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Biomedical subjects

R M Kessler

Publications and source records attributed to R M Kessler.

At least 73 records · Page 4Linked to original sources

Glucose utilization of cerebral gliomas measured by [18F] fluorodeoxyglucose and positron emission tomography.

Positron emission tomography was used to measure local cerebral glucose utilization by the 1-[18F]fluoro-2-deoxy-D-glucose technique in 23 patients with cerebral gliomas. All 10 high-grade (III and IV) astrocytomas demonstrated a region of high activity with a glucose consumption of 7.4 +/- 3.5 (SD) mg/100 gm per minute. The 13 low-grade (I and II) gliomas had a glucose metabolic rate of 4.0 +/- 1.8 mg/100 gm per minute, with no distinctly visible hot spot. Thus, we found a correlation between rate of glycolysis and malignancy in primary cerebral tumors. Cerebral cortical glucose utilization was often depressed in areas adjacent to or neurally connected to the tumor site, and there was focal irregular delta wave EEG activity in these areas.

Adult↗

Real-time sonographic detection of vesicoureteral reflux in children.

Real-time sonography and the principle of contrast sonography were used for evaluation of vesicoureteral reflux in children. Fifty-five kidneys were examined during the filling phase of cystourethrography. Of 15 positive cystograms, with grade II or greater reflux, 13 sonograms were positive. A positive sonogram was defined as visualization of moving microbubbles within the renal collecting system and/or dilatation of the collecting system during the course of bladder filling. This method may prove to be of value in the management of children with vesicoureteral reflux, particularly because sonography provides good visualization of renal size and parenchymal scarring while simultaneously demonstrating reflux.

Child↗

Leg function after radiotherapy for Ewing's sarcoma.

Twenty-nine patients with Ewing's sarcoma of the lower extremity who survived for two or more years following therapy (5000 rad locally and systemic chemotherapy) were studied to assess functional status of the affected leg. Twenty-two of twenty-nine were alive and were reexamined; the deceased patients were evaluated by record review. Twenty-two of the twenty-nine had serial radiographs, which were reviewed to assess growth change induced by radiation. The living patients were divided on the basis of clinical examination into four functional groups with Group I comprising patients with minor functional limitations and leg length discrepancy 1.5 cm or less. Group II patients had moderate functional limitations with 2.5-cm leg-length discrepancy or less. Group III patients had severe functional limitations with up to 4-cm leg length discrepancy. Group IV patients had severe complications, sufficient enough to warrant amputation. Thirteen of twenty-two patients were classified as functional Group I, five as Group II, three as Group III, and one as Group IV. Radiographic changes in growing bone did not correlate with functional results. Although a femoral fracture and an age less than 16 years at diagnosis were found to be less favorable prognostic factors for the functional treatment result, these results show that neither femoral location nor young age justify primary amputation for Ewing's sarcoma of the lower leg extremity.

Adolescent↗

Mesenteric vascular gas secondary to ischemic bowel in transmesenteric hernia.

A transmesenteric herniation of bowel with subsequent bowel ischemia in a thirteen-year-old boy is reported. Radiographic findings were that of abdominal mass and branching radiolucencies secondary to gas within the mesenteric vasculature. The unusual distribution of vascular gas (mesenteric rather than portal) is thought to be secondary to obstruction of mesenteric veins by strangulation.

Adolescent↗

Optimum energy for performing CT iodinated constrast studies.

A study has been made of CT contrast for iodine as a function of X-ray energy from 80 to 140 kV constant potential. The EMI CT 1010 scanner was used for phantom measurements of contrast signal, noise, artefact and dose. The results show that optimum detectability occurs at 80-100 kV, with the close efficiency being somewhat better at 80kV.

Models, Structural↗

[Beta-glycosidase system of sunflowers. Isolation of enzyme and study of their substrate specificity].

The beta-glucosidase, beta-galactosidase, beta-xylosidase and alpha-L-arabinosidase activities of a partially purified preparation from sunflower seeds were studied by chromatography, polyacrylamide gel electrophoresis and isoelectrofocusing. beta-Glucosidase was isolated as two fractions with high molecular weights. One form of beta-glucosidase does not possess strict specificity to stereochemistry of hexosides C-4 and C-6 and pentosides C-5, whereas the second form exhibits a narrow specificity for C-4 and is low specific towards substituents of C-5. The sunflower seeds also contain acid beta-galactosidase, which possesses a narrow specificity and is not coupled with the beta-glucosidase activity. The molecular weight of beta-galactosidase is 62000.

Glycoside Hydrolases↗

Left ventricular size and function in women receiving oral contraceptives.

Echocardiography and systolic time-interval measurements were performed to assess left ventricular size and function in 15 women receiving oral contraceptives and in a control group. There was no significant difference in heart rate (78 +/- 9 verus 72 +/- 12 beats/min), blood pressure (116 +/- 8/72 +/- 7 versus 110 +/- 11/67 +/- 9 mmHg), left ventricular ejection time/preejection period (LVET/PEP) (0.31 +/- 0.05 versus 0.29 +/- 0.05), left ventricular internal dimension in diastrol (4.3 +/- 0.3 versus 4.3 +/- 0.5 cm) or systole (2.7 +/- 0.3 versus 2.6 +/- 0.4 cm), shortening fraction (0.37 +/- 0.05 versus 0.41 +/- 0.05), or mean normalized velocity of circumferential shortening (1.30 +/- 0.21 versus 1.31 +/- 0.23). Therefore, young, healthy women receiving oral contraceptives do not appear to be at increased risk with respect to abnormalities of ventricular volume or contraction.

Adolescent↗

Acute symptomatic disk prolapse. Clinical manifestations and therapeutic considerations.

Intervertebral disk prolapse is a relatively common cause of acute low back dysfunction. The resultant symptoms and signs can be explained by the pathomechanics and pathophysiology of the intervertebral disk. Clinical manifestations should be used to differentiate the prolapse from more severe disk protrusions and from other types of spinal pathology, for treatment must be pathology-specific. Primary goals of management should include: resolution of the acute problem, restoration of optimal segmental mechanics, restoration of an optimal activity level, prevention of recurrent physical dysfunction, and prevention of chronic pain behavior patterns.

Acute Disease↗

Tissue signatures with dual-energy computed tomography.

By providing information on two parameters, dual-energy computed tomography can offer clinically useful tissue signatures for metallic deposits (Ca) or injected iodine, as well as for different normal and abnormal types of brain parenchymal tissues and CSF. Cerebral CT was performed on 36 patients and tissue differences analyzed using Hounsfield notation.

Brain↗

[Substrate specificity of sweet almond beta-glucosidase].

Beta-Glucosidase, beta-galactosidase, beta-xylosidase and alpha-L-arabinosidase activities of partially purified preparation of almond emulsin were investigated using chromatography, electrophoresis in polyacrylamide gel and isoelectric focusing. Beta-Glucosidase was found to exist as two components having equal molecular weight. Aggregation of the components with inactive proteins probably results in the appearance of multiple native forms which have similar specific activities. In no case separation of the beta-glucosidase activity from the accompanied activities was achieved. It is concluded therefore that these activities are exhibited by an enzyme which is not strictly specific to the C4, C6 stereochemistry for hexosides and to that of C4, C5 for pentozides.

Arabinose↗

Impaired ventilation in a patient with angiographically demonstrated pulmonary emboli.

Matched regional ventilation/perfusion studies (V/Q) have traditionally been associated with ventilatory diseases, while mismatched V/Q studies have been associated more often with vascular abnormalities. The authors describe a patient with multiple pulmonary emboli who demonstrated matched ventilation and perfusion studies five hours after the onset of symptoms.

Adult↗

Retrospective registration of PET and MR brain images: an algorithm and its stereotactic validation.

OBJECTIVE: We present a validation study of an algorithm for retrospective registration of PET and MR brain images. MATERIALS AND METHODS: This algorithm involves two steps. In the first step, the two volumes are reformatted by aligning their interhemispheric fissure planes (midsagittal plane). In the second step, the corresponding planes parallel to the midsagittal plane are further aligned in the reformatted volumes to produce a 3D rigid body registration of the two original volumes. It is an efficient algorithm because both steps are performed in 2D spaces, and in each step only a small number of landmarks are required. A user-friendly system has been implemented to facilitate easy and fast processing of registration and reformatting of image volumes. The accuracy of this algorithm is validated using clinical scans of neurosurgical patients with a stereotaxic frame attached to their skull. The frame-based stereotaxic system provides an effective method for transforming image coordinates from different image volumes into a common coordinate system. This common coordinate system is used for assessing the spatial correspondence of each pixel in the registered image volumes. Validation using the stereotaxic image volumes enables objective estimation of retrospective registration accuracy. RESULTS: Analysis of 11 MR/PET image pairs indicates that our registration method not only is efficient but also provides adequate accuracy for most clinical evaluation of PET studies. CONCLUSION: We have implemented and validated an efficient algorithm for retrospective registration of PET and MR brain images.

Adult↗

Case report. MR and CT appearance of cardiac hemangioma.

We present a case of cardiac hemangioma in a symptomatic patient. MR and CT each have specific characteristics that should make one consider including or excluding this in the differential diagnosis of a cardiac tumor.

Adult↗

Comparison and evaluation of retrospective intermodality brain image registration techniques.

PURPOSE: The primary objective of this study is to perform a blinded evaluation of a group of retrospective image registration techniques using as a gold standard a prospective, marker-based registration method. To ensure blindedness, all retrospective registrations were performed by participants who had no knowledge of the gold standard results until after their results had been submitted. A secondary goal of the project is to evaluate the importance of correcting geometrical distortion in MR images by comparing the retrospective registration error in the rectified images, i.e., those that have had the distortion correction applied, with that of the same images before rectification. METHOD: Image volumes of three modalities (CT, MR, and PET) were obtained from patients undergoing neurosurgery at Vanderbilt University Medical Center on whom bone-implanted fiducial markers were mounted. These volumes had all traces of the markers removed and were provided via the Internet to project collaborators outside Vanderbilt, who then performed retrospective registrations on the volumes, calculating transformations from CT to MR and/ or from PET to MR. These investigators communicated their transformations again via the Internet to Vanderbilt, where the accuracy of each registration was evaluated. In this evaluation, the accuracy is measured at multiple volumes of interest (VOIs), i.e., areas in the brain that would commonly be areas of neurological interest. A VOI is defined in the MR image and its centroid c is determined. Then, the prospective registration is used to obtain the corresponding point c' in CT or PET. To this point, the retrospective registration is then applied, producing c" in MR. Statistics are gathered on the target registration error (TRE), which is the distance between the original point c and its corresponding point c". RESULTS: This article presents statistics on the TRE calculated for each registration technique in this study and provides a brief description of each technique and an estimate of both preparation and execution time needed to perform the registration. CONCLUSION: Our results indicate that retrospective techniques have the potential to produce satisfactory results much of the time, but that visual inspection is necessary to guard against large errors.

Brain↗

Craniopharyngioma: CT and MR imaging in nine cases.

Magnetic resonance (MR) imaging and CT examinations were performed in nine patients with surgically proven craniopharyngioma. Computed tomography was found to be superior to MR in detection of calcification and cyst formation. Extent of involvement of adjacent structures (e.g., optic chiasm, third ventricle, and intracavernous carotid artery) was more clearly delineated by MR. Craniopharyngioma fluid collections were found to be uniformly bright on T2-weighted sequences. However, on T1-weighted sequences, the signal intensity of the fluid ranged from hypointense to hyperintense, reflecting the heterogeneous contents of cysts in these tumors. Since calcification and cyst formation are hallmarks of craniopharyngiomas, we believe that CT is more specific than MR in diagnosis of craniopharyngiomas. Magnetic resonance, however, offers a more accurate assessment of the tumor extent.

Adolescent↗