because they usually involve soft-tissue structures. With MRI, it is now possible to accurately assess the integrity of the ligaments, tendons, and muscles surrounding the elbow, and to detect pathologic changes in these tissues secondary to acute macrotrauma or chronic microtrauma, e.g., overuse injuries. By defining the nature and extent of these abnormalities, the choice of the appropriate therapeutic regimen is facilitated. With MRI, it is also now possible to noninvasively evaluate the natural history of these soft-tissue disorders and to determine the effects of different therapeutic interventions.

Elbow Joint↗
PubMed1992

The value of somatosensory evoked potential testing for upper lumbar radiculopathy. A correlation of electrophysiologic and anatomic data.

Patients with lumbar pain syndromes can present with a complex variety of complaints. Most clinicians focus on the lower lumbar nerve roots, but upper lumbar radicular syndromes can provide an especially difficult diagnostic challenge to the spine specialist requiring a multimodal approach to sort out diagnostic complexities. The purpose of this study was to analyze the correlation of somatosensory evoked potential findings with documented spinal pathology demonstrated on morphologic studies, thereby determining whether somatosensory evoked potential testing has a place in spinal diagnosis. The results of this study demonstrated the correlation of somatosensory evoked potential findings with anatomic abnormalities noted on computed tomographic and magnetic resonance imaging scans and discograms. Somatosensory evoked potential testing is recommended not as an isolated test, but as part of an electrophysiologic battery that would also include conventional electromyography.

Electromyography↗
PubMed1992

Imaging of the knee.

Acute and chronic knee dysfunction is a common clinical problem faced by physicians treating patients with musculoskeletal disorders. While standard roentgenograms provide most of the information needed to assess these disorders, the role of magnetic resonance imaging (MRI) is rapidly increasing in the diagnostic evaluation of soft-tissue, ligament, tendon, and osseous abnormalities. This article focuses on the role of MRI in the evaluation of disorders of the knee.

Cartilage, Articular↗