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T Kahn

Publications and source records attributed to T Kahn.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Infratentorial brain tumors in childhood and adolescence--value of MRT in initial and recurrence diagnosis].

MRI is the current method of choice for the diagnosis of infratentorial tumors in children and adolescents. The present article discusses the individual tumor entities on the basis of their magnetic resonance imaging characteristics in the patient pool of 1991/1992. New magnetic resonance imaging procedures are considered for infratentorial vascular anomalies. In addition to its use in the primary diagnosis, the significance of MRI for the detection of recurrences is discussed. Problems arising after prior surgery and irradiation as well as metastasization through CSF pathways are also mentioned.

Adolescent↗
PubMed1993

[The selective arterial and venous MR angiography of intracranial arteriovenous malformations].

This study evaluates the usefulness of MR angiography (MRA) in analysing cerebral arterial blood supply and venous drainage in patients with intracranial arteriovenous malformations (AVM). Selective MRA of the carotid, middle cerebral or vertebrobasilar territories was performed by means of presaturation of up to three of the brain-supplying arteries at the level of the middle or lower neck (angled presaturation slabs). Results obtained with selective, non-selective arterial, as well as venous MRA in 13 consecutive patients were compared with the findings at intraarterial angiography, the latter serving as the "gold standard". Sensitivity in identifying major feeding arteries was 100%. Determination of the absolute and relative AVM sizes at selective MRA corresponded with IAA. The mean difference was 17.6 and 3.9% respectively. Both display of superficial and deep venous drainage was provided by 2-dimensional venous MRA. The authors conclude that selective MRA of cerebral arteries as used here is a powerful non-invasive method to demonstrate blood supply by single feeding vessels in intracranial malformations. 2D venous MRA permits an accurate evaluation of the venous drainage pattern.

Adult↗
PubMed1993

[Quantification of extracranial carotid stenosis. Magnetic resonance angiography and Doppler sonography versus intra-arterial angiography].

UNLABELLED: To assess various non-invasive techniques for quantifying internal carotid artery CA stenosis, per cent luminal diameter reduction on intraarterial angiograms (IAA) was measured in 63 patients with ICA stenosis or occlusion. These data were compared with independent measurements based on MR-angiography, continuous-wave (cw) Doppler ultrasonography, systolic peak flow velocity and colour Doppler assisted duplex imaging. Correlations with IAA were equally strong for MR angiography, cw Doppler and colour Doppler analysis (0.95; 0.92; 0.92). Positive predictive values for > or = 70% ICA stenosis were lower and negative predictive values were higher for cw Doppler (0.85; 0.92) and colour duplex analysis (0.81; 0.94) than for MR angiography (0.86; 0.88). Statistical analysis showed non-linear correlations between percentage of lumen diameter narrowing and the length of the zone of signal intensity loss (0.72) and maximum systolic peak flow velocity (0.77). CONCLUSION: Several non-invasive methods do compare with IAA in identifying and quantifying high-grade ICA stenosis and may suffice for decisions on treatment.

Adult↗
PubMed1993

[The hemodynamics and anatomy of the circle of Willis. The technic and clinical value of selective MR angiography].

This study evaluates the usefulness of MR angiography in analysing the individual collateral flow dynamics and anatomy of the circle of Willis in 56 patients with high-grade extracranial carotid stenosis or occlusion. Selective MRA of the carotid or vertebrobasilar area was performed by means of presaturation up to the brain-supplying arteries at the level of the middle neck (angled presaturation slabs). Results obtained with selective and non-selective MRA in 56 consecutive patients were compared with the findings at transcranial Doppler ultrasonography and arterial angiography. Ischaemic cerebral infarctions were classified by computerized tomography and correlated with the results of collateral flow analysis: Sensitivity of selective MRA in detecting intracranial collateral flow via anterior or posterior communicating artery was 96 and 97%, respectively; sensitivity in depicting extracranial transorbital flow was lower (71%). Non-selective MRA was 100% sensitive in detecting a non-filling of the horizontal (A1) segment of the anterior cerebral artery and in identifying an origin of the posterior cerebral artery from the intracranial carotid artery. Slow flow infarctions occurred more frequently in patients with transorbital and posterior-to-anterior collateral flow than in patients with collateral flow via anterior communicating artery.

Angiography↗
PubMed1993

The genetic drift of human papillomavirus type 16 is a means of reconstructing prehistoric viral spread and the movement of ancient human populations.

We have investigated the diversity of a hypervariable segment of the human papillomavirus type 16 (HPV-16) genome among 301 virus isolates that were collected from 25 different ethnic groups and geographic locations. Altogether, we distinguished 48 different variants that had diversified from one another along five phylogenetic branches. Variants from two of these branches were nearly completely confined to Africa. Variants from a third branch were the only variants identified in Europeans but occurred at lower frequency in all other ethnic groups. A fourth branch was specific for Japanese and Chinese isolates. A small fraction of all isolates from Asia and from indigenous as well as immigrant populations in the Americas formed a fifth branch. Important patterns of HPV-16 phylogeny suggested coevolution of the virus with people of the three major human races, namely, Africans, Caucasians, and East Asians. But several minor patterns are indicative of smaller bottlenecks of viral evolution and spread, which may correlate with the migration of ethnic groups in prehistoric times. The colonization of the Americas by Europeans and Africans is reflected in the composition of their HPV-16 variants. We discuss arguments that today's HPV-16 genomes represent a degree of diversity that evolved over a large time span, probably exceeding 200,000 years, from a precursor genome that may have originated in Africa. The identification of molecular variants is a powerful epidemiological and phylogenetic tool for revealing the ancient spread of papillomaviruses, whose trace through the world has not yet been completely lost.

Africa↗
PubMed1993

Between-method correlation in quantifying internal carotid stenosis.

BACKGROUND AND PURPOSE: The degree of internal carotid stenosis has emerged as the most important predictor of ischemic stroke in extracranial carotid artery disease. The purpose of this study was to assess the validity of the noninvasive techniques for quantifying internal carotid stenosis with respect to the accepted standard of intra-arterial angiography. METHODS: We measured the maximum percentage reduction in luminal diameter on the intra-arterial digital subtraction angiograms of 56 symptomatic patients with extracranial internal carotid stenosis (n = 77) or occlusion (n = 20). These data were compared with independent measurements based on continuous-wave Doppler ultrasonography, pulsed-wave Doppler spectrum analysis, color Doppler-assisted duplex imaging, and magnetic resonance angiography. RESULTS: Correlations with intra-arterial angiography were equally strong (r > .90) for magnetic resonance angiography, continuous-wave Doppler, and color duplex analysis. Positive and negative predictive values for (therapeutically relevant) 70% to 99% stenosis were higher for continuous-wave Doppler (.82, .97) and color duplex (.84, .98) than for magnetic resonance angiography (.79, .81). Also, accuracy in quantifying high-grade stenosis was better for both of these ultrasonographic techniques, mainly due to the frequent occurrence of a "flow gap" on the magnetic resonance angiograms. Continuous-wave Doppler and magnetic resonance angiography, but not color duplex, failed to detect slow residual arterial flow in one and two cases of symptomatic "pseudo-occlusion" of the internal carotid, respectively. CONCLUSIONS: (1) Several noninvasive methods compare well with intra-arterial angiography in identifying and quantifying high-grade internal carotid stenosis; (2) the use of these noninvasive methods may suffice for treatment decisions; and (3) because residual between-method disagreement is partly explained by principles of physics, the validity of continuous-wave Doppler and color duplex in quantifying 60% to 99% stenosis is likely to be underestimated by correlation with intra-arterial angiography.

Blood Flow Velocity↗
PubMed1993

[DNA identification of human papillomavirus in anogenital condyloma of a male population].

Human Papillomaviruses (HPV) are the cause of benign human anogenital lesions where HPV 6 and HPV 11 are most commonly found. Conversely, HPV 16, 18, 31 and 33 are frequently detected in genital carcinomas and are thus considered as oncogenic types. In order to analyze the prevalence of specific HPV types in an Argentine male population, 43 anogenital lesions from different patients with diagnosis of condyloma acuminata were analyzed. These lesions were localized in different regions of the male genitalia comprising the corona glandis, urethral meatus, skin of the penis, scrotum and anus. The biopsies were screened for the presence of HPV 6, 11, 16, 18, 30, 31 and 33 by Southern blot at different stringent conditions of hybridization (Tm -48 degrees C and Tm -20 degrees C). HPV DNA was found in 41 examined cases (95.3%) with a clear prevalence of HPV 6 and HPV 11 types (51.2% and 23.3% respectively). Six samples (14.0%) were positive only under nonstringent conditions of hybridization. Mixed infections between HPV 16, 18, 30, 31, 33 or a HPV 30 related type with HPV 6 or HPV 11 were detected in 8 specimens (18.6%). Only one case was between HPV 16 and HPV 30. Two additional samples were only positive for HPV 30. Experiments in progress about the prevalence of HPV types in female lesions as well as in normal subjects will contribute to complete the description of the epidemiology of these infections in Argentina.

Adult↗
PubMed1992

Molecular cloning, analysis, and chromosomal localization of a mouse genomic sequence related to the human papillomavirus type 18 E5 region.

The E5 open reading frame (ORF) from bovine papillomavirus type 1 (BPV 1) as well as the E5 ORFs from human papillomaviruses (HPV) type 6 and type 16 have been reported to transform immortalized rodent cells. In an analysis of murine and human tumors for the presence of putative papillomavirus-related sequences, we cloned amplified cellular sequences from the mouse cell line Eb that cross-hybridized with the E5 ORF of HPV 18. A 2.1-kb fragment termed HC1 was sequenced. In normal murine cells, it was present as a single-copy genomic sequence located on chromosome 8. A region of 213 nucleotides corresponded to the E5 gene (HC1 E5), based on the best alignments and on the presence of direct and inverted repeats bearing a central sequence motif. These structural elements are also present in the HPV 18 E5 ORF. HC1 E5 contained an ORF that was transcribed bidirectionally. The transcription in the E5 direction was enhanced in RNA obtained from organs and tumors from carcinogen-treated animals and C127 cells. The polypeptide deduced from the sequence was related to E5 proteins from genital papillomaviruses, to the putative product of the Q300 mouse gene, and to several viral and human growth factors. The data suggest that there may be several cellular counterparts to the viral E5 proteins.

Amino Acid Sequence↗
PubMed1992

Sudden loss of hearing and vestibular function, muscular weakness, and multiple white matter lesions in preschool children.

Sudden cochlear hearing loss, occurring successively or simultaneously in both ears, was observed in four unrelated preschool children. Vestibular testing could be carried out in three patients and showed complete bilateral loss of function. All patients had a mildly retarded motor development due to nonprogressive muscular weakness. On MR imaging all patients showed multiple periventricular and subcortical white matter lesions. These lesions were not clearly progressive in one patient examined repeatedly over 6 years. Virological, bacteriological, immunological, and metabolic examinations were normal in all patients. Muscle biopsy showed morphologically abnormal mitochondria in two and lipid storage in one patient. No indications have been found for a disturbed functioning of the muscle mitochondria. The identical pattern and course of the disease in these patients suggests a new nosological entity, the aetiology of which can only speculatively be attributed to a vascular process associated with a mitochondriopathy.

Biopsy↗
PubMed1992

Seroprevalence of antibodies to the human immunodeficiency virus in dialysis workers: results of a multi-center study.

The Center for Devices and Radiological Health, in collaboration with the Department of Veterans Affairs Medical Center, Brooklyn, N.Y., conducted a multi-center, multi-institutional study of the seroprevalence of antibodies to the human immunodeficiency virus (HIV) among dialysis workers. Seven dialysis units and 112 dialysis workers participated in the study over a period of 2 years. Participation was limited to dialysis workers who, by questionnaire, denied non-occupational risk factors for HIV infection. The vast majority of the study participants were drawn from areas where the prevalence of HIV infection and AIDS cases are substantially greater than the national average. Study participants received the ELISA test for HIV antibodies. All 112 of the participants tested negative for HIV antibodies. These results are encouraging, as they failed to reveal unrecognized occupational transmission of HIV infection among dialysis workers.

HIV↗
PubMed1991

Presence and integration of human papillomavirus type 6 in a tonsillar carcinoma.

Human papillomavirus type 6 subtype a (HPV-6a) was detected in a human invasive tonsillar carcinoma. Southern blot hybridization analysis showed the presence of additional bands when using non-cutting and single-cut restriction enzymes. Molecular cloning yielded two recombinant clones of 8.0 and 1.4 kb in size. The first represents the complete HPV-6a genome. Sequence analysis of the second clone showed a 0.6 kb DNA sequence corresponding to the L2 region of HPV-6a, whereas the rest belongs to cellular sequences. These data show the presence of a usually low risk HPV type in an invasive carcinoma, at an unusual infection site, with viral DNA integrated into the host genome. These findings add evidence in support of the hypothesis of a relationship between HPV infection and at least some ororespiratory cancers.

Base Sequence↗
PubMed1991

[MRT in syringomyelia--follow-up control after syringo-arachnoid shunt surgery with clinical correlation].

In 8 patients with syringomyelia, MR long-term follow-ups (observation period 25-46 months) were done after syringosubarachnoidal shunt operations. MR showed directly after surgery in 6 cases an extensive collapse of the syringomyelias and in 2 cases a lesser reduction of the diameter of the syrinx. During the subsequent course the size of the cavities increased again in 3 cases. The size of the syrinx visualised by MR did not correlate with the clinical status during the follow-up studies. This seems to point to an insufficient representation of the disease process by the morphological visualisation of the size of the syrinx.

Adult↗
PubMed1991

Accuracy of imaging modalities in staging the local extent of prostate cancer.

In this study, none of the evaluated clinical staging methods was found to predict reliably the presence or absence of extracapsular growth of histologically proved carcinoma of the prostate. In this respect, digital rectal examination, transrectal ultrasound, CT, and MR imaging cannot contribute to treatment decisions in localized prostate cancer. Further studies are under way to determine the value of 7.5-MHz scanners in transrectal ultrasound and high-resolution surface coils in MR imaging.

Biopsy↗
PubMed1990

Sulcus topography of the parietal opercular region: an anatomic and MR study.

The study describes the sulcal and gyral topography, variability, and left-right asymmetry of the parietal operculum. Eighty postmortem hemispheres as well as sagittal magnetic resonance images from 20 health volunteers (40 hemispheres) were evaluated. Four different types of parietal opercular sulcus topography were recognized. Most frequently, and conforming with the anatomic "textbook pattern", the inferior postcentral sulcus (POCS) is the sulcus anterior to the posterior ascending ramus (PAR) of the Sylvian fissure (type 1). Variations were the following: lack of a PAR (type 2), interposition of an intermediate opercular sulcus and gyrus between PAR and POCS (type 3), and direct transition of PAR into POCS with subsequent lack of a classical supramarginal gyrus (type 4). Inconstancy of the sulcal standard arrangement was especially pronounced among left hemispheres, where the patterns differed from type 1 in one third of the cases. Types 2 and 3 were significantly more frequent in left hemispheres, whereas type 4 occurred significantly more frequently in right hemispheres. Upon intraindividual left-right comparison, a remarkable 38% of the brains showed gross asymmetry of the parietal opercular sulcus patterns, characterized by a left type 2 or 3 and/or a right type 4; another 5% exhibited a reverse type of asymmetry. The findings supplement previous data on gross variability and left-right asymmetry of the posterior Sylvian fissure and its lower bank. They indicate that the Sylvian fissure is an unreliable landmark with respect to inferior parietal structures especially in left hemispheres. Individual mapping of perisylvian topography may contribute to studies on structural-functional relationship.

Adult↗
PubMed1990

Serum creatinine in patients with spinal cord injury.

In a group of 18 male patients with spinal cord injury, we found serum creatinine to be within normal limits or only minimally elevated despite significant reduction in creatinine clearance. In 8 control subjects with serum creatinine between 1.0 and 1.5 mg/dL (88.4 and 132.6 mumol/L), the measured creatinine clearance was 66.4 +/- 28.2 mL/min. In contrast, in the 5 patients with spinal cord injury whose serum creatinine was in the same range, the measured creatinine clearance was only 31.0 +/- 19 mL/min. Urinary creatinine excretion was lower in patients with spinal cord injury than in the 18 male controls (653 mg/24 hr vs. 1505 mg/24 hr). The decreased urinary creatinine could not be explained by differences in age, sex, or body weight. We calculated the relationship of creatinine clearance (Ccr) and serum creatinine (Scr) in patients with spinal cord injury to be given by the equation Ccr (mL/min) = 45/Scr (mg/dL), r = 0.73. We recommend timed urine collections for creatinine to estimate creatinine clearance accurately for clinical evaluation of patients with spinal cord injury.

Creatinine↗