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  • Electronic Resource  (239)
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  • 2010-2014
  • 2000-2004  (239)
  • Magnetic resonance imaging  (158)
  • chemotherapy  (81)
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  • Electronic Resource  (239)
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  • 101
    Electronic Resource
    Electronic Resource
    Magnetisation transfer ratio is low in normal-appearing cerebral white matter in patients with normal pressure hydrocephalus (2000)
    Springer
    Neuroradiology 42 (2000), S. 174-179 
    Details
    ISSN: 1432-1920
    Keywords: Key words Magnetisation transfer ; Normal-pressure hydrocephalus ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We measured the magnetisation transfer ratios (MTR) of normal-appearing rostral (PR) and caudal (PC) periventricular white matter, the genu (CG) and the splenium (CS) of the corpus callosum and the thalamus (TH) in 12 patients with normal-pressure hydrocephalus (NPH) and compared them with 16 healthy control subjects. We found a significantly lower MTR in the NPH group than in the normal group for PR, PC, CG, and CS but not for TH. MT measurements give additional information which cannot be gained by conventional MRI, suggesting that NPH is associated with diffuse white matter damage, even in normal-appearing cerebral white matter.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050040
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  • 102
    Electronic Resource
    Electronic Resource
    MRI appearances mimicking the dural tail sign: a report of two cases (2000)
    Springer
    Neuroradiology 42 (2000), S. 199-202 
    Details
    ISSN: 1432-1920
    Keywords: Key words Dural tail sign ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report two cases in which the MRI appearances mimicked the dural tail sign; a glioma extending into the subarachnoid space, and a meningioma extending to the subdural space. They indicate that tumour invasion into the subarachnoid or subdural space, should be considered when prominent linear enhancement is observed along the dura mater adjacent to tumours.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050045
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  • 103
    Electronic Resource
    Electronic Resource
    Aqueduct stenosis due to venous ectasia with a dural arteriovenous fistula (2000)
    Springer
    Neuroradiology 42 (2000), S. 267-271 
    Details
    ISSN: 1432-1920
    Keywords: Key words Aqueduct ; stenosis ; Fistula ; arteriovenous ; dural ; Magnetic resonance imaging ; Embolisation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report aqueduct compression by venous ectasia in a 65-year-old man with a dural arterio-venous fistula in the posterior cranial fossa draining into a superior vermian vein. Conventional and phase-contrast MRI showed the aqueduct stenosis and the causative dilated vein.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050883
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  • 104
    Electronic Resource
    Electronic Resource
    Transient oedema of the cervical spinal cord (2000)
    Springer
    Neuroradiology 42 (2000), S. 280-284 
    Details
    ISSN: 1432-1920
    Keywords: Key words Oedema ; intramedullary ; Spinal cord ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Transient but very intense oedema of the cervical spinal cord was observed in two patients with obstruction of the cerebrospinal fluid (CSF) pathways. Both presented with hydrocephalus, one due to an infratentorial obstructing mass and the other due to postmeningitic adhesive obstruction of the outlet foramina of the fourth ventricle. In animal experiments with obstruction of CSF pathways (due to outlet foramina obstruction or to downward tentorial herniation) flattening and stretching of the ependymal cells along the central canal is observed, followed by disruption and splitting of the ependymal lining and then by extracellular oedema of the subependymal tissue. Without treatment, frank cavity formation develops in a fourth stage. In our two patients, however, most probably because of appropriate decompressive therapy, the oedema disappeared completely without a residual spinal cord lesion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050886
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  • 105
    Electronic Resource
    Electronic Resource
    Regression after biopsy of a pilocytic opticochiasmatic astrocytoma in a young adult without neurofibromatosis (2000)
    Springer
    Neuroradiology 42 (2000), S. 352-356 
    Details
    ISSN: 1432-1920
    Keywords: Key words Optic glioma ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serial MRI over 60 months demonstrated regression after biopsy of a pilocytic opticochiasmatic astrocytoma in a 20-year-old woman with no signs of neurofibromatosis, together with improvement in vision. The patient did not receive radio- or chemotherapy. Close MRI follow-up of optic gliomas is recommended. Aggressive treatment should be limited to cases with clear clinical and radiological progression.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050897
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  • 106
    Electronic Resource
    Electronic Resource
    Primary malignant rhabdoid tumour of the brain in an adult (2000)
    Springer
    Neuroradiology 42 (2000), S. 363-367 
    Details
    ISSN: 1432-1920
    Keywords: Key words Tumour malignant rhabdoid ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a mass in the left cerebral hemisphere of a 20-year-old man. Histological, ultrastructural and immunohistochemical features of the tumour were consistent with primary malignant rhabdoid tumour. The age of presentation, imaging features prior to histological examination, and prognosis in this case were unusual.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050900
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  • 107
    Electronic Resource
    Electronic Resource
    Nasu-Hakola disease in two Tunisian siblings: new radiological findings (2000)
    Springer
    Neuroradiology 42 (2000), S. 375-378 
    Details
    ISSN: 1432-1920
    Keywords: Key words Nasu-Hakola disease ; Membranous lipodystrophy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report radiological features of a biopsy-proven early infantile form of Nasu-Hakola disease in two Tunisian sisters with new bony and cerebral findings.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050903
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  • 108
    Electronic Resource
    Electronic Resource
    Cystic lesions of the pineal region – MRI and pathology (2000)
    Springer
    Neuroradiology 42 (2000), S. 399-402 
    Details
    ISSN: 1432-1920
    Keywords: Key words Pineal region ; Cysts pineal ; Pineocytomas ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pineal lesions are rare. Tumours in this location comprise 0.4–1 % of intracranial tumours. They grow mainly as solid-mass lesions, and cystic tumours are not common. On MRI, a cystic configuration is associated usually with non-neoplastic pineal lesions rather than with a tumour, but analysis does not allow cystic pineal tumours to be distinguished from glial cysts with certainty. We compared neuroradiological and pathological data from 13 cystic pineal lesions, analysing preoperative MRI. Formalin-fixed, paraffin-embedded surgical specimens were stained routinely and immunocytochemically, using the streptavidin-biotin-complex method. Histology revealed six pineocytomas, four glial cysts, an arachnoid cyst, a low-grade astrocytoma and a teratoma. Signal characteristics of pineocytomas were similar in many respects to those of glial pineal cysts. Histomorphological analysis allowed unambiguous discrimination between pineocytomas and glial pineal cysts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000308
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  • 109
    Electronic Resource
    Electronic Resource
    MRI in decompression illness (2000)
    Springer
    Neuroradiology 42 (2000), S. 368-370 
    Details
    ISSN: 1432-1920
    Keywords: Key words Decompression illness ; Caisson disease ; Spinal cord ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of decompression illness in which the patient developed paraparesis during scuba diving after rapid ascent. MRI of the spine revealed a focal intramedullary lesion consistent with the symptoms. The pathophysiological and radiological aspects of spinal decompression illness are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050901
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  • 110
    Electronic Resource
    Electronic Resource
    Spontaneously regressing infundibular cyst: a case report (2000)
    Springer
    Neuroradiology 42 (2000), S. 357-359 
    Details
    ISSN: 1432-1920
    Keywords: Key words Stalk, pituitary ; Cyst, infundibular ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 74-year-old man reported headaches and blurring of vision for 1 month. MRI showed a nonenhancing infundibular cyst. Neurologic findings, blood and cerebrospinal fluid examinations, and chest and abdominal CT were all normal. MRI 4 months later showed no change. The patient was without any medication other than simple analgesics. One year later, the stalk had returned to its normal size and configuration on MRI.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050898
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  • 111
    Electronic Resource
    Electronic Resource
    Can intravascular lymphomatosis mimic sinus thrombosis? A case report with 8 months' follow-up and fatal outcome (2000)
    Springer
    Neuroradiology 42 (2000), S. 436-440 
    Details
    ISSN: 1432-1920
    Keywords: Key words Lymphomatosis intravascular ; Infarcts, brain haemorrhagic ; Venous occlusion ; Magnetic resonance imaging ; Magnetic resonance angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of intravascular lymphomatosis of the brain with 8 months' follow-up and fatal outcome. Several MRI investigations revealed variegated, rapidly changing infarct-like lesions and invasion of the walls of the superior sagittal sinus and deep veins. When disturbances of the venous outflow are detected with multifocal infarct-like lesions, intravascular lymphomatosis should be considered in the differential diagnosis. Brain biopsy may ensure the proper diagnosis ante mortem, but failure of biopsy is frequent, as in our case.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000282
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  • 112
    Electronic Resource
    Electronic Resource
    Spontaneous intracranial hypotension: use of unenhanced MRI (2000)
    Springer
    Neuroradiology 42 (2000), S. 529-531 
    Details
    ISSN: 1432-1920
    Keywords: Key words Meninges ; Hypotension ; spontaneous intracranial ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of spontaneous intracranial hypotension diagnosed with unenhanced cranial MRI, showing laminar subdural fluid and engorgement of the hypophysis and perisellar sinuses. Cerebrospinal fluid pressure was low. MRI was normal after resolution of symptoms. Prior reports emphasise the enhancing pachymeninges seen in this syndrome. We maintain that, when subdural collections and perisellar engorgement are detected on unenhanced MRI in the proper clinical setting, contrast enhancement may not be necessary for the diagnosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000327
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  • 113
    Electronic Resource
    Electronic Resource
    The value of MRI in the diagnosis of postoperative spondylodiscitis (2000)
    Springer
    Neuroradiology 42 (2000), S. 580-585 
    Details
    ISSN: 1432-1920
    Keywords: Key words Spine ; surgery ; Infection ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the role of MRI in the diagnosis of postoperative spondylodiscitis. Spondylodiscitis is a serious complication of surgery, and the diagnosis frequently depends on a combination of clinical, laboratory and imaging findings. We compared the MRI findings in six patients with biopsy- or surgery-proven spondylodiscitis with those in 38 asymptomatic postoperative patients. Contrast enhancement and signal changes in the intervertebral disc or the vertebral endplates are not specific for spondylodiscitis, being also seen in the asymptomatic patients. However, absence of Modic type 1 changes, of contrast enhancement of the disc or of enhancing paravertebral soft tissues suggests that the patient does not have spondylodiscitis. MRI appears more useful for exclusion than for confirmation of postoperative spondylodiscitis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000361
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  • 114
    Electronic Resource
    Electronic Resource
    Proton MR spectroscopy in gliomatosis cerebri (2000)
    Springer
    Neuroradiology 42 (2000), S. 612-615 
    Details
    ISSN: 1432-1920
    Keywords: Key words Gliomatosis cerebri ; Magnetic resonance imaging ; Magnetic resonance spectroscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two cases of gliomatosis cerebri are presented in which there was markedly decreased N-acetyl aspartate and an elevated lactate-lipid area in the MR proton spectra.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000343
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  • 115
    Electronic Resource
    Electronic Resource
    Acute spontaneous spinal subdural haematoma: MRI features (2000)
    Springer
    Neuroradiology 42 (2000), S. 586-590 
    Details
    ISSN: 1432-1920
    Keywords: Key words Spine ; Subdural haematoma ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present MRI findings in three patients with acute spontaneous subdural haematomas of the spine. Acute haematomas (1–3 days) were isointense or gave slightly high signal on T1- and heterogeneous signal on T2-weighted images. MRI precisely defined the level and extent of the haematoma preoperatively. The MRI was prospectively correctly interpreted as acute subdural haematomas in all patients. As a specific, noninvasive modality, MRI is the preferred imaging technique in this rare clinical entity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000331
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  • 116
    Electronic Resource
    Electronic Resource
    The basal ganglia in haemochromatosis (2000)
    Springer
    Neuroradiology 42 (2000), S. 9-13 
    Details
    ISSN: 1432-1920
    Keywords: Key words Haemochromatosis ; Magnetic resonance imaging ; Computed tomography ; Transcranial ultrasound ; Nucleus, lentiformis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Haemochromatosis is characterised by deposition of iron-containing pigment in various organs, but little is known about possible deposition in the brain and its clinical impact. We therefore investigated 14 patients with hereditary haemochromatosis with MRI, CT and transcranial ultrasound (TCS) and examined them neurologically. In six of the patients dense lesions were found within the lentiform nucleus on CT, all of whom displayed hyperechogenic lesions in the same area on TCS, as did one other patient. In these patients the relative signal intensities of the lentiform nucleus measured by MRI relaxometry were higher. No patient had clinical signs of basal ganglia disorders.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050002
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  • 117
    Electronic Resource
    Electronic Resource
    MRI in acute neuropathic Gaucher's disease (2000)
    Springer
    Neuroradiology 42 (2000), S. 48-50 
    Details
    ISSN: 1432-1920
    Keywords: Key words Gaucher's disease ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the cranial MRI findings in a 6-month-old girl with biopsy-proven acute neuropathic Gaucher's disease, which include unilateral cerebral atrophy and dural thickening with contrast enhancement.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050012
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  • 118
    Electronic Resource
    Electronic Resource
    Intraocular contrast enhancement in Adams pattern III hypoxic brain damage: MRI (2000)
    Springer
    Neuroradiology 42 (2000), S. 54-55 
    Details
    ISSN: 1432-1920
    Keywords: Key words Brain, hypoxia ; Blood-aqueous barrier ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The MRI findings of a patient with diffuse cortical hypoxic brain damage (Adams pattern III) are presented. Besides intense cortical contrast enhancement, a peculiar leakage of contrast medium at the anterior chambers of the eye was observed. The pathogenetic mechanism of this enhancement is discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050014
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  • 119
    Electronic Resource
    Electronic Resource
    An arachnoid granulation in the straight sinus (2000)
    Springer
    Neuroradiology 42 (2000), S. 746-748 
    Details
    ISSN: 1432-1920
    Keywords: Key words Granulation, arachnoid ; Sinuses, venous ; Computed tomography ; Magnetic resonance imaging ; Magnetic resonance venography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report CT, MRI and angiographic findings of an arachnoid granulation in the straight sinus in a young man. Its density and signal intensity were isodense and isointense with cerebrospinal fluid on CT and MRI, respectively. The lesion appeared as a filling defect on MR venography and conventional angiography.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000381
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  • 120
    Electronic Resource
    Electronic Resource
    Visibility of the central canal on MRI (2000)
    Springer
    Neuroradiology 42 (2000), S. 756-761 
    Details
    ISSN: 1432-1920
    Keywords: Key words Spinal cord, central canal ; Syringomyelia ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The central canal of the spinal cord is present at birth and becomes progressively obliterated. Cadaver studies have shown that it may persiste partially or completely. To our knowledge, this entity has not been described on MRI. We reviewed 794 MRI studies of the spinal cord, and found 12 patients (aged 14 to 65 years) who had an intramedullary cavity. The cavity was at the junction of the ventral 1/3 and dorsal 2/3 of the spinal cord, except at the level of the lumbar enlargement, where it was central. It was filiform in most cases, although sometimes fusiform (3 to 4 mm in diameter), and had regular contours. The cavity were thoracic in 69 % of cases. The clinical features were totally unrelated to the image, and there were no anatomical factors (Chiari malformation, dysraphism) predisposing to syringomyelia. The images were perfectly compatible with a persistent central canal, which we interpret as a variant of normal anatomy. Therefore it is important to regard these findings as normal, to avoid unnecessary treatment and follow-up.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000373
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  • 121
    Electronic Resource
    Electronic Resource
    MRI and 18F-fluorodeoxyglucose positron emission tomography in hemimegalencephaly (2000)
    Springer
    Neuroradiology 42 (2000), S. 749-752 
    Details
    ISSN: 1432-1920
    Keywords: Key words Hemimegalencephaly ; Positron emission tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report hemimegalencephaly in a 44-year-old woman with mental retardation, epilepsy and a mild hemiparesis. In addition to typical findings on MRI, 2-deoxy-2[18F]fluorodeoxyglucose positron-emission tomography (PET) demonstrated glucose hypometabolism of the affected hemisphere. The results of PET have been coregistered with morphological information from the MRI studies by image fusion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000398
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  • 122
    Electronic Resource
    Electronic Resource
    Perirolandic hypoperfusion on single-photon emission computed tomography in term infants with perinatal asphyxia: comparison with MRI and clinical findings (2000)
    Springer
    Neuroradiology 42 (2000), S. 908-912 
    Details
    ISSN: 1432-1920
    Keywords: Key words Cerebral palsy ; Birth asphyxia ; Magnetic resonance imaging ; Single-photon emission computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe the findings on single-photon emission computed tomography (SPECT) in patients with perinatal asphyxia at term, with perirolandic cortico-subcortical changes on MRI, and to correlate them with clinical features. SPECT of 7 patients was obtained after injection of 185–370 MBq of Tc-99m-ECD (ethyl cysteinate dimer). The patients had spastic quadriplegia (7/7) with perinatal asphyxia (6/7) at term (7/7). The results were correlated with the MRI findings. Hypoperfusion of the perirolandic cortex was clearly seen on SPECT in all patients, even in two with subtle changes on MRI. SPECT demonstrated a more extensive area of involvement than MRI, notably in the cerebellum (in 4), the thalamus (in 7) and basal ganglia (in 5), where MRI failed to show any abnormalities.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000357
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  • 123
    Electronic Resource
    Electronic Resource
    MRI of ranulas (2000)
    Springer
    Neuroradiology 42 (2000), S. 917-922 
    Details
    ISSN: 1432-1920
    Keywords: Key words Mouth, cysts ; Neck, cysts ; Glands, salivary ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the MRI of 20 patients with a ranula (8 simple and 12 plunging) and ten with other cystic masses in the floor of the mouth and/ or suprahyoid portion of the neck (three haemangiomas, two neuromas, one monomorphic adenoma, one lipoma, two lateral cervical cysts and one dermoid cyst). Histological diagnoses were obtained in all cases with the exception of one presumed haemangioma. Ranulas were all well-defined, homogeneous masses giving low signal on T1-and markedly high signal on T2-weighted images. While simple ranulas were all confined to the sublingual space, plunging ranulas were centered on the submandibular space and tended to spill into one or more adjacent spaces. They extended into the sublingual space anteriorly (producung a so-called tail sign) in eight of 12 cases and into the parapharyngeal space superiorly in five. Although they sometimes filled a considerable part of the parapharyngeal space, displacement of surrounding muscles or vessels was usually slight, which was thought to reflect the nature of extravasation pseudocysts. All other cystic masses in our study had one or more MRI finding different from those of ranulas and could be easily differentiated from them.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000341
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  • 124
    Electronic Resource
    Electronic Resource
    CT and MRI in severe hypophosphataemia with central nervous system involvement (2000)
    Springer
    Neuroradiology 42 (2000), S. 112-114 
    Details
    ISSN: 1432-1920
    Keywords: Key words Hypophosphataemia ; Brain ; Myelinolysis, extrapontine ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 38-year-old woman with extreme hypophosphataemia in whom CT and MRI disclosed bilateral lesions within the basal ganglia, thalamus and occipital lobes. After adequate substitution of phosphate the lesions grossly resolved and the patient recovered. This case is the first to demonstrate that profound changes of serum phosphate may be associated with reversible brain lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050026
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  • 125
    Electronic Resource
    Electronic Resource
    Radionecrosis of the temporal lobe: dynamic susceptibility contrast MRI (2000)
    Springer
    Neuroradiology 42 (2000), S. 149-152 
    Details
    ISSN: 1432-1920
    Keywords: Key words Carcinoma nasopharyngeal ; Radionecrosis ; Magnetic resonance imaging ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We examined nine patients with histologically proven nasopharyngeal carcinoma (NPC), treated with radiotherapy, using dynamic susceptibility contrast MRI (DSC-MRI). In eight there was clinical evidence of radionecrosis of the temporal lobe, and one was examined for local recurrence in the nasopharynx. All patients had either high-signal finger-like or cystic lesions in the temporal lobes on T2-weighted images. Heterogeneous contrast enhancement occurred in all patients. Relative regional cerebral blood volume (rrCBV) mapping revealed marked hypoperfusion in all patients. One underwent bilateral temporal lobectomy and radionecrosis was confirmed histologically.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050036
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  • 126
    Electronic Resource
    Electronic Resource
    Imaging and radiological-pathological correlation in histologically proven cases of focal cortical dysplasia and other glial and neuronoglial malformative lesions in adults (2000)
    Springer
    Neuroradiology 42 (2000), S. 157-167 
    Details
    ISSN: 1432-1920
    Keywords: Key words Dysplasia, focal cortical ; Hamartomas ; Epilepsy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Focal cortical dysplasia (FCD) is a pathological entity first described in 1971. Other more subtle cortical malformations found in patients with epilepsy include microdysgenesis (MD), and glioneuronal hamartias. Although these glial and neuronoglial malformations have distinct histological features, there is terminological confusion in the radiological literature. Few cases have been reported in adults with both imaging and histology. We address these issues, giving a radiological-pathological correlation of histologically proven cortical malformations in adults. We describe clinical, radiological and histological features of 12 cases (five FCD, five MD with glioneuronal hamartias, and two hamartomas), unassociated with other conditions, and discuss them in the light of the literature. FCD is usually seen on MRI as cortical thickening, with or without signal change, which may extend into the adjacent white matter. On histology, abnormal neurons and/or glial cells, blurring of the grey-white matter interface, myelin pallor, demyelination, and gliosis may be found. Glioneuronal hamartias and hamartomas usually appear as complex masses on MRI. FCD and hamartias may be associated, and a combination of imaging findings may be seen on MRI. Atrophy of the ipsilateral hippocampus may be present on MRI in patients with hamartias, and minor cell loss on histology, but not definitive hippocampal sclerosis. Although the imaging findings of cortical malformations are protean, some characteristic MRI features, with histological correlates, may be found. The relevance of most of these observations remains unclear.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050038
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  • 127
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    Triple-dose contrast-enhanced images in neurologically symptomatic HIV-positive patients (2000)
    Springer
    Neuroradiology 42 (2000), S. 256-260 
    Details
    ISSN: 1432-1920
    Keywords: Key words Acquired immunodeficiency syndrome ; Magnetic resonance imaging ; Contrast-enhancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our purpose was to determine whether triple-dose delayed contrast-enhanced images would improve lesion detection in patients with symptomatic human immunodeficiency virus (HIV) infection. We reviewed 33 MRI studies on 29 patients. Single-dose immediate T 1-weighted spin-echo (1x-T 1) images were compared with delayed triple-dose images (D3x-T 1). Two neuroradiologists decided which technique showed more lesions, increased lesion conspicuity and/or altered the radiologic diagnosis. The D3x-T 1 technique improved lesion detection in 14 of 29 patients (48 %). In two patients (7 %), the improvement changed the radiologic diagnosis by showing new meningeal lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050881
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  • 128
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    Diagnosing CADASIL using MRI: evidence from families with known mutations of Notch 3 gene (2000)
    Springer
    Neuroradiology 42 (2000), S. 249-255 
    Details
    ISSN: 1432-1920
    Keywords: Key words Cerebral autosomal dominant arteriopathy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Clinical data and MRI findings are presented on 18 subjects from two families with neuropathologically confirmed CADASIL. DNA analysis revealed mutations in exon 4 of Notch 3 gene in both families. All family members with mutations in Notch 3 gene had extensive abnormalities on MRI, principally lesions in the white matter of the frontal lobes and in the external capsules. Of several family members in whom a diagnosis of CADASIL was suspected on the basis of minor symptoms, one had MRI changes consistent with CADASIL; none of these cases carried a mutation in the Notch 3 gene. MRI and clinical features that may alert the radiologist to the diagnosis of CADASIL are reviewed. However, a wide differential diagnosis exists for the MRI appearances of CADASIL, including multiple sclerosis and small-vessel disease secondary to hypertension. The definitive diagnosis cannot be made on MRI alone and requires additional evidence, where available, from a positive family history and by screening DNA for mutations of Notch 3 gene.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050880
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  • 129
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    Neuroradiological and clinical findings in rhombencephalosynapsis (2000)
    Springer
    Neuroradiology 42 (2000), S. 272-274 
    Details
    ISSN: 1432-1920
    Keywords: Key words Rhombencephalosynapsis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Rhombencephalosynapsis is an unusual disorder characterised by maldevelopment of the rhombencephalon, sometimes with supratentorial midline anomalies. We report MRI findings in a 39-year-old woman, the oldest in the literature. MRI demonstrated hypoplasia of the cerebellar vermis, with fusion of the cerebellar hemispheres and abnormally oriented folia. Supratentorial anomalies were also seen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050884
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  • 130
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    Spontaneous regression of a cyst of the cavum septi pellucidi (2000)
    Springer
    Neuroradiology 42 (2000), S. 360-362 
    Details
    ISSN: 1432-1920
    Keywords: Key words Cyst, cavum septi pellucidi ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 20-year-old woman with secondary amenorrhoea and an empty sella turcica was found to have a cyst of the cavum septi pellucidi (CSP) on MRI. The cyst had regressed spontaneously on follow-up MRI.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050899
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  • 131
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    White-matter abnormalities in unirradiated patients cured of primary central nervous system lymphoma (2000)
    Springer
    Neuroradiology 42 (2000), S. 406-412 
    Details
    ISSN: 1432-1920
    Keywords: Key words Lymphoma, primary central nervous system ; Chemotherapy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract On MRI, primary brain tumors are commonly seen as contrast-enhancing masses surrounded by areas of abnormal signal on T2-weighted images. Following successful treatment tumors may no longer show contrast enhancement. The residual abnormalities are assumed to be represent “edema” and infiltrating tumor cells. We report nine patients with primary lymphoma of the central nervous system who had complete responses to intravenous methotrexate, but did not receive intrathecal chemotherapy or cranial irradiation. After complete resolution of contrast-enhancing lesions, persistent abnormalities on T2-weighted images in the region of prior tumor were initially assumed to reflect residual viable tumor. As they remained unchanged for years, however, this may not hold true in the cases in which primary central nervous system lymphoma responds to chemotherapy alone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000301
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  • 132
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    Atrophy of the corpus callosum correlates with white matter lesions in patients with cerebral ischaemia (2000)
    Springer
    Neuroradiology 42 (2000), S. 413-419 
    Details
    ISSN: 1432-1920
    Keywords: Key words Corpus callosum ; White matter lesions ; Cerebral ischaemia ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Many studies of white matter high signal (WMHS) on T2-weighted MRI have disclosed that it is related to cerebral ischaemia and to brain atrophy. Atrophy of the corpus callosum (CC) has also been studied in relation to ischaemia. Our objective was to test the hypothesis that CC atrophy could be due to ischaemia. We therefore assessed CC, WMHS and brain atrophy in patients with risk factors without strokes (the risk factor group) and in those with infarcts (the infarct group), to investigate the relationships between these factors. We studied 30 patients in the infarct group, 14 in the risk factor group, and 29 normal subjects. Using axial T1-weighted MRI, cortical atrophy and ventricular enlargement (brain atrophy) were visually rated. Using axial T2-weighted MRI, WMHS was assessed in three categories: periventricular symmetrical, periventricular asymmetrical and subcortical. Using the mid-sagittal T1-weighted image, the CC was measured in its anterior, posterior, midanterior and midposterior portions. In the normal group, no correlations were noted between parameters. In the infarct group, there were significant correlations between CC and brain atrophy, and between CC atrophy and WMHS. After removing the effects of age, gender and brain atrophy, significant correlations were noted between some CC measures and subcortical WMHS. In the risk factor group, there were significant correlations between CC and brain atrophy and between CC atrophy and WMHS. After allowance for age, gender and brain atrophy, significant correlations between some CC measures and periventricular WMHS remained. The hypothesis that CC atrophy could be due to cerebral ischaemia was supported by other analyses. Namely, for correlations between the extent of infarcts and partial CC atrophy in patients with anterior middle cerebral artery (MCA) and with posterior MCA infarcts, there were significant correlations between the extent of infarct and midanterior CC atrophy in the former, and posterior CC atrophy in the latter. Our findings could indicate that CC atrophy is associated with cerebral ischaemia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000302
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  • 133
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    MRI of infections and neoplasms of the spine and spinal cord in 55 patients with AIDS (2000)
    Springer
    Neuroradiology 42 (2000), S. 551-563 
    Details
    ISSN: 1432-1920
    Keywords: Key words Acquired immune deficiency syndrome ; Spine ; infections ; Spine ; neoplasms ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our purpose was to describe the range of MRI findings in infectious and neoplastic involvement of the spine and spinal cord in symptomatic patients with the acquired immunodeficiency syndrome (AIDS). MRI studies in 55 patients with AIDS and neurological signs and symptoms thought to be related to the spine or spinal cord were reviewed. We categorized the findings according to the spinal compartment involved. There were 29 patients with extradural, 11 with intradural-extramedullary and 9 with intramedullary disease. In 6 patients more than one compartment was involved simultaneously, and patients presented with multiple lesions in the same compartment. The most common causes of extradural disease were bone lesions (28); an epidural mass was seen in 14 and spondylodiscitis in 4 patients. Cytomegalovirus polyradiculitis was the most common cause of intradural-extramedullary disease (in 10 cases); herpes radiculitis was seen in two, and tuberculous infection in another two. In three cases leptomeningeal contrast enhancement was due to lymphoma. Human immunodeficiency virus (HIV) myelitis was seen in two patients, presumed vacuolar myelopathy in two, toxoplasma myelitis in four, intramedullary lymphoma in one, and herpes myelitis in one. Familiarity with the various potential pathological entities that can affect the spine and spinal cord in the AIDS population and their imaging characteristics is crucial for initiation of further diagnostic tests and appropriate medical or surgical treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000344
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    Apparent diffusion coefficient measurements in progressive supranuclear palsy (2000)
    Springer
    Neuroradiology 42 (2000), S. 643-647 
    Details
    ISSN: 1432-1920
    Keywords: Key words Progressive supranuclear palsy ; Magnetic resonance imaging ; Diffusion-weighted imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We measured the apparent diffusion coefficient (ADC), using diffusion-weighted imaging (DWI) and signal intensity on T2-weighted MRI in the cerebral white matter of patients with progressive supranuclear palsy (PSP) and age-matched normal subjects. In PSP, ADC in the prefrontal and precentral white matter was significantly higher than in controls. There was no significant difference in signal intensity on T2-weighted images. The ADC did correlate with signal intensity. The distribution of the elevation of ADC may be the consequence of underlying pathological changes, such as neurofibrillary tangles or glial fibrillary tangles in the cortex. Our findings suggest that ADC measurement might be useful for demonstrating subtle neuropathological changes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000372
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  • 135
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    Spontaneous drainage in syringomyelia: magnetic resonance imaging findings (2000)
    Springer
    Neuroradiology 42 (2000), S. 676-678 
    Details
    ISSN: 1432-1920
    Keywords: Key words. Syringomyelia, spontaneous drainage ; Cerebrospinal fluid, hydrodynamics ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We present five cases of syringomyelia associated with Chiari I or other causes of partial obstructions at the cervicomedullary junction, with spontaneous disruption of the wall of a cervical syrinx and formation of a communication between the cavity and the subarachnoid space, shown on axial MRI. MRI can be used to investigate the hydrodynamics, showing the liquid inside the disrupted syrinx wall and the pathway of drainage. The finding of spontaneous drainage may be important for understanding the pathogenesis of syringomyelia and may be helpful for choosing a surgical approach.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000358
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  • 136
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    Cerebral vasculitis in Henoch-Schönlein purpura: a case report with sequential magnetic resonance imaging changes and treated with plasmapheresis alone (2000)
    Springer
    Pediatric nephrology 15 (2000), S. 276-278 
    Details
    ISSN: 1432-198X
    Keywords: Key words Henoch-Schönlein purpura ; Methylprednisolone ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Neurological complications are rare during the course of Henoch-Schönlein purpura (HSP). We report a 7-year-old girl with HSP who presented with seizures, loss of vision and disturbance of consciousness. Magnetic resonance imaging (MRI) showed high signal intensity in the gray and white matter over the left parietal and both occipital lobes, compatible with MRI findings of cerebral vasculitis. The eye fundi revealed multiple branches of retinal artery occlusion. Intravenous pulse methylprednisolone (MTP) followed by oral steroid therapy was initially administered for HSP nephritis. Cerebral vasculitis developed 10 days post-MTP treatment, with progressive worsening of consciousness. Oral steroid was discontinued and plasmapheresis was performed alone. Her level of consciousness dramatically improved after plasmapheresis. The brain MRI and eye fundi findings were consistent with her clinical improvement. To the best of our knowledge, this is the first description of MRI abnormalities and multiple retinal artery branch occlusion of cerebral vasculitis in a patient with HSP that was successfully treated by plasmapheresis alone. In conclusion, we propose that plasmapheresis may be used as a first-line therapy or rescue therapy for cerebral vasculitis in HSP.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004670000477
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  • 137
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    Central nervous system involvement in a child with hemolytic uremic syndrome (2000)
    Springer
    Pediatric nephrology 14 (2000), S. 990-992 
    Details
    ISSN: 1432-198X
    Keywords: Key words Hemolytic uremic syndrome ; Cerebral hypoxia ; Magnetic resonance imaging ; Central nervous system lesions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report a 20-month-old girl with post- diarrheal (Shiga toxin) hemolytic uremic syndrome and severe encephalopathy. Magnetic resonance (MR) images were obtained in the acute phase of the disease and after 10 months. The first MR images showed widespread high signal intensity on T2-weighted and low signal intensity on T1-weighted images, in deep and subcortical white matter; the splenium of the corpus callosum was also involved, as well as cerebellar hemispheres. Neurological symptoms and signs gradually disappeared within 35 days. Follow-up MR imaging showed almost complete resolution of the previous findings, and the patient recovered without central nervous system impairment. The neurological lesions were probably due to hypoxia, although several other mechanisms could be involved, such as metabolic derangements and the action of Shiga toxin. In spite of the dramatic clinical manifestations, we observed a good outcome, indicating that patients with similar lesions do not necessarily have a poor prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004670050059
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    Radiologische Diagnostik der Leber (2000)
    Springer
    Der Radiologe 40 (2000), S. 904-915 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Leber ; Sonographie ; Computertomographie ; Magnetresonanztomographie ; Szintigraphie ; Positronenemissionstomographie ; Keywords Liver ; Ultrasonography ; Computed tomography ; Magnetic resonance imaging ; Radionuclide imaging ; Positron emission tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Highly specific methods are required for the diagnostic workup of focal hepatic lesions, since benign circumscribed liver changes are very common. Although cross-sectional imaging techniques have a high diagnostic accuracy, radionuclide imaging techniques such as colloid, red blood cell, or hepatobiliary scan are commonly performed when a benign lesion is assumed since these permit a definite diagnosis with high specificity. The diagnosis of a primary or secondary malignant liver tumor, however, usually relies on radiological imaging techniques alone, supported by needle biopsy. Whether positron emission tomography as a primary or supplementary diagnostic tool will have a role in the routine staging of malignant tumors remains to be determined.
    Notes: Zusammenfassung Die Abklärung umschriebener Leberveränderungen erfordert den Einsatz von Methoden hoher Spezifität, da die Prävalenz benigner, fokaler Läsionen sehr hoch ist. Hierfür sind radiologische Schnittbildtechniken grundsätzlich gut geeignet. Wenn aufgrund der sonographischen, computertomographischen oder magnetresonanztomographischen Befunde eine gutartige Läsion anzunehmen ist, werden jedoch häufig ergänzend die Kolloiderythrozyten- oder hepatobiliäre Szintigraphie – ggf. in Kombination – eingesetzt, da hiermit rasch eine abschließende Diagnose mit hoher Spezifität gestellt werden kann. Bei malignen primären oder sekundären Lebertumoren hingegen werden nuklearmedizinische Zusatzuntersuchungen seltener angefordert, da der radiologische Befund, ggf. gestützt durch eine Ultraschall- oder CT-gezielte Biopsie, eine Diagnose in den meisten Fällen erlaubt. Inwieweit sich der primäre oder ergänzende Einsatz der Positronenemissionstomographie im Vergleich zu radiologischen Schnittbildtechniken beim Staging bösartiger Tumoren bewährt, ist noch nicht abschließend geklärt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050850
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  • 139
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    Klinik und bildgebende Diagnostik der Sarkoidose des Nervensystems (2000)
    Springer
    Der Radiologe 40 (2000), S. 1064-1076 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Sarkoidose ; Neurosarkoidose ; Granulom ; MRT ; Keywords Sarcoidosis ; Sarcoidosis complications ; Neurosarcoidosis ; Granuloma ; Brain diseases complications ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The central nervous system is frequently affected during the course of sarcoidosis. Many of these lesions remain without clinical correlates. Unenhanced and contrast enhanced CT and MRI play an important role during the diagnostic work-up of patients with sarcoidosis and suspected or proved CNS involvement. This article summarizes the most frequent manifestations of neurosarcoidosis and provides illustrative examples of MRI findings.
    Notes: Zusammenfassung Das Nervensystem ist bei der Sarkoidose häufiger mitbeteiligt als nach klinischen Gesichtspunkten zu vermuten wäre. Den bildgebenden Untersuchungsverfahren kommt eine große Bedeutung beim Nachweis der pathologischen Veränderungen zu. Insbesondere die Kernspintomographie sichert die Diagnosestellung und dient der Verlaufsbeurteilung. In dieser Übersichtsarbeit werden die typischen klinischen und bildgebenden Befunde bei der Neurosarkoidose vorgestellt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050879
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  • 140
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    Radiodiagnostik der Lunge (2000)
    Springer
    Der Radiologe 40 (2000), S. 870-877 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Lunge ; Perfusion ; Ventilation ; Computertomographie (CT) ; Magnetresonanztomographie (MRT) ; Keywords Lung ; Perfusion ; Ventilation ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Radiological cross-sectional imaging modalities, particularly computed tomography (CT) have become the mainstays for diagnosing lung disease in recent years. These enable morphological visualization of pathological processes with the greatest possible spatial resolution. Modern technical developments and complementary strategies have led to new applications and new functional assessments which need to be reviewed together with state-of-the-art techniques in nuclear imaging. The diagnosis of pulmonary embolism using spiral CT angiography and magnetic resonance (MR) angiography certainly belongs in this category. CT has become the an alternative modality of first choice, and it is also challenging pulmonary angiography as the gold standard. Direct visualization of patent pulmonary arteries and thromboembolic material is complemented by that of effects on the pulmonary parenchyma and right heart function; it also provides perfusion studies and MR-based flow measurement to assess hemodynamic compromise. Ventilation studies have long been a domain of nuclear imaging, and new techniques for the direct visualization of ventilation are emerging from recent developments in the field of MR imaging, for example, using hyperpolarized inert gases. New functional parameters of ventilation can be derived from these studies. For the diagnosis of metabolically active disease, such as tumor and pneumonia, CT offers very high sensitivity, for example, in screening for intrapulmonary nodules using low-dose CT and in the early detection of pulmonary infiltrates in high-risk patients. Especially for characterizing pulmonary nodules there is a need to combine nuclear medicine techniques, such as in positron-emission tomography.
    Notes: Zusammenfassung Die radiologischen Schnittbildverfahren, insbesondere die CT, haben sich innerhalb kurzer Zeit einen herausragenden Stellenwert in der Diagnostik von Lungenerkrankungen erworben. Dies umfasst in erster Linie die morphologische Darstellung pathologischer Prozesse mit hoher räumlicher Auflösung. Moderne technische Entwicklungen und kombinierte Untersuchungsstrategien eröffnen neue Einsatzgebiete und auch funktionelle Aussagen, die nach einer aktuellen Standortbestimmung gemeinsam mit den nuklearmedizinischen Verfahren verlangen. Dazu gehört die Diagnostik der Lungenembolie mittels Spiral-CT-Angiographie und MR-Angiographie der Pulmonalarterien. Hier hat sich mittlerweile die CT als alternatives Verfahren der Wahl etabliert und die Rolle der Pulmonalisangiographie als Goldstandard infrage gestellt. Die reine direkte Darstellung der durchströmten Pulmonalarterien und des thromboembolischen Materials wird durch Diagnostik intrapulmonaler und kardialer Veränderungen, Perfusionsuntersuchungen sowie MR-basierte Flussmessungen zur hämodynamischen Beurteilung erweitert. Nachdem Untersuchungen der Ventilation lange Zeit eine Domäne der Nuklearmedizin waren, eröffnen aktuelle Entwicklungen in der MRT neue Verfahren zur direkten Visualisierung der Lungenbelüftung, z. B. mittels polarisierter Edelgase. Aus diesen Verfahren lassen sich auch neue funktionelle Parameter der Ventilation ableiten. In der Diagnostik von Tumoren und Entzündungen überzeugt die CT insbesondere durch ihre hohe Sensitivität, z. B. beim Screening auf intrapulmonale Rundherde mittels Niedrigdosis-CT oder bei der Früherkennung pneumonischer Infiltrate bei Risikopatienten. Insbesondere bei der Charakterisierung intrapulmonaler Rundherde ist eine Kombination mit nuklearmedizinischen Verfahren (PET) grundsätzlich anzustreben.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050846
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    Myokardperfusion in Ruhe und unter Belastung (2000)
    Springer
    Der Radiologe 40 (2000), S. 155-161 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Koronare Herzkrankheit ; Magnetresonanztomographie ; Myokardperfusion ; SPECT ; Key words ; Coronary artery disease ; Magnetic resonance imaging ; Myocardial perfusion ; SPECT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Aim: Performance of combined rest/stress MR perfusion studies and the analysis of qualitative signal intensity parameters in comparison with 99mTc-SestaMIBI SPECT in patients with known coronary artery disease (CAD). Methods: Sixteen patients with CAD underwent MR myocardial perfusion assessment at rest and after dipyridamole-induced hyperemia. Qualitative parameters (SI increase, SI upslope) of the SI time-curves were evaluated and characteristics of normal, reversible and persistent hypoperfused myocardium as assessed by 99mTc-SestaMIBI SPECT were compared. Results: Compared with the rest values, normal myocardium showed a significant increase of the SI upslope during hyperemia (P〈0.001), whereas persistent (P=0.07) and reversible (P=0.15) hypoperfusions showed only minor changes. SI increase over baseline also showed a significant increase only in normal myocardium (P〈0.001). At rest, reversible ischemic areas showed no significant differences from normal myocardium, whereas during hyperemia SI increase was significantly lower (P=0.02). Conclusions: Qualitative SI parameters of a combined rest/stress MR myocardial perfusion study allow to differentiate normal from reversibly or persistently hypoperfused myocardium.
    Notes: Zusammenfassung Fragestellung: Die kombinierte Ruhe- und Belastungsuntersuchung der myokardialen Durchblutung in der MRT sowie die Analyse qualitativer SI-Parameter der MR-Myokardperfusion bei Patienten mit koronarer Herzkrankheit wurden mit der 99mTc-SestaMIBI SPECT verglichen. Methode: Bei 16 Patienten mit koronarer Herzkrankheit (KHK) wurde in der MRT mit einer Mehrschichtgradientenechotechnik die Myokardperfusion unter Ruhe- und Belastungsbedingungen untersucht. Qualitative Signalintensitätsparameter der Kontrastmittelanflutung wurden berechnet und die Parameter in normalen, reversibel und persistierend minderperfundierten Myokardarealen miteinander verglichen. Ergebnisse: Normales Myokard zeigte im Gegensatz zu reversiblen (P=0,15) und persistierenden (P=0,07) Ischämien eine signifikante Zunahme der SI-Anstiegssteilheit unter Belastung (P〈0,001). Die SI-Zunahme zeigte ebenfalls nur in normal perfundierten Arealen eine signifikante Zunahme (P〈0,001) nach Belastung. Unter Belastung zeigte sich bei reversiblen Ischämien eine signifikant niedrigere SI-Zunahme als in normalem Myokard (P=0,02), während sich in Ruhe kein Unterschied zeigte. Schlussfolgerung: Qualitative SI-Parameter der kombinierten MR-Perfusionsuntersuchung des Myokards in Ruhe und unter Belastung erlauben die Differenzierung zwischen normalem sowie reversibel oder persistierend minderperfundiertem Myokard.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050025
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    Endoanale Magnetresonanztomographie bei fäkaler Inkontinenz (2000)
    Springer
    Der Radiologe 40 (2000), S. 465-468 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Fäkale Inkontinenz ; Magnetresonanztomographie ; Endoanalspule ; Key words Faecal incontinence ; Magnetic resonance imaging ; Endoanal coil
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Purpose. Within the recent years several studies have been performed to determine the value of endoanal magnetic resonance imaging (MRI) in faecal incontinence. Methods. MRI is performed using a 0.5 – 1.5T unit. A surface coil with a maximum diameter of 19 mm is placed in the anal canal. T2* 3D gradient-echo-sequences and T2-weighted turbo-spin-echo-sequences in coronal, axial und sagittal orientation are acquired. Results. Compared to endoanal ultrasound (EUS), which is the gold standard for diagnosis in faecal incontinence, endoanal MRI is better in visualization of the external sphincter. The accurate delineation of the external sphincter has led to the possibility to evaluate sphincter atrophy. Preliminary results have shown, that endoanal MRI has an accuracy of 90–95% in the demonstration of lesions in the external sphincter. In detection of lesions of the internal sphincter EUS is still superior to endoanal MRI. Conclusion. EUS and endoanal MRI are currently the optimal imaging techniques for faecal incontinenc, with the advantage of detecting external sphincter atrophy with endoanal MRI.
    Notes: Zusammenfassung Zielsetzung. In den letzten Jahren wurden mehrere Studien durchgeführt, deren Ziel es war, den Stellenwert von Endoanalspulen in der Magnetresonanztomographie (MRT) zur Abklärung von Sphinkterdefekten bei fäkaler Inkontinenz (FI) zu bestimmen. Methode. Die endoanale MRT wird an 0,5–1,5-Tesla-Geräten durchgeführt. Zur Darstellung der Sphinkteren werden Oberflächenspulen mit einem maximalen Querdurchmesser von 19 mm endoanal appliziert. T2*-gewichtet 3D-Gradientenechosequenzen und T2-gewichtete Turbospinechosequenzen in koronaler, axialer und sagittaler Schnittführung werden zur Darstellung des Analkanals angefertigt. Ergebnisse. Im Vergleich zum endoanalen Ultraschall (EUS), der den Goldstandard bei der Abklärung einer FI darstellt, kann mit der endoanalen MRT v. a. der M. sphincter externus besser abgegrenzt werden. Die exakte Differenzierung des M. sphincter externus vom ischiorektalem Fettgewebe ermöglicht die Diagnose einer Atrophie des äußeren Schließmuskels. Erste Studienergebnisse haben gezeigt, daß die endoanale MRT eine Treffsicherheit von 90–95% bei der Detektion von Defekten im M. sphincter externus erreicht. Die Abklärung einer Kontinuitätsunterbrechung im M. sphincter internus ist nach wie vor eine Domäne des EUS. Schlussfolgerung. Die endoanale MRT stellt eine ergänzende Methode zum EUS dar und ist diesem in der Beurteilung der Morphologie des M. sphincter externus überlegen.
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    URL: http://dx.doi.org/10.1007/s001170050697
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  • 143
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    Maligne Tumoren des Pharynx (2000)
    Springer
    Der Radiologe 40 (2000), S. 625-631 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Computertomographie ; Magnetresonanztomographie ; Pharynx ; Tumoren ; Key words Computed tomography ; Magnetic resonance imaging ; Pharynx ; Tumors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Background. Malignant tumors of the head and neck region are amongst the six most often occurring tumors of the body. They can be associated with the different anatomical compartments as well as different histologic types. The way of tumor spread of these malignancies depends on their histologic type and on the region. These compartments can be separated into the nasopharynx, the oropharynx, and the hypopharynx. Most of the malignant tumors belong to the squamous cell carcinomas, other histologic types are depicted less frequently. The histologic types of the other groups which are seen more often comprise of lymphomas and adenoidcystic carcinomas. The undifferentiated carcinoma of the nasopharynx is supposed to be a special type of tumor. The malignant tumors of the pharynx can also involve all three compartments. Beside these tumors, malignancies of mesenchymal origin can also be delineated. Imaging modalities. The imaging modalities most frequently used to detect these tumors and to clarify their extension are contrast enhanced computed tomography, magnetic resonance imaging, nuclearmedicine imaging modalities such as positron emission tomography. Other scintigraphic imaging methods play a less important role. Conclusion. The different imaging modalities of malignant pharyngeal tumors and of potentially infiltrated lymphnodes with the weightness on computed tomography and magnetic resonance imaging and their appearance in these imaging techniques shall be enhanced in this paper.
    Notes: Zusammenfassung Hintergrund. Der Kopf-Hals-Bereich zählt weltweit zu den 6 am häufigsten von malignen Tumoren befallenen Körperregionen. Maligne Tumoren des Pharynx können dabei entsprechend der anatomischen Unterteilung – d. h. Nasopharynx, Oropharynx und Hypopharynx – diesen Regionen zugeordnet werden. Neben der grundsätzlich heterogenen Wachstumstendenz weisen diese Tumoren je nach histologischer Herkunft ein recht unterschiedliches Ausbreitungsmuster auf. Bei der überwiegenden Mehrzahl handelt es sich um Plattenepithelkarzinome, die anderen histologischen Typen – wie adenoidzystische Karzinome oder Lymphome – sind weitaus seltener vertreten. Daneben kommen sehr selten auch noch maligne Tumoren mesenchymalen Ursprungs wie z. B. die Rhabdomyosarkome vor. Bildgebung. Die bildgebende Abklärung erfolgt mit der kontrastmittelverstärkten CT, der MRT und in jüngster Zeit mit nuklearmedizinischen Methoden, z. B. PET. Andere szintigraphische Untersuchungsmethoden spielen eine untergeordnete Rolle. Resümee. Verschiedene bildgebende Methoden (schwerpunktmäßig CT und MRT) und die entsprechenden Erscheinungsbilder sowie Lokalisations- bzw. Ausbreitungsdiagnostik der malignen Tumoren und evtl. befallener Lymphknoten dieser Regionen werden vorgestellt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050784
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  • 144
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    MR-Angiographie der supraaortalen Gefäße (2000)
    Springer
    Der Radiologe 40 (2000), S. 785-791 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Zerebrovaskuläre Erkrankung ; Arteriosklerose ; Magnetresonanztomographie ; Magnetresonanzangiographie ; Digitale Subtraktionsangiographie ; A. carotis ; Keywords Cerebrovascular disease ; Arteriosclerosis ; Magnetic resonance imaging ; Magnetic resonance angiography ; Digital subtraction angiography ; Carotid artery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Purpose. To compare high resolution contrast-enhanced MR angiography (MRA) and digital subtraction angiography (DSA) in the assessment of supraaortic vessel stenosis. Methods. 14 patients with suspicion of cerebrovascular disease or upper limb ischemia underwent selective DSA and high resolution contrast enhanced MRA employing a new Panoramic-Array coil. Stenosis assessment in comparison to DSA followed NASCET criteria. Additionally signal-/noise ratios (SNR) were evaluated to assess contrast enhancement. Results. Diagnostic image quality was achieved in all patients. Sensitivity and specificity for assessing high-grade stenosis of the supraaortic vessels were 100% and 96% respectively. In the assessment of high-grade common or internal carotid artery stenosis sensitivity and specificity was 100%. Conclusion. High resolution contrast enhanced supraaortic MRA combined with new coil sytems allow for a reliable assessment of stenoses along the whole vessel course including the aortic arch. Previous stent procedures limit its use in post-interventional follow-up.
    Notes: Zusammenfassung Fragestellung. Ziel der Studie war ein Vergleich zwischen hochauflösender kontrastverstärkter MR-Angiographie (MRA) und digitaler Subtraktionsangiographie (DSA) in der Diagnostik von Stenosen der supraaortalen Gefäße. Methoden. 14 Patienten mit Verdacht auf eine zerebrovaskuläre Erkrankung oder Durchblutungsstörung der oberen Extremität wurden mit DSA und hochaufgelöster, kontrastverstärkter MR-Angiographie mit Verwendung einer Panoramic-Array-Spule untersucht. Neben der Beurteilung der Kontrastierung erfolgte die Bestimmung der Stenosegrade im Vergleich zur selektiven DSA nach den NASCET-Kriterien. Ergebnisse. Bei allen Patienten konnte mit der MRA eine diagnostisch ausreichende Bildqualität erzielt werden. In der Diagnostik hochgradiger Stenosen der supraaortalen Gefäße ergab sich eine Sensitivität von 100% und eine Spezifität von 96%. In der Erkennung hochgradiger Stenosen der A. carotis communis oder interna lagen Sensitivität und Spezifität bei 100%. Schlussfolgerung. Die ultraschnelle MRA der supraaortalen Gefäße in Kombination mit einer geeigneten Spulenkombination ermöglicht die zuverlässige Erkennung stenotischer Veränderungen im gesamten Gefäßverlauf einschließlich des Aortenbogens. Stentimplanationen limitieren derzeit den Einsatz in der postinterventionellen Kontrolle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050824
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  • 145
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    Neurophysiological studies in acute transverse myelitis (2000)
    Springer
    Journal of neurology 247 (2000), S. 943-948 
    Details
    ISSN: 1432-1459
    Keywords: Key words Transverse myelitis ; Motor evoked potentials ; Somatosensory evoked potentials ; Electromyography ; Prognosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A systematic evaluation of anterior horn cell, motor and sensory pathways is possible by electromyography (EMG), motor (MEPs) and somatosensory (SEPs) evoked potentials, respectively, which may provide valuable information on acute transverse myelitis (ATM). In a prospective hospital-based study, EMG, MEP and SEP studies were carried out on admission and after 3 months in 39 patients with ATM. All the patients also underwent detailed clinical evaluation, and spinal magnetic resonance imaging (MRI) was performed in 28. Outcome was defined at the end of 3 months as poor, partial or complete recovery on the basis of functional status. Spinal MRI revealed hyperintense signal changes in T2 extending for two segments to the entire spinal cord. Central motor conduction time to tibialis anterior (CMCT-TA) was more frequently abnormal (90%), followed by tibial SEP (77%). CMCT to abductor digiti minimi (ADM) was abnormal in 30% and median SEP in 15% of patients. Evidence of denervation on EMG was present in 51% of patients. The CMCT-TA improved in 48% patients and tibial SEP in 32%. Median SEP improved in all patients, and CMCT-ADM remained prolonged in two. At 3 months 2 patients had died, and 18 had poor, 10 partial and 9 complete recovery. CMCT was correlated with miscle power, tone, reflec and MRI changes. Patients' outcome of was correlated with CMCT, SEP and EMG. These results are consistent with pronounced involvement of dorsal region of spinal cord in ATM. MEP is more frequently abnormal than SEP.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150070051
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  • 146
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    Cerebral venous thrombosis: diagnosis and management (2000)
    Springer
    Journal of neurology 247 (2000), S. 252-258 
    Details
    ISSN: 1432-1459
    Keywords: Key words Cerebral venous ¶thrombosis ; Dural sinuses ; Magnetic resonance imaging ; Heparin ; Thrombolysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In contrast to arterial stroke, cerebral venous thrombosis (CVT) is an infrequent condition which presents with a wide spectrum of signs and with a highly variable mode of onset. The clinician must therefore consider it systematically in all brain syndromes and perform the appropriate neuroimaging investigations: computed tomography (CT) with computed tomography angiography and/or magnetic resonance imaging with magnetic resonance angiography and, if necessary intra-arterial angiography. Once the diagnosis is established, a wide investigation for should be carried out in search of the cause, and treatment started as soon as possible. Treatment is based on the combination of intravenous heparin (followed by oral anticoagulants for 3–6 months), symptomatic treatment (anticonvulsants, analgesics, treatment of increased intracranial pressure) and treatment of the cause. Local thrombolysis is indicated if there is deterioration due to thrombosis extension despite adequate anticoagulation. Diagnosis and treatment of CVT should be considered as an emergency because of the considerable potential for full recovery in this condition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050579
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  • 147
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    A comparison of neuropsychological deficits in primary and secondary progressive multiple sclerosis (2000)
    Springer
    Journal of neurology 247 (2000), S. 97-101 
    Details
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Neuropsychological ; Cognitive ; Magnetic resonance imaging ; Lesion load
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Neuropsychological deficits and the relationship to brain pathology were examined in 13 primary progressive (PP) and 12 secondary progressive (SP) multiple sclerosis patients with a similar duration of the progressive phase and comparable physical disability. A battery of neuropsychological tests to assess attention, short-term and working memory was administered to the patients, and their performance was compared to that of 20 healthy controls matched for age and premorbid IQ. Total cerebral lesion load on T2-weighted magnetic resonance imaging was measured in the patients. Both PP and SP patients performed significantly worse than controls in most of the neuropsychological tests. There were only subtle differences between SP and PP on the working memory task although magnetic resonance imaging lesion load was significantly higher in SP than in PP patients. In this exploratory study only subtle differences in cognitive impairment were detected between SP and PP patients matched for physical disability and relevant illness features. The results also suggest that the severity of cognitive impairment cannot be fully explained by the extent of abnormalities detected on conventional T2-weighted magnetic resonance images, and that other pathological abnormalities such as in normal-appearing white matter are likely to be involved.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00007804
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  • 148
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    Carotid atherosclerosis and cerebral white matter lesions in a population based magnetic resonance imaging study (2000)
    Springer
    Journal of neurology 247 (2000), S. 291-296 
    Details
    ISSN: 1432-1459
    Keywords: Key words Leukoaraiosis ; Aged ; Atherosclerosis ; Magnetic resonance imaging ; Carotid artery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebral white matter lesions are frequently observed on magnetic resonance imaging of elderly, nondemented persons. There is evidence that white matter lesions are involved in the pathophysiology of cognitive decline and dementia. White matter lesions can be divided into those in the periventricular and those in the subcortical region. Pathological and epidemiological studies suggest that atherosclerosis is involved in the pathogenesis of these lesions. Our study reports on the association between atherosclerosis in the carotid arteries and white matter lesions in a population-based study among 1077 elderly subjects. We randomly sampled 1077 subjects aged between 60–90 years from two prospective population-based studies. All subjects underwent ultrasonography of the carotid artery. In addition, 1.5 T magnetic resonance imaging was performed; white matter lesions in the subcortical and periventricular regions were rated separately. With increasing number of plaques in the carotid artery the severity of periventricular white matter lesions increased (P trend = 0.03), but not the severity of subcortical white matter lesions (P trend = 0.19). In addition, an increase in intima media thickness was borderline significantly associated with an increased severity of periventricular white matter lesions (P trend = 0.09), but not of subcortical white matter lesions (P trend = 0.68). These findings suggest that partly dissimilar pathogenetic mechanisms are involved in the etiology of periventricular and subcortical white matter lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050586
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  • 149
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    MRI and motor evoked potential findings in nondisabled multiple sclerosis patients with and without symptoms of fatique (2000)
    Springer
    Journal of neurology 247 (2000), S. 506-509 
    Details
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Fatigue ; Magnetic resonance imaging ; Motor evoked potentials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fatique is a common symptom of multiple sclerosis (MS) even in the early phases of the disease, when neurological disability is usually still not present. To investigate the pathophysiology of fatigue we compared neurophysiological (motor evoked potentials of the four limbs, MEPs) and brain magnetic resonance imaging (MRI) findings in two groups of nondisabled MS patients, those with (n=15) and those without (n=15) fatigue. Fatigue was assessed by an interview and scored by the Fatigue Severity Scale. The two groups were matched for sex, age, disease duration, Expanded Disability Status Scale score, pyramidal Functional System (FS) score, and depression score. MEPs were abnormal in five patients with fatigue and in one patient without fatigue. A significant association was found between the patient scores on the Fatigue Severity Scale, and the burden of MRI lesions (r=0.5; P〈0.005). Significantly higher parietal lobe (P〈0.05), internal capsule (P〈0.05), and periventricular trigone (P〈0.05) lesion loads were found in patients with fatigue than in those without. Our results agree with a central nervous system origin of fatigue in MS patients. This symptom might be a consequence either of a functional deafferentation of the cortex due to cortico-subcortical interconnection damage or of a demyelination in critical sites of the CNS, such as the cortico-spinal tract.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150070148
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  • 150
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    MRI findings of small subcortical “lacunar-like” infarction resulting from large vessel disease (2000)
    Springer
    Journal of neurology 247 (2000), S. 280-285 
    Details
    ISSN: 1432-1459
    Keywords: Key words Small subcortical ¶infarction ; Large-vessel disease ; Magnetic resonance imaging ; Silent white-matter hyperintensity ; Lacunar infarction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Small subcortical infarctions resulting from large-vessel disease are often observed. It is important to distinguish these from pure lacunar infarction resulting from small-vessel disease because the investigations and examinations differ. We investigated the differences on brain magnetic resonance imaging (MRI) between small subcortical ¶“lacunar-like” infarcts resulting from large-vessel disease and pure lacunar infarcts. Thirteen subjects with small lacunar-like infarcts (size 〈 2 cm), resulting from large-vessel disease, ¶and 30 subjects with lacunar infarcts (〈 2 cm), without large-vessel disease were studied. We measured infarction size using a 1.5-T MRI device and evaluated silent subcortical hyperintensity lesions using the modified Scheltens’ score. Large-vessel lesion was confirmed by conventional angiography, duplex carotid scan, and magnetic resonance angiography. There was no difference in the mean age of the two groups. Cerebrovascular risk factors and atherosclerotic complications were also comparable for the two groups. Progressive stroke was more common ¶in the lacunar-like infarction group than in the lacunar infarction group ¶(P = 0.004). Scores for periventricular hyperintensity, white matter hyperintensity, basal ganglia hyperintensity, and total subcortical hyperintensity scores were significantly higher in the lacunar infarction group than in the lacunar-like infarction group. The difference in basal ganglia hyperintensity scores was remarkable (P = 0.001). The enlargement of the perivascular space was also significantly greater in the lacunar infarction group than in the lacunar-like infarction group. These findings seem to reflect differences in the pathogenesis of infarction between the two groups. Silent subcortical hyperintensity lesions and enlargement of perivascular space are useful for between distinguishing small lacunar-like infarct resulting from large-vessel disease and pure lacunar infarction. This may have significant implications for the management of patients with lacunar-sized infarctions. It suggests that the pathogenesis of lacunar-sized infarction is variable.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050584
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  • 151
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    Differential response to corticosteroid therapy of MRI findings and clinical manifestations in spinal cord sarcoidosis (2000)
    Springer
    Journal of neurology 247 (2000), S. 544-549 
    Details
    ISSN: 1432-1459
    Keywords: Key words Sarcoidosis ; Spinal cord ; Magnetic resonance imaging ; Corticosteroid therapy ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Spinal cord sarcoidosis is a rare disorder whose natural history and therapeutic outcome are not fully known. We examined four patients with spinal cord sarcoidosis both clinically and radiologically, particularly in relation to corticosteroid treatment. The initial manifestation was cervical myelopathy in three and uveitis in one. All four patients progressed slowly until corticosteroid therapy was initiated. The cervial spine was involved in all patients. Magnetic resonance imaging (MRI) showed spinal cord swelling with T2-weighted high intensity and linear leptomeningeal and patchy or diffuse intramedullary enhancement with gadolinium diethylene triaminepentaacetic acid. With corticosteroid therapy, dramatic improvement was seen on MRI, including disappearance or marked reduction of swelling and enhancement. Plasma levels of angiotensin-converting enzyme (ACE) were also markedly improved. In contrast, the clinical symptoms were little improved in one patient, unchanged in two, and rather worsened in one patient. Recurrence was seen on MRI at the maintenance dose in all four patients, without any dramatic change in clinical manifestation. MRI findings and plasma ACE are well correlated with active leasion of the spinal cord sarcoidosis, providing a useful marker for recurrence, but do not parallel the clinical manifestations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150070154
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  • 152
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    Intra-articular membranous interposition detected by MRI in developmental dysplasia of the hip (2000)
    Springer
    Skeletal radiology 29 (2000), S. 726-728 
    Details
    ISSN: 1432-2161
    Keywords: Keywords Developmental dysplasia ; Hip ; Membrane ; Interposition ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Intra-articular membranous interposition was detected by MRI in the hip joint with residual subluxation of a girl aged 5 years 10 months. This structure, which had low signal intensity on both T1- and T2-weighted images, separated the femoral head from the acetabulum. Histological examination revealed chondrometaplasia, which suggested that this interposition might be transformed to a surface cartilaginous tissue of the secondary acetabulum often observed in residual subluxation of the hip.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000293
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  • 153
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    Are magnetic resonance flexion views useful in evaluating the cervical spine of patients with rheumatoid arthritis? (2000)
    Springer
    Skeletal radiology 29 (2000), S. 85-89 
    Details
    ISSN: 1432-2161
    Keywords: Key words Rheumatoid arthritis ; Cervical spine ; Magnetic resonance imaging ; Dynamic imaging ; Flexion views
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To determine whether MR imaging in flexion adds value relative to imaging in the neutral position with respect to displaying involvement of the subarachnoid space, brainstem and spinal cord. Design and patients. T1-weighted MR images of the cervical spine in 42 rheumatoid arthritis patients with cervical spine involvement were obtained and analyzed prospectively. We assessed changes between images obtained in the neutral position and following active flexion, especially horizontal atlantoaxial and subaxial motion, presence or absence of brainstem compression, subarachnoid space involvement at the atlantoaxial and subaxial level and the cervicomedullary angle. Vertical atlantoaxial subluxation and the amount of pannus were correlated with motion and change in subarachnoid space. Results. The flexion images showed horizontal atlantoaxial motion in 21 patients and subaxial motion in one patient. The flexion view displayed brainstem compression in only one patient. Involvement of the subarachnoid space increased at the atlantoaxial level in eight (19%) patients (P=0.004) and at the level below C2 in five (12%) patients (P=0.03). There were no patients with a normal subarachnoid space in neutral position and compression in the flexed position. The cervicomedullary angle changed significantly with flexion. Vertical atlantoaxial subluxation and the amount of pannus did not show a significant correlation with motion or subarachnoid space involvement. Conclusion. MR imaging in the flexed position shows a statistically significant narrowing of the subarachnoid space at the atlantoaxial level and below C2. Cord compression is only observed on flexion views if the subarachnoid space in neutral position is already decreased. MR imaging in the flexed position might be useful, since subarachnoid space involvement may be an indicator for the development of neurologic dysfunction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050015
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  • 154
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    Dumb-bell-type teratoma in the lumbar spine (2000)
    Springer
    Skeletal radiology 29 (2000), S. 104-108 
    Details
    ISSN: 1432-2161
    Keywords: Key words Adult teratoma ; Dumb-bell type tumor ; Lumbar spine ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report a case of a lumbar teratoma in a 50-year-old woman. The teratoma showed a dumb-bell-type expansion at the level of the left L3/4 foramen with massive erosion of the L3 vertebral body. MRI revealed inhomogeneous signal changes in the tumor, which were histologically compatible with a mixture of bone, muscle, fat, and cyst containing sebaceous material. Complete resection of the tumor and spinal arthrodesis with pedicle screw fixation was necessary to obtain stability of the affected spinal segment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050020
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  • 155
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    Giant cystic craniopharyngiomas with extension into the posterior fossa (2000)
    Springer
    Child's nervous system 16 (2000), S. 138-142 
    Details
    ISSN: 1433-0350
    Keywords: Key words Craniopharyngioma ; Posterior fossa tumors ; Microsurgery ; Magnetic resonance imaging ; Computerized tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Between 1991 and 1998, 24 patients underwent surgery for a craniopharyngioma in our department. This group included two patients who had tumors with extensive growth along the midline, and along the posterior fossa in particular. In both cases suprasellar calcifications were typical features on magnetic resonance imaging (MRI) and computed tomography (CT). A 7-year-old boy presented with a 6-month history of headache, nausea, and progressive unilateral hearing loss. With a suboccipital approach it was possible to remove the main part of the tumor. In a 13-year-old boy headache and visual deterioration led to the diagnosis of a craniopharyngioma, which was removed with a pterional approach. For the neuroimaging work-up in such cases of atypically growing craniopharyngiomas MRI is the method of choice. Additional CT scanning is recommended, which provides valuable information about bony changes at the skull base due to space-occupying growth. CT substantiates the differential diagnosis if typical calcifications are seen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050480
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  • 156
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    Early diffuse leptomeningeal primitive neuroectodermal tumors can escape detection by magnetic resonance imaging (2000)
    Springer
    Child's nervous system 16 (2000), S. 398-401 
    Details
    ISSN: 1433-0350
    Keywords: Keywords Primitive neuroectodermal tumor ; Diffuse leptomeningeal neoplasia ; Magnetic resonance imaging ; Pseudotumor cerebri ; Sinus thrombosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Primitive neuroectodermal tumors are easily detected by neuroradiologic imaging, as a rule. We report on two patients with early diffuse leptomeningeal primitive neuroectodermal tumors which escaped detection by contrast-enhanced magnetic resonance imaging.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810000297
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  • 157
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    Acute-onset nontraumatic paraplegia in childhood: fibrocartilaginous embolism or acute myelitis? (2000)
    Springer
    Child's nervous system 16 (2000), S. 551-554 
    Details
    ISSN: 1433-0350
    Keywords: Keywords Acute myelitis of childhood ; Fibrocartilaginous embolism ; Magnetic resonance imaging ; Spinal cord infarction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Fibrocartilaginous embolus causing acute spinal cord infarction is a rare cause of acute-onset paraplegia or quadriplegia. Few cases of survivors have been reported in the neurosurgical literature, with most reports involving post-mortem or biopsy findings. There is little information on MRI findings in such patients. We present the youngest patient ever reported, and discuss the important differences between fibrocartilaginous embolus and acute myelitis of childhood. A 6-year-old girl with a history of back pain presented with sudden-onset nontraumatic paraplegia, with a clinical anterior spinal artery syndrome. Initial MRI scan revealed intervertebral disc disease at L1–2 and an incidental thoracic syrinx, but no cause for her acute-onset paraplegia was identified. Cerebrospinal fluid and other investigations were all negative. Sequential MRI scans revealed development of spinal cord expansion from T10 to the conus medullaris, with increased cord signal in the anterior aspect of the spinal cord. The intervertebral disc disease was unchanged. The imaging and clinical findings were caused by fibrocartilaginous embolus, which meant there was no need for spinal cord biopsy. The report describes the clinical and imaging criteria for diagnosis of fibrocartilaginous embolus, highlighting the case for avoiding an unnecessary biopsy. The clinical pattern in the paediatric group is discussed, with features differentiating it from acute myelitis of childhood.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810000268
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  • 158
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    Scalp cavernous angioma presenting as sinus pericranii: diagnostic value of cerebral angiography and magnetic resonance imaging (2000)
    Springer
    Child's nervous system 16 (2000), S. 598-602 
    Details
    ISSN: 1433-0350
    Keywords: Keywords Cavernous angioma ; Cerebral angiography ; Dynamic scan ; Magnetic resonance imaging ; Sinus pericranii
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objects: Sinus pericranii is only a symptom complex, and it can have a variety of etiologies. Therefore, it is important to differentiate these etiologies preoperatively by means of radiological examinations. A 5-year-old boy was admitted with a soft and fluctuant tumor in the right parietal region near the midline. The tumor appeared when the child was in a recumbent position, distending noticeably with the Valsalva maneuver and disappearing completely when the patient was in the sitting position. Methods: Magnetic resonance imaging showed the lesion with honeycomb-like heterogeneous iso- and low-intensity signals on the T1-weighted image and with heterogeneous high- and iso- intensity signal on the T2-weighted image. Dynamic study with an injection of gadolinium diethylene-triaminopentaacetic acid demonstrated and nodular peripheral enhancement at early phase and subsequent progressive enhancement towards the center of tumor. The internal carotid angiogram was normal. The external carotid angiogram, however, showed a tumor stain fed by the superficial temporal arteries. The stain was retained until the late phase and drained into the scalp veins and into the superior sagittal sinus. Following direct injection of contrast medium into the tumor there was prolonged retention of the medium in the tumor and leakage into scalp veins and the superior sagittal sinus. The mass under the periosteum was totally removed and proved to be a cavernous angioma. Conclusions: Scalp cavernous angioma is one of the etiologies of sinus pericranii and may be diagnosed preoperatively by cerebral angiography or magnetic resonance imaging. Serial dynamic magnetic resonance imaging will be particularly helpful for this diagnosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810000288
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  • 159
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    Wertigkeit der diffusionsgewichteten MRT in der Beurteilung von Knochenmarkveränderungen bei Wirbelkörpermetastasen (2000)
    Springer
    Der Radiologe 40 (2000), S. 731-736 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Diffusionsgewichtete Kernspintomographie ; Wirbelkörpermetastasen ; Diffusionskoeffizient ; Keywords Diffusion weighted imaging (DWI) ; Magnetic resonance imaging ; Vertebral metastases ; Diffusion coefficient ; ADC
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Aim of the study. The aim of the study was the evaluation of the diffusion coefficient (ADC) of vertebral metastasis and regular vertebral bodies with diffusion weighted MRI (DWI). DWI evaluates the tissue-specific molecular diffusion of protons. In tissues with high cell densities (neoplasm) a decreased ADC can be expected due to restricted diffusion according to an exaggerated amount of intra- and intercellular membranes (i. e. diffusion barriers). Methods. In 5 breast cancer patients the ADC of both known vertebral metastases and of adjacent regular vertebral bodies were measured with DWI (1.0 T; Phased-Array-Body-Coil; b: 880 and 440 s/mm2). Results. The ADC of regular vertebral bodies (1.3±0.23×10–,3s/mm2) was significantly (p≤0.0002) higher than in vertebral metastases (0.39±0.11×10–3s/mm2). Conclusions. These data demonstrate that the ADC can be reliably measured in vertebral bodies. The quantitative evaluation of the ADC in vertebral bodies seems to be an objective and comparable parameter for differentiating malign from benign vertebral tissue.
    Notes: Zusammenfassung Ziel. Ziel der Arbeit war die Messung des Diffusionskoeffizienten (ADC) mittels diffusionsgewichteter (DW) MRT in Wirbelkörpermetastasen und in MR-morphologisch unauffälligen Wirbelkörpern. Die DW-MRT misst den für ein Gewebe spezifischen ADC, welcher der Eigendiffusion von Wasserstoffmolekülen entspricht. In zellreichem Tumorgewebe mit zahlreichen intra- und interzellulären Membranen (d. h. Diffusionsbarrieren) ist ein niedriger, in zellarmen oder nekrotischem Gewebe, ein hoher ADC zu erwarten. Methode. Bei 5 Patientinnen mit Mammakarzinom wurde der ADC von Lendenwirbelkörpermetastasen sowie von angrenzenden, MR-morphologisch unauffälligen Wirbelkörpern ermittelt (1,0 T; Phased-Array-Body-Coil; b: 880 und 440 s/mm2). Ergebnisse. Der ADC in MR-morphologisch unauffälligen Wirbelkörpern (1,3±0,23×10–3s/mm2) war signifikant (p≤0,0002) höher als in Wirbelkörpermetastasen (0,39±0,11×10–3s/mm2). Schlussfolgerung. Anhand dieser Daten konnte gezeigt werden, dass der ADC von Wirbelkörpern verlässlich gemessen werden kann, und dass durch die quantitative Bestimmung des ADC ein objektiv vergleichbarer Parameter zur Verfügung steht, der zur Differenzierung von malignem und benignem Gewebe gut geeignet erscheint.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050803
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  • 160
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    Diffusionsgewichtete Magnetresonanztomographie in der Diagnostik der Encephalitis disseminata (2000)
    Springer
    Der Radiologe 40 (2000), S. 1057-1063 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Diffusion ; Magnetresonanztomographie ; Encephalitis disseminata ; Keywords Diffusion ; Magnetic resonance imaging ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Magnetic resonance (MR) imaging is one of the best methods in diagnosis of multiple sclerosis, particularly in disclosure of active demyelinating lesions. Aim of this study was to compare diffusion weighted imaging and contrast enhancement in the detection of active lesions. A MR study with a contrast enhanced T1-weighted pulse sequence with magnetization transfer presaturation and a diffusion weighted echoplanar pulse sequence (b=1000 s/mm2) was performed in 17 patients (11 women, 6 men) with multiple sclerosis. 29 of 239 lesions showed an increased signal intensity in diffusion weighted imaging, 24 lesions a contrast enhancement, but only 16 lesions were visible in both pulse sequences. In patients with short clinical symptomatology significant more lesions could be detected with diffusion-weighted pulse sequence in comparison to patients with long standing symptomatology showing more lesions with contrast enhancement. Hence it is likely, that both pulse sequences detect different histopathologic changes. The early detection of demyelinating lesions in diffusion weighted imaging is attributed to the extracellular edema, however the contrast enhancement is caused by a blood brain barrier abnormality. It can be expected that diffusion weighted imaging will have a high impact on imaging of multiple sclerosis not only in therapeutic trials, but also in clinical routine.
    Notes: Zusammenfassung Die Magnetresonanztomograpie ist eine der wichtigsten Untersuchungsmethoden in der Diagnostik der Encephalitis disseminata, insbesondere im Nachweis aktiver Entmarkungsherde. Ziel der Untersuchung war es, diffusionsgewichtete und kontrastverstärkte Untersuchungen bezüglich der Erkennung aktiver Läsionen zu vergleichen. Bei 17 Patienten (11 Frauen, 6 Männer) mit bekannter Encephalitis disseminata wurden sowohl eine kontrastverstärkte T1-gewichtete Sequenz mit Magnetization-Transfer-Sättigung als auch eine diffusionsgewichtete Echoplanar-Sequenz (b=1000 s/mm2) durchgeführt. 29 der 239 Läsionen zeigten eine Signalsteigerung in der diffusionsgewichteten Sequenz, 24 eine Kontrastmittelaufnahme, jedoch waren nur 16 Läsionen in beiden Techniken nachweisbar. Bei Patienten mit kurzzeitig bestehender Symptomatik zeigten sich signifikant mehr Entmarkungsherde mit Signalsteigerung in der Diffusionswichtung im Vergleich zu Patienten mit länger bestehender neurologischer Symptomatik, die mehr kontrastmittelaffine Läsionen aufwiesen. Dies lässt darauf schließen, dass mit beiden Verfahren unterschiedliche histopathologische Veränderungen beobachtet werden. Das sehr frühe Auftreten der Diffusionsänderung in den Entmarkungsherden wird auf das Ödem zurückgeführt, während die Kontrastmittelaufnahme durch eine Blut-Hirnschranken-Störung verursacht wird. Es ist zu erwarten, dass die diffusionsgewichtete Magnetresonanztomographie einen hohen Stellenwert in der Bildgebung der Encephalitis disseminata nicht nur in Therapiestudien, sondern auch in der klinischen Routinediagnostik erlangen wird.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050878
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  • 161
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    Spontaneous osteonecrosis of the medial compartment of the knee: a MRI follow-up after conservative and operative treatment, preliminary results (2000)
    Springer
    Knee surgery, sports traumatology, arthroscopy 8 (2000), S. 83-88 
    Details
    ISSN: 1433-7347
    Keywords: Key words Osteonecrosis ; Bone marrow edema ; Knee ; High tibial osteotomy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract Symptoms in patients suffering from spontaneous osteonecrosis of the knee (SONK) may be reduced by high tibial osteotomy (HTO). However, the fate of the necrotic lesion is unknown and needs further investigation. We conducted a prospective study to evaluate magnetic resonance imaging (MRI) changes after operative and nonoperative treatment. Ten consecutive patients suffering from SONK of the medial compartment were given two treatment options: either HTO (n = 6) or conservative treatment with partial weight bearing for 3 months (n = 4). We measured the greatest extent of well-defined subchondral low signal intensity abnormality, considered to represent necrosis, and the surrounding area of intermediate signal intensity, considered to represent perifocal bone marrow edema, on T1-weighted coronal MRI images before and after treatment. The MRI follow-up period was 17.5 months (range 12–¶27) in the HTO group and 14.5 months (range 8–25) in the nonoperative group. At follow-up the MRI evaluation revealed a decrease in the low signal intense areas (necrosis) in five of the six patients in the HTO group. Only one of the four nonoperative patients showed a decrease in the low signal intense area. The intermediate intense areas (edema) decreased in all patients in the HTO group and in three of four in the nonoperative group. The mean decrease in the area of perifocal edema was significantly greater in the HTO group than in the nonoperative group (P = 0.019). No statistically significant difference was found for the area of necrosis between the two groups (P = 0.171). A clinical improvement was observed in all patients of the HTO group but in only two of the four patients of the nonoperative group. We conclude that the decrease in perifocal bone marrow edema seems to be associated with improved patient comfort. The MRI appearance of the necrotic lesion does not alter with either treatment mode.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001670050191
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  • 162
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    Intraoperative imaging with open magnetic resonance imaging and neuronavigation (2000)
    Springer
    Child's nervous system 16 (2000), S. 829-831 
    Details
    ISSN: 1433-0350
    Keywords: Keywords Intraoperative imaging ; Magnetic resonance imaging ; Anatomical and functional neuronavigation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The Erlangen-concept of image-guided-surgery is based on the installation of an open magnetic resonance (MR) scanner (Magnetom Open, 0.2 T, Siemens AG) in a twin operating room in combination with two neuronavigation systems (Stealth NeuroStation, Sofamor Danek, MKM Zeiss). Since March 1996 this method has been used for a total of 402 patients, among them 44 children. In 214 patients, mainly with gliomas or pituitary adenomas or who needed surgery for epilepsy, we performed intraoperative MR imaging to monitor the extent of resection, allowing a second look for possible tumor remnants and also compensating for brain shift by an intraoperative update of neuronavigation. Functional neuronavigation, i.e. the combination of anatomical neuronavigation with functional imaging [e.g. magnetoencephalography (MEG) and functional magnetic resonance imaging (fMRI)] was used in patients with lesions in brain areas such as the motor and speech areas. For MEG we used a MAGNES II biomagnetometer (Biomagnetic Technologies, San Diego, Calif.) and for fMRI a 1.5 T Siemens Symphony MR scanner. So far we have treated 89 patients with functional neuronavigation. Our preliminary experience indicates that intraoperative MR imaging, especially in combination with functional neuronavigation, allows more radical resections with lower morbidity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810000344
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  • 163
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    Cavum veli interpositi and psychotic disorder in a monocygotic twin (2000)
    Springer
    European archives of psychiatry and clinical neuroscience 250 (2000), S. 76-78 
    Details
    ISSN: 1433-8491
    Keywords: Key words Septum pellucidum ; Developmental ¶disorder ; Schizophrenia ; Magnetic resonance imaging ; Cavum veli interpositi ; Cavum septi pellucidi
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The case of monocygotic twins discordant for a psychotic disorder is presented. An anomaly of the septum pellucidum, a so-called cavum veli interpositi was found in the psychotic twin while his brother showed no such anomaly. Previous studies have shown a higher prevalence of septum pellucidum anomalies in schizophrenic patients. Abnormalities of the septum pellucidum may be associated with disturbed neuronal development in distinct limbic brain areas which cannot yet be visualized yet by brain imaging techniques. The finding of the cavum veli interpositi in the psychotic twin could be incidental; however, it may indicate a dysgenic process in early brain development and, thus, play a significant role in the etiology of psychosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004060070038
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  • 164
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    Infusional ECarboF in patients with advanced breast cancer: A very active and well-tolerated out-patient regimen (2000)
    Springer
    Annals of oncology 11 (2000), S. 1557-1561 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; carboplatinum ; chemotherapy ; continuous 5-fluorouracil
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We performed a trial using the combination of epirubicin 50mg/m2/day 1, carboplatinum AUC 5/day 1 and continuous5-fluorouracil (5-FU) 200 mg/m2/day (every 4 weeks for6 months) to confirm the efficacy and low toxicity profile of thisregimen in breast cancer. In 51 patients with metastatic(n = 33) or locally advanced (n = 18)breast cancer the overall response rate was 86% (95% confidenceinterval (95% CI): 73%–94%): 94% in locallyadvanced and 81% metastatic disease. Grade 3–4 toxicity was low:4% of patients presented with febrile neutropenia, 16% withsevere palmar-plantar syndrome, 10% with Port-a-cath thrombosis. This study confirms the high efficacy of infusional 5-FU-based regimens andjustifies further research into novel promising oral 5-FU derivatives.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008378220547
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  • 165
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    Intra-arterial chemotherapy for unresectable pancreatic cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 569-573 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; intra-arterial ; liver metastasis ; unresectable pancreatic cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:A phase II trial of a new intra-arterial chemotherapyregimen for unresectable pancreatic cancer (UPC). Patients and methods:Ninety-six patients with UPC were treatedwith intra-arterial chemotherapy at three-weekly intervals. The schedule usedwas FLEC: 5-fluorouracil 1000 mg/m2, folinic acid 100mg/m2, carboplatin 300 mg/m2; epirubicin 60mg/m2. Results:The overall response rates by CT-scan evaluation were:15% partial response (PR), 44% stable disease (SD), 17%progressive disease (PD). The overall median survival was 9.9 months, and 10.6and 6.8 for UICC stage III and IV, respectively. Pain reduction occurred in42% of patients. A weight gain 〉7% from baseline occurred in8% of patients. A total of 341 courses of FLEC were administered. Grade3–4 hematological toxicity was seen in 25% of patients;ematemesis in 4%; grade 3 gastrointestinal toxicity in 3%; andgrade 3 alopecia in 16%. One sudden death, a pre-infarction angina, anda transitory ischemic attack were observed. The only complication related tothe angiographic procedure was an intimal dissection of the iliac artery. Conclusions:The intra-arterial FLEC regimen was well toleratedand active. It requires only one day of hospitalization. Efficacy could onlybe assessed in a randomized study against a gemcitabine containing regimen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008335331516
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  • 166
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    Ifosfamide plus oral etoposide salvage chemotherapy for platinum-resistant paclitaxel-pretreated ovarian cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 607-612 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; combination ; etoposide ; ifosfamide ; ovarian cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:The prognosis of platinum resistant ovarian cancer isvery poor and the treatment of choice has not been clearly defined. Patients and methods:We conducted a phase II study with thecombination of ifosfamide i.v. at 2.25 g/m2 (days 1, 2) andetoposide per os at 100 mg daily (days 1–10) every four weeks. To beeligible for the study patients had to be resistant to platinum and paclitaxelpretreated. Results:Forty-one patients entered the study. The median intervalfrom the previous chemotherapy was 3.9 months. The median number of previouschemotherapeutic regimens was 2. Severe toxicities included neutropenia(41% of patients), leukopenia (29%) and thrombocytopenia(13%). Thirty-five patients are assessable for response. Nine patientsresponded (22% of the eligible, 26% of the assessable), four ofthemdemonstrated complete response to chemotherapy (10% and 12%,respectively), while three patients demonstrated stabilization of theirprogressive disease. After a median follow-up of 18 months, time toprogression is 3 months (range 0.9–14.4), duration of response is 9months (2.5–11) and median survival is 13 months (2.5–37.4+). Conclusions:The combination of ifosfamide with oral etoposideappears to have significant but manageable toxicity and encouraging efficacyin platinum resistant ovarian cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008327412571
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  • 167
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    Recurrent squamous-cell carcinoma of the head and neck: Overview of current therapy and future prospects (2000)
    Springer
    Annals of oncology 11 (2000), S. 11-16 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; gene therapy ; head and neck cancer ; immunotherapy ; radiotherapy ; recurrent ; surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Locoregional recurrence is the most common cause of failure after head andneck cancer surgery. It is a disease which causes significant morbidityespecially on speech and swallowing. There are many different treatmentsavailable including surgery, reirradiation and chemotherapy. However, none ofthese have produced any significant survival benefit. Because of this, therehas been considerable interest in the development of new biological therapiessuch as gene therapy and immunotherapy for this disease. The objectives ofthis article are to provide an overview of the currently available therapiesfor recurrent head and neck cancer including gene therapy and immunotherapy.Prevention of recurrent disease by the detection and treatment of minimalresidual disease is also discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008330026617
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  • 168
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    A phase II study of pegylated liposomal doxorubicin for treatment of advanced hepatocellular carcinoma (2000)
    Springer
    Annals of oncology 11 (2000), S. 113-114 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; hepatocellular carcinoma ; liposomal doxorubicin ; phase II
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Pegylated liposomal doxorubicin has an enhancedefficacy and reduced toxicity compared with free doxorubicin. The efficacy andtoxicity of pegylated liposomal doxorubicin was investigated in patients withhepatocellular carcinoma. Patients and methods:Patients with histologically confirmed,locally advanced or metastatic hepatocellular carcinoma and a Karnofsky index〉60% were included in this prospective single-arm study. Exclusioncriteria were liver cirrhosis stage Child–Pugh C, previous chemotherapy,or chemoembolization. Pegylated liposomal doxorubicin was given in a dose of30 mg/m2 every three weeks until progression of disease. Afterinclusion of five patients the dose could be escalated to 40 mg/m2in absence of toxicity grade 3 and 4. Results:Sixteen patients were evaluable for response. Noobjective response was achieved. The median survival time was 140 days(95% confidence interval: 126–154 days). Treatment toxicitiesgrade ≥3 comprised increased liver enzymes in patients with preexistinggrade 1 or 2 elevation (n = 6), hematologic toxicity (n =5), and hypersensitivity (n = 2). Conclusions:Pegylated liposomal doxorubicin is not effective fortreatment of advanced hepatocellular carcinoma. The favorable toxicity profilewas confirmed even in patients with underlying liver disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008386822906
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  • 169
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    A phase I–II study of gemcitabine and paclitaxel in advanced non-small-cell lung cancer patients (2000)
    Springer
    Annals of oncology 11 (2000), S. 109-112 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; gemcitabine ; non-small-cell lung cancer ; paclitaxel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thirty patients with chemotherapy-naïve advanced non-small-cell lungcancer (NSCLC) were given escalating doses of paclitaxel (150, 175, 200mg/m2) on day 1 in three consecutive cycles, together with a fixeddose of gemcitabine 1000 mg/m2 on days 1 and 8; cycles wererepeated every three weeks. The dose escalation of paclitaxel was feasible inthe majority of patients. Subsequently, 30 other NSCLC patients received adose of 200 mg/m2 paclitaxel with gemcitabine 1000 mg/m2in a phase II study. The major side effect was mild myelosuppression. Aresponse rate of 24% was achieved in 49 fully evaluable patients. Thisregimen proved to be safe and easy to administer on an out-patient setting,and constitutes now one of the arms of the current EORTC randomized study foradvanced NSCLC.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008321000887
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  • 170
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    Acute hematologic toxicity and practicability of dose-intensified BEACOPP chemotherapy for advanced stage Hodgkin's disease (2000)
    Springer
    Annals of oncology 11 (2000), S. 1105-1114 
    Details
    ISSN: 1569-8041
    Keywords: BEACOPP ; chemotherapy ; dose intensification ; hematotoxicity ; Hodgkin's disease ; practicability
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Evidence is recently accumulating that the novelBEACOPP (bleomycin (B), etoposide (E), adriamycin (A), cyclophosphamide (C),vincristine (O), procarbazine (P), prednisone (P)) chemotherapy is a highlyeffective treatment for advanced stage Hodgkin's disease. Two dose variantsof BEACOPP are currently tested in a phase III randomized multicenter trialof the GHSG. To enable more extensive testing of BEACOPP we characterized itspracticability regarding schedule adherence, acute hematotoxicity and need forsupportive treatment. Patients and methods:Data of 858 patients (6592 therapy cycles)from 184 participating institutions were evaluated. Planned total drug dosesof the baseline variant (arm 1) were 80, 2400, 200, 5200, 11.2, 5600 and 4480mg/m2 for B, E, A, C, O, P and P, respectively. Compared to arm 1,the doses of E, A and C in the dose-intensified variant (arm 2) were escalatedby factor 2.0, 1.4, 1.92, respectively, using G-CSF assistance. Stepwise dosereductions were specified in case of dose-limiting toxicities. Both variantsare given in eight three-weekly courses. Results:Median dose adherence (dose actually given relative toplanned arm 1 dose) in arm 1 was 1.0 for all drugs. Relative dose escalationof E, A, and C actually maintained in arm 2 was 1.83, 1.37 and 1.77 (medians),respectively, and 70% of patients maintained elevated dose levelsthroughout the entire treatment. Dose-limiting toxicities occurred in25% of cycles in arm 2, most frequently due to leukocytopenia andthrombocytopenia. Time courses of leukocytes in arm 2 showed more severe butnot more prolonged leukocytopenia compared with arm 1. WHO grades 3–4infections were documented in 2.1% (arm 1) and 3.1% (arm 2) ofall cycles. Erythrocytes were transfused in 6% (arm 1) and 28%(arm 2), platelets in 〈1% (arm 1) and 6% (arm 2) of allcycles. Conclusions:Both BEACOPP schemes are practicable in a largemulticenter setting. Despite increased hematotoxicity, moderate doseescalation is safe for the majority of the patients with G-CSF assistance andstandard supportive treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008301225839
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  • 171
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    Radiation myositis: The possible role of gemcitabine (2000)
    Springer
    Annals of oncology 11 (2000), S. 1615-1616 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; gemcitabine ; radiotherapy ; radiation myositis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008353224251
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  • 172
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    A phase II trial of docetaxel in platinum pre-treated patients with advanced epithelial ovarian cancer: A Japanese Cooperative Study (2000)
    Springer
    Annals of oncology 11 (2000), S. 1531-1537 
    Details
    ISSN: 1569-8041
    Keywords: advanced ovarian cancer ; chemotherapy ; docetaxel ; phase II trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:This phase II study was conducted to evaluate theefficacy and toxicity of docetaxel in Japanese patients with advanced ovariancancer. Patients and methods:Docetaxel was administered at a dose of 70mg/m2 intravenously to patients with platinum pre-treated advancedovarian cancer. Treatment was repeated every three weeks. No routinecorticosteroid premedication was given. Results:Ninety patients with advanced ovarian cancer were enteredand sixty were assessable for response. The overall response rate was28% in the assessable patients (95% confidence interval(95% CI): 17.5%–41.4%). CA125 responses were seenin 8 (24%) of 34 assessable patients for CA125 criteria. The 36platinum-refractory patients had a response rate of 25% compared with33% in the platinum-sensitive patients. The predominant toxicity wasneutropenia, with 86% of the patients experiencing grade 3 or 4.Hypersensitivity reactions occurred in 37% of the patients and were notlife threatening. Edema was mild and infrequent. Conclusion:Docetaxel at 70 mg/m2 demonstratedeffectiveness as a treatment of both platinum-sensitive andplatinum-refractory ovarian cancer patients, with a low incidence of severehypersensitivity reactions and edema.
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    URL: http://dx.doi.org/10.1023/A:1008337103708
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  • 173
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    Is `one cycle every three or four weeks' obsolete? A critical review of dose-dense chemotherapy in solid neoplasms (2000)
    Springer
    Annals of oncology 11 (2000), S. 133-149 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; dose ; dose-density ; dose-intensity ; high-dose chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Shortening the interval between cycles is one meansof increasing the dose intensity of chemotherapy, and can be supported bybiological and mathematical rationales. Our objective was to assess theclinical relevance of the rapid repetition of regimens (so-called `dose-densechemotherapy') in various solid neoplasms. Design:The medical literature was reviewed in accord withMulrow's recommendations. Randomised studies comparing frequently-repeatedchemotherapy to standard regimens as well as open studies are described andcritically examined. Results:Dose-dense regimens were widely found to be feasible. In small-cell lung cancer, survival of patients receiving dose-denseregimens was better than that of patients treated by standard chemotherapy inthree trials, two of which reached significance, when these intensive regimensallowed better dose intensity. In poor-prognosis germ-cell tumors, a dose-dense regimen was not betterthan standard therapy, perhaps because of an excessively high toxicity-relateddeath rate. However, recent phase II studies have provided encouragingresults. In early breast cancer, the one published randomized study in the adjuvantsetting showed only a trend towards better disease-free survival innode-positive women receiving a weekly-repeated regimen. Two randomized trialsfailed to show any benefit in the neoadjuvant setting with a dose-denseregimen. No evidence of a benefit was provided in metastatic breast cancer. In advanced colorectal cancer, evidence of an improvement in survival withweekly or bi-weekly 5-FU–leucovorin compared to a classic monthlyschedule has recently been shown in two randomized trials, and dose-denseregimens are recognized as standard therapy in many countries. Phase II studies of dose-dense regimens have also shown high response ratesand long survival in many neoplasms, including Ewing's sarcoma, gestationaltrophoblastic disease, ovarian carcinoma and gastric cancer. Conclusions:A considerable amount of experience has been gainedwith frequently-repeated regimens. A few randomized trials have demonstrateda benefit for survival on standard chemotherapy in small-cell lung cancer andadvanced colorectal cancer. However, this benefit appears to be weak. Thecombination of dose-dense chemotherapy regimens with new anti-cancerstrategies based on our insights into the mechanisms of oncogenesis is achallenge on the eve of the millennium.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008344014518
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  • 174
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    Thyroid carcinosarcoma, a rare and aggressive histotype: A case report (2000)
    Springer
    Annals of oncology 11 (2000), S. 1497-1499 
    Details
    ISSN: 1569-8041
    Keywords: carcinosarcoma ; chemotherapy ; thyroid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thyroid carcinosarcoma is a rare and aggressive thyroid tumor. Histologicalexamination of a tumor showed the characteristic of epithelial carcinoma andmesenchymal differentiation. We retrospectively analyzed the course of thepatient and reviewed the literature in which only 19 other cases aredescribed. Carcinosarcoma of the thyroid is a very aggressive tumor with aclinical course similar to anaplastic thyroid carcinoma. Survival is veryshort despite aggressive multimodal treatment.
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    URL: http://dx.doi.org/10.1023/A:1026538410510
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  • 175
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    Acute myeloid leukemia and lung cancer occurring in a chronic lymphocytic leukemia patient treated with fludarabine and autologous peripheral blood stem-cell transplantation (2000)
    Springer
    Annals of oncology 11 (2000), S. 1493-1495 
    Details
    ISSN: 1569-8041
    Keywords: acute myeloid leukemia ; chemotherapy ; chronic lymphocytic leukemia ; immunosuppression ; second neoplasms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An increased incidence of different malignancies associated to chroniclymphocytic leukemia (CLL) has been reported. The association of CLL and acuteleukemia is a rare event described in 〈1% of CLL, the type of acuteleukemia being either from the lymphoid or more often from the myeloidlineage. The coexistence of acute myeloid leukemia (AML) and CLL in the samepatient has been occasionally reported. Most of these cases have beenassociated with the administration of chemotherapy or radioterapy for CLL,suggesting that the former may be a secondary leukemia. On the other hand, CLLcould precede, but could also be diagnosed at the same, or delayed time asAML, suggesting the presence of other leukemogenic factors. We describe theexceptional development of AML and lung cancer in a patient with previouslydiagnosed CLL in minimal residual disease status after fludarabine treatmentfollowed by autologous peripheral blood stem-cell transplantation.
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    URL: http://dx.doi.org/10.1023/A:1026505632679
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  • 176
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    Phase II EORTC trial with 5-fluorouracil, cisplatin and interferon-α as second-line treatment of advanced transitional cell cancer of the urothelial tract (2000)
    Springer
    Annals of oncology 11 (2000), S. 1391-1394 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; interferon ; transitionall-cell carcinoma ; urothelial tract
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Based on the favorable results of the combination5-fluorouracil (5-FU), cisplatin and interferon-α as second-line treatmentin advanced metastatic transitional-cell carcinoma of the urothelial tract aconfirmatory study was executed in a multicenter setting. Patients and methods:In this open label phase II study 43patients failing adequate previous chemotherapy were treated with IFN-α2b5 MU/m2 subcutaneously for 5 consecutive days starting on day 1 and22 simultaneous with 5-FU 500 mg/m2 daily as a continuous infusion.In between the same dose of IFN-α2b was given 3 times weekly with CDDP 25mg/m2 on days 1, 8, 15 and 22. This cycle was repeated every sixweeks. Results:In 40 eligible patients 5 PR were seen (12.5%;95% confidence interval (95% CI):4.1%–26.8%). The major toxicity was hematological. Twotoxic deaths were seen due to gastro-intestinal hemorrhage. Conclusions:In view of these results this combination can not berecommended as second line treatment for metastatic transitional-cellcarcinoma of the urothelial tract.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1026589120989
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  • 177
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    Metastatic secretory breast cancer. Non-responsiveness to chemotherapy: Case report and review of the literature (2000)
    Springer
    Annals of oncology 11 (2000), S. 1343-1347 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; Her2/neu ; indolent ; malignant ; palliative care ; secretory breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Secretory carcinoma of the breast is a rare and indolent tumour originallydescribed in children but occurring equally in the adult population. Theprincipal management problems following primary surgical treatment are localrecurrence and axillary lymph node metastases. Distant metastases areextremely rare. We present the case of a 27-year-old woman with pulmonary metastases froma secretory breast cancer treated by mastectomy and axillary lymph nodedissection 12 years previously. There was no response to chemotherapy; however, the patient remained aliveand active two years from presentation with metastatic disease and one yearfrom cessation of all cytotoxic chemotherapy. She eventually died ofrespiratory failure two and a half years after presentation. To our knowledge, this is only the fourth reported case of distantmetastases from secretory breast cancer and the second reported case in whichcurrent active chemotherapy has been used. We review the literature anddiscuss the apparent chemoresistance of this tumour including the lack ofmembrane staining for Her2/neu. In the absence of any proven effective chemotherapy we believe that symptomcontrol becomes the focus of management and offers patients with metastaticsecretory breast cancer the greatest chance of a functional and good qualityexistence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008387800525
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  • 178
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    A phase I trial of docetaxel and gemcitabine in patients with advanced cancer (2000)
    Springer
    Annals of oncology 11 (2000), S. 421-426 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; docetaxel ; gemcitabine ; non-small-cell lung cancer ; phase I trials ; taxanes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Docetaxel and gemcitabine are active in a broad rangeof malignancies. The objective of this phase I trial was to determine themaximally tolerated doses of the combination of docetaxel and gemcitabine. Patients and methods:Patients with advanced cancer, WHOperformance status 0–2, who had received up to one prior chemotherapyregimen were treated with gemcitabine on days 1 and 8 and docetaxel on day 8repeated every 21 days. Prophylactic ciprofloxacin was commenced on day 11 ofeach cycle and continued until the neutrophil count reached 1.0 ×109/l. G-CSF was not administered. Dose levels studied weredocetaxel/gemcitabine: 60/800, 60/1000, 75/1000, 75/1200, 85/1200 and 100/1200mg/m2. Results:Thirty-nine patients were entered and all were assessablefor toxicity. The highest administered dose level was 100 mg/m2docetaxel and 1200 mg/m2 gemcitabine with dose limiting toxicitiesof febrile neutropenia, grade 4 neutropenia ≥7 days, grade 4thrombocytopenia, grade 3 stomatitis and/or grade 3 fatigue in three out ofsix patients. Treatment was well tolerated (40 cycles) in the 10 patientstreated at the recommended dose level (85/1200) with only a single episode offebrile neutropenia and grade 3 or 4 non-hematologic toxicity was infrequent.There was no significant pulmonary toxicity. Responses were seen in a rangeof malignancies including non-small-cell lung cancer. Conclusions:The recommended dose level of 85 mg/m2docetaxel and 1200 mg/m2 gemcitabine has a favourable toxicityprofile and is suitable for further investigation in phase II trials. Thisnon-platinum containing regimen warrants further investigation as a potentialalternative to platinum containing regimens in non-small-cell lung cancer andother malignancies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008384326701
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  • 179
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    Phase I study with weekly cisplatin–paclitaxel and concurrent radiotherapy in patients with carcinoma of the cervix uteri (2000)
    Springer
    Annals of oncology 11 (2000), S. 455-459 
    Details
    ISSN: 1569-8041
    Keywords: cervical cancer ; chemotherapy ; phase I ; radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background.Cisplatin and paclitaxel are active in cervical cancerand both are able to potentiate the effects of radiotherapy. In this study weevaluated the maximum-tolerated dose (MTD) of paclitaxel in combination witha fixed dose of cisplatin when given weekly concurrently with pelvicradiotherapy to patients with carcinoma of the cervix uteri. Patients and methods:Eighteen patients with cervical cancer wereenrolled in this study. Cisplatin (30 mg/m2) and paclitaxel(starting dose 40 mg/m2; 5 mg/m2 escalation per level)were given on day 1 of radiotherapy and then weekly for six times.Radiotherapy was given to the pelvis with a four-field box technique for fivedays each week. Patients received 65 Gy in 1.8 Gy fractions. Cohorts of threepatients were enrolled at each level and three further patients were includedif one or two dose-limiting severe adverse events (SAE) were recorded. SAE wasdefined as grade 3 or 4 nonhematologic toxicity, excluding nausea or vomitingand alopecia, grade 4 neutropenia or thrombocytopenia, and prolonged (〉1week) neutropenia or thrombocytopenia. Results:Four levels were studied (paclitaxel 40, 45, 50, 55mg/m2) with three, five, four and six patients enrolled,respectively. The MTD of paclitaxel was found at 50 mg/m2/wk andcisplatin 30 mg/m2/wk. Diarrhea was the dose-limiting toxicity.Thirteen patients were evaluable for response: seven complete and five partialresponses were obtained with an overall response rate of 92.3%. Conclusions:The MTD of paclitaxel is 50 mg/m2/wk whenassociated to cisplatin 30 mg/m2/wk and concurrent pelvicradiotherapy. Diarrhea is the dose limiting side effect. Preliminary datasuggest that concurrent chemoradiotherapy with paclitaxel and cisplatin couldbe a very active treatment for patients with locally advanced carcinoma of thecervix.
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    URL: http://dx.doi.org/10.1023/A:1008379922120
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  • 180
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    Grading of chemotherapy-induced peripheral neuropathy (2000)
    Springer
    Annals of oncology 11 (2000), S. 509-513 
    Details
    ISSN: 1569-8041
    Keywords: assessment ; chemotherapy ; eripheral neuropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008345613594
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  • 181
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    Gemcitabine and vinorelbine as second-line treatment in patients with metastatic breast cancer progressing after first-line taxane-based chemotherapy: A phase II study conducted by the Hellenic Cooperative Oncology Group (2000)
    Springer
    Annals of oncology 11 (2000), S. 873-875 
    Details
    ISSN: 1569-8041
    Keywords: advanced breast cancer ; chemotherapy ; gemcitabine ; vinorelbine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Gemcitabine and vinorelbine have shown activity inbreast cancer. A phase II trial was initiated in order to evaluate theresponse rate (RR) and time to progression (TTP) of the combination of the twodrugs in patients with metastatic breast cancer progressing after first-linetaxane-based chemotherapy. Patients and methods:Thirty-one patients were treated with thecombination of gemcitabine 1000 mg/m2 days 1 + 8 and vinorelbine30 mg/m2 days 1 + 8. The cycles were repeated every three weeks. Results:Of 27 evaluable patients 1 (4%, 95%confidence interval (95% CI): 0.1%–19%) achievedcomplete remission (CR), five (18%; 95% CI:6%–38%) partial remission (PR), eleven (40%;95% CI: 22%–61%) stable disease and ten patientsprogressed. The median duration of response was six months (range 4–10+)and the median duration of disease stabilization was five months (range2–22+). With a median follow-up of 16 months (range 0.4–22+) themedian TTP was 3.5 months (range 0.4–22+) and the median survival was9.5 months (range 0.4–22+). Grade 3–4 toxicities weregranulocytopenia 15 patients (48%), rash 3 patients (10%),neuropathy 1 patient (3%) and thrombocytopenia 1 patient (3%).In conclusion the combination of gemcitabine/vinorelbine in the dosesadministered in this group of patients had a response rate of 22% andneeds to be further evaluated in metastatic breast cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008361711049
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  • 182
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    Therapeutic management of primary central nervous system lymphoma: Lessons from prospective trials (2000)
    Springer
    Annals of oncology 11 (2000), S. 927-937 
    Details
    ISSN: 1569-8041
    Keywords: brain lymphomas ; chemotherapy ; intrathecal chemotherapy ; methotrexate ; primary central nervous system lymphoma ; radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Primary central nervous system lymphomas (PCNSL) are aggressivemalignancies, exhibiting one of the worst prognoses among lymphomas. The besttreatment modality for PCNSL has not yet been identified. Several therapeuticquestions still remain unanswered, and some methodological pitfalls inclinical trials prevent definitive conclusions from being drawn. In thisreview, certain aspects of trial design as well as emerging therapeuticguidelines are analyzed, and future perspectives are discussed. In the vast majority of prospective trials, general criteria for treatmentof aggressive lymphomas were adopted, choosing primary chemotherapy (CHT)followed by radiotherapy (RT) as therapeutic modality. This strategy produceda five-year survival of 22%–40% in comparison to the3%–26% reported with RT alone. Systemic high-dosemethotrexate (HD-MTX) seems to be the most effective drug, producing aresponse rate of 80%–90% and a two-year survival of60%–65%. To date, the addition of other drugs atconventional doses have not consistently improved outcome. With a fewexceptions, any regimen without HD-MTX comprehensively performed no betterthan RT alone. In combined treatment, RT doses should be decided on the bases of responseto primary CHT and the number of lesions, and, until definitive conclusionsfrom well-designed trials are available, RT parameters should follow thewidely accepted principles used for other aggressive lymphomas. CHT asexclusive treatment, keeping RT for relapses or persistent disease, appearsto be an attractive strategy. However, the worldwide experience with thismodality is still limited, and corroborating data are needed. Intrathecal CHTstill has not found a defined role in PCNSL management. Preliminary data seemto indicate that adequate meningeal treatment with HD-MTX, but withoutintrathecal CHT, could also be suitable in positive-cerebrospinal fluidpatients. Future efforts should be addressed to identify new active drugs and moreefficient CHT combinations, to evaluate the efficacy of high-dose CHTsupported by autologous peripheral blood stem cells transplantation, and toclarify the impact of RT delay in complete responders, the usefulness ofintrathecal CHT, and the best management for elderly patients. The assessmentof impact of treatment on neuropsychological functions and quality of life isa mandatory endpoint in clinical trials.
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    URL: http://dx.doi.org/10.1023/A:1008376412784
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  • 183
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    Acute deterioration of Charcot–Marie–Tooth disease IA (CMT IA) following 2 mg of vincristine chemotherapy (2000)
    Springer
    Annals of oncology 11 (2000), S. 743-747 
    Details
    ISSN: 1569-8041
    Keywords: Charcot–Marie–Tooth disease ; chemotherapy ; hereditary motor and sensory neuropathy ; PMP22 ; vincristine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Severe up to life-threatening neuropathy has beenobserved in patients with hereditary neuropathies receiving vincristine. Case report:A 52-year-old female painter suffering fromhigh-grade non-Hodgkin's lymphoma (stage IVB) was treated with a total of 4mg of vincristine during two courses of CHOP chemotherapy (cyclophosphamide,vincristine, adriamycin, prednisone). At onset of treatment no neurologicalproblems were reported. There was good lymphoma response to chemotherapy. Atthe same time, however, the patient gradually developed dysphagia, dysarthria,muscular weakness of both lower and upper extremities, areflexia, paraesthesiaof the fingertips and bilateral sensory impairment of feet and lower legs.These symptoms continually worsened over a period of seven weeks until she wasunable to walk or to perform her work. Electrophysiological studies showedperipheral axonal and demyelinative sensorimotor neuropathy in correlation tohistological findings. Molecular analysis revealed 17p11.2 duplication typicalfor Charcot–Marie–Tooth disease IA. While continuing chemotherapywithout the use of vincristine the patient's neurologic symptoms slowlyrecovered within six months. Conclusion:Prior to administration of vincristine family andpatient history as well as physical examination should be performed carefullyto look for underlying hereditary neuropathy. For those patients with aclinical history or symptoms suggestive for CMT nerve conduction velocitystudies and on an individual base even molecular genetic analysis areneccessary to prevent serious neurologic complications.
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    URL: http://dx.doi.org/10.1023/A:1008369315240
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  • 184
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    Chemotherapy in advanced androgen-independent prostate cancer 1990–1999: A decade of progress? (2000)
    Springer
    Annals of oncology 11 (2000), S. 1523-1530 
    Details
    ISSN: 1569-8041
    Keywords: androgen-independent prostate cancer ; chemotherapy ; metastatic prostate cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background and purpose:A great number of clinical researchstudies have been reported in the field of chemotherapy for advancedandrogen-independent prostate cancer during the last ten years. The aims ofthe present review were to assess their impact on management of the diseaseand on survival of patients. Methods:The review of full published reports was facilited by theuse of a MEDLINE computer search. Results:Clinical research studies have focused on definingguidelines for eligibility criteria and accurate endpoints for patients to beenrolled onto clinical trials and developing new agents or combinationof drugs including estramustine phosphate. Any combination of currentchemotherapy has no impact on overall survival of patients. Among drugs indevelopment, only the promising activity observed with docetaxel deservesrandomized trials to assess its impact on survival. The major innovativeadvance of the 90s is the demonstration of the impact of chemotherapy(mitoxantrone + prednisone) on quality of life as compared to prednisonealone. A greater and longer-lasting improvement in quality of life along witha concomitant decrease in costs was observed. Conclusions:At the present time, chemotherapy should beconsidered as a palliative treatment in patients with symptomaticandrogen-independent disease. The enrollment of patients into clinical trialsdealing with quality of life as primary endpoint is strongly solicited. Astandard methodology should be used in phase II trials with a primary goal ofselection of agents which should progress to randomized trials using survivalas an endpoint. Hopefully new specific strategies targeted to reverse themolecular changes that underlie prostate tumorigenesis should rapidly impactthe multimodality management of AIPC in the third millenium.
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    URL: http://dx.doi.org/10.1023/A:1008394823889
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  • 185
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    Pancreatic metastasis of a pleuropulmonary blastoma in an adult (2000)
    Springer
    Annals of oncology 11 (2000), S. 1609-1611 
    Details
    ISSN: 1569-8041
    Keywords: cancer ; chemotherapy ; pleuropulmonary blastoma ; PPB ; soft tissue sarcoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pleuropulmonary blastoma (PPB) is a rare dysontogenetic tumor that usuallydevelops in the first decade of life and has been recognized as a distinctclinico-pathological entity different from the ordinary pulmonary blastoma ofadulthood. Since the tumor grows aggressively and tends to metastasize early,physicians have to be aware of late onset of symptoms and uncommonmanifestations. We report a case of PPB in a young adult and its recurrencein the pancreas after primary surgical treatment and adjuvant chemotherapy.Keeping in mind the moderate prognosis of PPB in children, accurate assessmentand treatment of PPB require a team approach of oncology, radiology andsurgery to establish new therapeutic guidelines in the future.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008339425495
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  • 186
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    Guillain–Barré syndrome in a patient with non-Hodgkin's lymphoma (2000)
    Springer
    Annals of oncology 11 (2000), S. 217-220 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; Guillain–Barré syndrome ; lymphoma ; polyneuropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe a case of Guillain–Barré syndrome (GBS) in apatient with non-Hodgkin's lymphoma (NHL). A 21-year-old woman with a newlydiagnosed stage IV high-grade lymphoma (precursor T-cell NHL according to theR.E.A.L. Classification) developed flaccid quadriparesis and bilateral facialdiplegia after three weeks of treatment with vincristine, daunorubicin,L-asparaginase and prednisolone. The clinical course and neurologicalexamination were consistent with GBS. Despite treatment with intravenousimmunoglobulins her neurological symptoms progressed. Plasmapheresis wastherefore initiated followed by intravenous immunoglobulins. After partialremission of neurologic symptoms, induction chemotherapy with cyclophosphamideand cytarabine was continued without any further complication. Three monthslater, the lymphoma was in complete remission. GBS has been described inHodgkin's disease and after bone marrow transplantation but is rare in NHL.In patients with NHL who develop neurological symptoms, drug toxicity andnervous system infiltration are the leading cause of neuropathology, but GBSshould be considered in the differential diagnosis.
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    URL: http://dx.doi.org/10.1023/A:1008389607293
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  • 187
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    Pegylated liposomal doxorubicin in treating a case of advanced hepatocellular carcinoma with severe hepatic dysfunction and pharmacokinetic study (2000)
    Springer
    Annals of oncology 11 (2000), S. 349-354 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; doxorubicin ; hepatocellular carcinoma ; liposome ; pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:There is lack of effective and safe chemotherapy foradvanced hepatocellular carcinoma. Polyethylene glycol-coated (pegylated)liposomal doxorubicin (PLD) has long circulation time and enhanced drugaccumulation in the tumor tissues. It has significant activity in Kaposi'ssarcoma, breast and ovarian cancers and the acute adverse effects of free drugare reduced. Patients and methods:A patient with advanced hepatocellularcarcinoma was treated with PLD and a pharmacokinetic study was performed.Initial serum total and direct bilirubin were 3.6 and 6.8 folds of uppernormal, respectively, and an indocyanine green clearance test at 15 minuteswas 26.3% (normal 〈 15%). Results:Compared to cases with normal liver function, increasedvolume of distribution of doxorubicin correlated with a large amount ofascites (P〈 0.05). The clearance of drug was unexpectedly higherthan in cases with normal liver function (P〈 0.05). According tothe pharmacokinetic studies, the disposition of PLD in this case has not beenretarded even in the presence of severe liver dysfunction. Only minimaltoxicities including grade 2 stomatitis and moderate leukopenia were observed.The tumor had a partial remission and the patient survived nine months afterPLD treatment. Conclusion:PLD could serve as a safe and effective treatment forhepatocellular carcinoma even in the presence of impaired liver function. Itsrole in treating advanced hepatocellular carcinoma is worthy of further study.
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    URL: http://dx.doi.org/10.1023/A:1008394125040
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  • 188
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    Vinorelbine–gemcitabine in advanced non-small-cell lung cancer (NSCLC): An AASLC phase II trial (2000)
    Springer
    Annals of oncology 11 (2000), S. 993-998 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; gemcitabine ; non-small-cell lung cancer ; phase II trial ; vinorelbine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose:The purpose of the present phase II trial was todetermine the efficacy and toxicity of vinorelbine–gemcitabine inpatients with advanced non-small-cell lung cancer (NSCLC). Patients and methods:From December 1997 to February 1999, 78chemotherapy-naive patients (median age 60 years, Karnofsky performance statusof 100, 90, 80 and 70 present in 5%, 41%, 36% and18% of the patients, respectively) with stage IIIB (17%) or IV(83%) NSCLC (65% adenocarcinomas, 22% squamous-cellcarcinomas, 10% large-cell carcinomas, 3% mixed-cell carcinomas)received 25 mg/m2 vinorelbine and 1200 mg/m2 gemcitabineon days 1, 8 and 15 of a four-week cycle. Results:In an intent-to-treat analysis, partial responses wereseen in 19% of the patients. The median duration of response was 4.4months. The median survival time was seven months and the one-year survivalrate was 32%. Myelosuppression was the main side effect with WHO grade3/4 neutropenia and thrombocytopenia in 35% and 11% of thepatients, respectively. Other side effects were usually mild to moderate. Conclusions:Vinorelbine–gemcitabine is active, welltolerated and easy to administer on an outpatient basis in advanced NSCLC.Thus a randomized comparison of this combination with platinum-based protocolsis warranted in patients with advanced NSCLC.
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    URL: http://dx.doi.org/10.1023/A:1008370704612
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  • 189
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    Second-line chemotherapy with weekly oxaliplatin and high-dose 5-fluorouracil with folinic acid in metastatic colorectal carcinoma: A Hellenic Cooperative Oncology Group (HeCOG) phase II feasibility study (2000)
    Springer
    Annals of oncology 11 (2000), S. 163-167 
    Details
    ISSN: 1569-8041
    Keywords: chemotherapy ; colorectal cancer ; oxaliplatin ; phase II
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Backround:Oxaliplatin is a novel platinum derivative, which,combined with 5-fluorouracil (5-FU), and folinic acid (FA), demonstratessynergistic activity in metastatic colorectal cancer (MCC). The HeCOGperformed a multicenter phase II study of a weekly oxaliplatin administrationschedule in patients with previously treated MCC to evaluate the antitumorefficacy and toxicity of this combination. Patients and methods:Eligible patients included those whorelapsed after or during chemotherapy with 5-FU and FA and/or irinotecan.Prior radiotherapy was accepted provided that measurable disease was outsidethe radiation fields. Other eligibility criteria included written informedconsent, a WHO performance status ≤2 and adequate bone marrow, liver andrenal function. Treatment consisted of Oxaliplatin 50 mg/m2 bytwo-hour intravenous (i.v.) infusion followed by FA 500 mg/m2(two-hour i.v. infusion) and 5-FU 2500 mg/m2 (24-hour continuousi.v. infusion) on days 1, 8, 15, 22, 29, 36. The regimen was repeated every50 days. Results:Thirty-two patients (Median age 61 years, range25–76) entered the trial. The majority (75%) had progressed afterreceiving first-line chemotherapy. Diarrhea was the main non-hematologic toxicity. More than half of thepatients (53%) developed grades 3 or 4 diarrhea. Due to this sideeffect only 29% of cycles were given with at least 90% of theplanned dose of 5-FU. Hematologic toxicity included grade 3 neutropenia andthrombocytopenia (10% for each), and grade 4 thrombocytopenia(3%). Two patients (6%) died of sepsis, one related toneutropenia and one due to urinary tract sepsis. Sixteen patients (50%)developed grades 1 and 2 neurotoxicity in the form of sensory neuropathy,which was mild and transient. The objective response rate was 13%(95% CI: 3%–29%). All four responses were partial.Twelve patients (38%) had stable disease and 8 (25%) progressivedisease. The median time to progression was three months and the mediansurvival was nine months from the start of therapy. The Kaplan–Meierestimated probability of one-year survival for the group as a whole was32%. Conclusions:The weekly administration of oxaliplatin with 5-FUand FA was associated with considerably less neurotoxicity than otherschedules. However, the high percentage of diarrhea suggests that a dosereduction of 5-FU in this regimen may result in better therapeutic synergy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008397109048
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  • 190
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    Electronic Resource
    Magnetic Resonance Imaging in Patients with Cardiomyopathies: When and Why (2000)
    Springer
    Herz 25 (2000), S. 384-391 
    Details
    ISSN: 1615-6692
    Keywords: Key Words Cardiomyopathy ; Magnetic resonance imaging ; Schlüsselwörter Kardiomyopathie ; Magnetresonanztomographie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die kardiale Magnetresonanztomographie (MRT) bietet als nichtinvasives Verfahren die Möglichkeit, innerhalb einer Untersuchung die für die verschiedenen Formen der Kardiomyopathien charakteristischen funktionellen und morphologischen Veränderungen darzustellen. In dieser Übersicht werden die Einsatzmöglichkeiten der MRT bei den verschiedenen Formen dieser Erkrankung diskutiert. Die geringe Variabilität der MRT-Messungen gestattet ge-naue Verlaufskontrollen im klinischen Alltag, eröffnet aber auch die Möglichkeit, Therapiestudien mit einer geringeren Anzahl von einzuschließenden Patienten zu sicheren Ergebnissen zu führen. Damit erweitert sich das Spektrum der Indikationen über die Präzisierung unklarer Befunde hinaus auf die Verlaufsbeobachtung während einer pharmakologischen Intervention und auf alle wissenschaftlichen Fragestellungen. Der Vorzug der MRT, nichtinvasiv Gewebe charakterisieren zu können, verdeutlicht das Potential dieser Technik bei sekundären Kardiomyopathien sowie bei entzündlichen und infiltrativen Formen myokardialer Erkrankungen.
    Notes: Abstract Cardiac magnetic resonance imaging (MRI) is a noninvasive tool which is able to diagnose and differentiate cardiomyopathies in a single study. The assessment of essential information such as alterations of myocardial and ventricular geometry and function is possible with a high degree of accuracy and reproducibility, based on a small inter- and intraobserver variability. Thus, very small morphological and functional changes in different types of cardiomyopathy are detectable, thereby enabling the cardiologist to increase the safety of therapeutic decisions. Furthermore, MRI bears the potential to characterize tissue transformation in the different types of myocardial affections including ischemic, toxic, infiltrative or inflammatory forms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s000590050030
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  • 191
    Electronic Resource
    Electronic Resource
    A pericardial hydatid cyst extending to the left lobe of the liver: the diagnostic value of MRI (2000)
    Springer
    Heart and vessels 15 (2000), S. 44-45 
    Details
    ISSN: 1615-2573
    Keywords: Key words Pericardial hydatid cyst ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003800070047
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  • 192
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    Electronic Resource
    Unbiased and efficient estimation of left ventricular volumes by three-dimensional echocardiography with coaxial sections. Validation with magnetic resonance imaging (2000)
    Springer
    Heart and vessels 15 (2000), S. 35-43 
    Details
    ISSN: 1615-2573
    Keywords: Key words Three-dimensional echocardiography ; Magnetic resonance imaging ; Left ventricular volume ; Stereology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective of this study was to investigate the degree of bias with coaxial three-dimensional echocardiography in an experimental animal setup and to establish the minimum number of sections needed for estimation of left ventricular (LV) volume. Epicardial coaxial echocardiography and magnetic resonance imaging (MRI) was used to measure LV volume in 14 pigs, with chronic remodeled left ventricles induced by repeated intracoronary microembolizations. In addition, six animals underwent serial MRI at baseline, immediately after intracoronary microembolization, and after 119–165 days (mean 129 days). Coaxial echocardiography was performed by rotational acquisition of long-axis sections starting from an arbitrary angle. Planimetered MRI contours of LV endocardial borders were analyzed to investigate the relationship between the number of coaxial sections, and the precision of volume estimates. The mean ± 2SD of the differences between coaxial epicardial echocardiography with six sections and MRI were −2.5 ± 16.4 ml, 0.8 ± 13. 1 ml, and 2% ± 14% for end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF), respectively. Numerical analysis conducted on MRI contours of LV endocardial borders showed that with six coaxial sections the average coeffi-cient of error was 〈1% for the EDV and ESV. Three-dimensional echocardiography with six coaxial sections provides unbiased LV volume estimation with minimal geometric error.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00007260
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  • 193
    Electronic Resource
    Electronic Resource
    The use of magnetic resonance images to investigate the influence of recruitment on the relationship between torque and cross-sectional area in human muscle (2000)
    Springer
    European journal of applied physiology 83 (2000), S. 475-480 
    Details
    ISSN: 1439-6327
    Keywords: Key words Human ; Muscle function ; Physiological cross-sectional area ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of the present study was to investigate the effect of recruitment on the relationship between peak torque and physiological cross-sectional area (PCSA) in human muscle. A group of 11 healthy men participated in this study. Isokinetic knee extension torques at seven (0, 30, 60, 120, 180, 240, and 300° · s−1) velocities were determined. Magnetic resonance imaging (MRI) was performed to calculate PCSA of right quadriceps femoris (QF) muscle. Exercise-induced contrast shifts in spin-spin relaxation time (T2)-weighted MRI were taken at rest and immediately after repetitive knee-extension exercise and T2 of QF were calculated. The MRI pixels with T2 values more than 1 SD greater than the means at rest were considered to represent QF muscle that had contracted. The area of activated PCSA within the total in QF was expressed as percentage activated PCSA and used as an index of muscle recruitment. The PCSA correlated with peak torque at 0° · s−1 (r=0.615, P 〈 0.05); in contrast, activated PCSA correlated with peak torque at 120° · s−1 (r=0.603, P 〈 0.05) and 180° · s−1 (r=0.606, P 〈 0.05). Additionally, there was a significant difference in correlation coefficients between the activated PCSA-peak torque relationship and the PCSA-torque relationship (P 〈 0.05). These results suggested that muscle recruitment affects the PCSA-torque relationship.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004210000310
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  • 194
    Electronic Resource
    Electronic Resource
    Validity of bioelectrical impedance and ultrasonographic methods for estimating the muscle volume of the upper arm (2000)
    Springer
    European journal of applied physiology 82 (2000), S. 391-396 
    Details
    ISSN: 1439-6327
    Keywords: Key words B-mode ultrasound ; Bioelectrical impedance ; Data acquisition system ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The present study aimed to investigate the validity of bioelectrical impedance and ultrasonographic methods for predicting the muscle volume of the upper arm. Bioelectrical impedance of the right upper arm and the thickness of elbow flexor and extensor muscles were measured from 26 healthy young adult men using a specially designed bioelectrical impedance data acquisition system and brightness-mode ultrasound apparatus, respectively. As reference data, the muscle volume (MVMRI) of the right upper arm was determined using a magnetic resonance imaging method. The impedance index was calculated as L 2/Z, where L is the upper arm length and Z is the impedance of the shoulder to the elbow. The muscle volume (MVULT) was calculated as π·(d/2)2·L, where d is muscle thickness. L 2/Z and MVULT were significantly correlated with MVMRI with correlation coefficients of 0.971 and 0.962, respectively. In these relationships, the standard errors of estimation were 44.2 cm3 (6.3%) for L 2/Z and 50.7 cm3 (7.2%) for MVULT. There was no significant difference between the absolute errors of muscle volumes estimated by L 2/Z and MVULT: 36.2 (4.8, SEM) cm3 for L 2/Z versus 40.3 (5.8) cm3 for MVULT. The present results suggest that both bioelectrical impedance and ultrasonographic methods may be useful for predicting the muscle volume of the upper arm.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004210000213
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  • 195
    Electronic Resource
    Electronic Resource
    Activated leukocyte cell adhesion molecule (ALCAM) and annexin II are involved in the metastatic progression of tumor cells after chemotherapy with Adriamycin (2000)
    Springer
    Clinical & experimental metastasis 18 (2000), S. 45-50 
    Details
    ISSN: 1573-7276
    Keywords: ALCAM ; annexin II ; chemotherapy ; metastasis ; progression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Metastasis frequently occurs during and/or after chemotherapy resulting in failure. This suggests that inadequate chemotherapy promotes the emergence of more malignant tumor cells with metastatic potential. However, it is not determined how chemotherapy could promote the metastatic progression of tumor cells. In this study, we isolated highly metastatic clones from the tumors treated with ADR using an in vivo experimental model, in which non-metastatic tumor cells were inoculated s.c. in mice, treated with or without Adriamycin and then culture lines were re-established from the tumors. Then we isolated cDNAs for activated leukocyte cell adhesion molecule (ALCAM), osteopontin, and annexin II as candidates for metastasis-promoting genes with the use of a PCR-based subtraction method. Further we examined the metastatic potential of transfectants over-expressing ALCAM, osteopontin, or annexin II and combinations of them. Metastasis to the lung was observed in the mice where transfectants over-expressing ALCAM plus annexin II had been inoculated via tail vein. These results suggest that the over-expression of ALCAM and annexin II play a role in the metastatic progression after chemotherapy with ADR.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1026507713080
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  • 196
    Electronic Resource
    Electronic Resource
    Chemotherapy for Intramedullary Spinal Cord Tumors (2000)
    Springer
    Journal of neuro-oncology 47 (2000), S. 293-307 
    Details
    ISSN: 1573-7373
    Keywords: chemotherapy ; intramedullary ; spinal cord tumors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intramedullary tumors are rare, accounting for only about 4% of all CNS neoplasms. Although surgery represents the most effective treatment, recurrence may occur. As a large proportion of intramedullary malignancies occur in children, who are more sensitive to the deleterious effects of irradiation, chemotherapy assumes an important role. This article describes the most common intramedullary tumors and the role of chemotherapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006499313482
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  • 197
    Electronic Resource
    Electronic Resource
    Phase II Trial of Pre-irradiation KRN8602 (MX2) in Malignant Glioma Patients (2000)
    Springer
    Journal of neuro-oncology 48 (2000), S. 145-149 
    Details
    ISSN: 1573-7373
    Keywords: malignant glioma ; chemotherapy ; anthracyclines ; KRN8602 (MX2) ; phase II study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract KRN8602 (MX2) is a newly developed morpholino anthracycline that crosses the blood–brain barrier where it becomes distributed in brain tissue after intravenous administration. This morpholino anthracycline has been found to be effective against human glioma cells and the intracerebrally transplanted tumors in vivo. We performed a phase II trial using KRN8602 as a single agent in malignant glioma patients who had not received prior adjuvant therapy. The 13 patients (5 glioblastomas, 7 anaplastic astrocytomas and 1 malignant oligodendroglioma) enrolled received at least 1 cycle of KRN8602 at 35 mg/m2/day in 3–4 week intervals by intravenous bolus. Ten of these patients could be evaluated for response, and 13 for toxicity. Three patients (1 glioblastoma and 2 anaplastic astrocytomas) demonstrated a complete response (3/10, 30%). Concerning side effects, myelosuppression was moderately severe, with 30.7% of patients developing grade 3 leukopenia. Severe nausea/vomiting was observed in 69% of the patients, however, cardiotoxicity was not observed. The results indicate that KRN8602 demonstrated modest activity against malignant glioma with relatively severe, but manageable toxicity. Further assessment of the efficacy and toxicity of KRN86O2 against malignant glioma may be worthwhile.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006482006138
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  • 198
    Electronic Resource
    Electronic Resource
    Treosulfan Chemotherapy for Recurrent Malignant Glioma (2000)
    Springer
    Journal of neuro-oncology 49 (2000), S. 231-234 
    Details
    ISSN: 1573-7373
    Keywords: treosulfan ; chemotherapy ; malignant glioma ; myelosuppression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Treosulfan is a bifunctional alkylating prodrug with activity against various solid tumors. To improve the outcome for patients with recurrent malignant glioma, we assessed the efficacy of intravenous treosulfan (6–10 g/m2 4-weekly) as salvage therapy for patients with recurrent or progressive glioblastoma (GB, n = 14) or anaplastic astrocytoma (AA, n = 2). All patients had prior involved-field radiotherapy and adjuvant nitrosourea-based chemotherapy. A total of 56 cycles were administered. Tumor responses were assessed radiologically and clinically prior to each cycle. All patients were assessable for toxicity, response and survival. There were no complete or partial responses (CR, PR). Two patients progressed after the first cycle, 14 patients had initially stable disease (SD). Median progression-free survival was 3.25 months for the GB patients. Five patients were progression-free at 6 months (30%), including the 2 AA patients. The 2 AA patients are stable at 22 months. Myelosuppression was the dose-limiting toxicity in this cohort of nitrosourea-pretreated patients. Treosulfan has modest activity in patients with recurrent malignant glioma. Further evaluation of treosulfan in chemonaive malignant glioma patients is warranted.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006496831144
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  • 199
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    Electronic Resource
    A Randomized Phase II and Pharmacokinetic Study of Dacarbazine in Patients with Recurrent Glioma (2000)
    Springer
    Journal of neuro-oncology 49 (2000), S. 255-261 
    Details
    ISSN: 1573-7373
    Keywords: DTIC ; dacarbazine ; recurrent gliomas ; brain tumors ; chemotherapy ; glioblastoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We conducted a randomized phase II study to determine the efficacy of dacarbazine (DTIC) in recurrent gliomas. Patients were randomly assigned to receive either DTIC 750 mg/m2 IV day 1 every 28 days (Arm A) or DTIC 200 mg/m2 IV days 1–5 every 28 days (Arm B). Pharmacokinetics were studied in 6 patients on each arm using HPLC analysis. Thirty-nine patients (30 male, 9 female), ages 27–67 years (median 53) were entered on the study (20 on Arm A, 19 on Arm B). No objective responses were seen. Median time to progression was 3 months. Median survival was 8 months. Treatment was generally well tolerated. Major toxicities were grade 1–2 nausea (33%), lethargy (28%), diarrhea (15%), alopecia (15%), and grade 3 neutropenia (8%). Four patients on Arm A had mild self-limited episodes of intravascular hemolysis occurring immediately after drug infusion, the mechanism of which is unknown. Mean AUC for DTIC, HMMTIC (5-[3-hydroxymethyl-3-methyl-1-triazeno] imidazole-4-carboxamide), and MTIC (5-[3-methyl-1-triazeno] imidazole-4-carboxamide), in Arm A were 14.8, 0.17, and 1.15 mM min, respectively. Corresponding values for Arm B (on day 1 of 5) were 1.7, 0.06, and 0.29 mM min, respectively. The predicted HMMTIC and MTIC exposure over 5 days for Arm B, based on the day 1 data, is higher than with Arm A. We conclude that DTIC is well tolerated but does not have activity in patients with recurrent gliomas. The 5-day schedule appears less toxic, and pharmacokinetic studies show that it provides greater exposure to MTIC and HMMTIC compared to the one-day schedule.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006454427026
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  • 200
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    Electronic Resource
    Drug Resistance-associated Factors in Primary and Secondary Glioblastomas and their Precursor Tumors (2000)
    Springer
    Journal of neuro-oncology 50 (2000), S. 227-237 
    Details
    ISSN: 1573-7373
    Keywords: astrocytomas ; chemotherapy ; drug resistance ; glioblastomas ; recurrence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Malignant gliomas are largely resistant to current chemotherapeutic strategies often displaying a multidrug-resistant phenotype. Mechanisms involved in drug resistance are reduced cellular drug accumulation through membrane efflux pumps, drug detoxification as well as alterations in drug target specificity. In 27 primary and 17 secondary glioblastomas and their astrocytic precursor tumors, we studied the immunohistochemical expression profile of P-glycoprotein (P-gp), multidrug resistance-associated protein (MRP), lung resistance-related protein (LRP), metallothionein, and topoisomerase II α. Glial tumor cells in all glioblastomas showed constant up-regulation of LRP, MRP, and topoisomerase II α. P-gp was found in 90% of the primary and 60% of the secondary glioblastomas. In precursor tumors, these drug resistance-related factors were expressed in varying proportions. Metallothionein, also found in normal and activated astrocytes, was retained in all neoplastic phenotypes. Furthermore, metallothionein, P-gp, LRP, and topoisomerase II α were strongly expressed by normal and neoplastic vessels which may confer to impaired penetration of therapeutic agents through the blood–brain and blood–tumor barrier. However, the expression profiles of drug resistance-related proteins neither differed between primary and secondary glioblastomas nor revealed any correlation to precursor or recurrent tumors. Nevertheless, inhibition of these factors may be promising approaches to the management of malignant gliomas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006491405010
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