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  • 1995-1999  (180)
  • 1998  (180)
  • breast cancer  (116)
  • Computed tomography
  • Nuclear reactions
  • 1
    Electronic Resource
    Electronic Resource
    Timing of computed tomography in acute diverticulitis (1998)
    Springer
    Diseases of the colon & rectum 41 (1998), S. 1023-1028 
    Details
    ISSN: 1530-0358
    Keywords: Diverticulitis ; Computed tomography ; Hospital costs ; Complications ; Surgery ; Accuracy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The purpose of this study was to evaluate the use and timing of computed tomography in the treatment of patients with acute left-sided diverticulitis. METHODS: We reviewed our four-year experience of 47 patients with the diagnosis of acute diverticulitis. We have evaluated the benefits of admissionvs. delayed computed tomography in patients with this diagnosis. RESULTS: Of the 47 patients, 17 were diagnosed on clinical grounds alone, treated, and released. Thirty patients had their clinical diagnoses of diverticulitis evaluated with either computed tomographic scan (26) or laparotomy (4). Eleven of those 30 (36 percent) patients were found to have normal computed tomographic scans, indicating inaccurate clinical diagnosis, and all patients who underwent laparotomy had the pathologic diagnosis of diverticulitis. Six of the 47 patients had abscesses, but only 2 were identified at the time of admission. The remaining four abscesses were identified on delayed computed tomographic scans after failure of medical therapy. Thirty-seven hospital days were used by patients with inaccurate diagnoses before their computed tomographic scans. Analysis of cost revealed that a computed tomographic scan for all 47 patients would have cost less than the expense of admission for just the 11 patients who had normal computed tomographic scans. CONCLUSION: Routine admission computed tomographic scan for patients with acute diverticulitis leads to more accurate diagnosis, earlier identification of complications, and possible decreased hospital costs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02237394
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  • 2
    Electronic Resource
    Electronic Resource
    Role of chest CT in patients with negative chest X-rays referred for hepatic colorectal metastases (1998)
    Springer
    Annals of surgical oncology 5 (1998), S. 9-15 
    Details
    ISSN: 1534-4681
    Keywords: Hepatic metastases ; Colorectal ; Computed tomography ; Pulmonary metastases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Hepatic resection is the standard treatment for hepatic colorectal metastases. The lung represents the next most likely site, after the liver, of metastatic disease. Computed tomography (CT) of the chest is more sensitive than is chest x-ray in detecting metastatic lung lesions. However, the usefulness of chest CT in the evaluation of patients before hepatic resection remains uncertain. Methods: One hundred consecutive patients with negative chest x-rays and potentially resectable hepatic colorectal metastases underwent chest CT. Patients with CT findings suggestive of meta-static disease were subjected to thoracotomy or video-assisted thoracic surgery (VATS) before laparotomy and attempted hepatic resection. The operative findings and clinical course were analyzed. Results: Eleven of 100 patients had a positive chest CT. Four of these 11 patients had malignant lesions of the lung (three metastatic colorectal cancers and one primary lung cancer). There was no difference in median total hospital stay (8.5 days [range 7 to 13 days] vs. 8.0 days [range 3 to 49 days]), number of perioperative deaths (0 vs. 2 deaths), or long-term outcome between those patients with a positive chest CT undergoing thoracotomy/VATS and those patients with a negative chest CT. Overall, chest CT provided a positive yield of 4% and a positive predictive value of 36% for the detection of malignant lesions of the lung. Conclusions: Chest CT only minimally improved detection of malignant lesions of the lung over chest x-ray. Thoracotomy/VATS and wedge resection of lung nodules did not adversely affect outcome. The low positive yield and low positive predictive value of chest CT in the setting of a negative chest x-ray places in question the usefulness of routinely performing chest CT as part of the extent-of-disease work-up before hepatic resection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02303757
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  • 3
    Electronic Resource
    Electronic Resource
    Histological Evaluation of the Effects of Intraarterial Chemotherapy for Advanced Breast Cancer: A Long-term Followup Study with Respect to the Survival Rate (1998)
    Springer
    Surgery today 28 (1998), S. 509-516 
    Details
    ISSN: 1436-2813
    Keywords: Key Words: intraarterial chemotherapy ; breast cancer ; histological response
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005950050175
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  • 4
    Electronic Resource
    Electronic Resource
    Seroma with Fibrous Capsule Formation Requiring a Surgical Resection After a Modified Radical Mastectomy: Report of a Case (1998)
    Springer
    Surgery today 28 (1998), S. 669-672 
    Details
    ISSN: 1436-2813
    Keywords: Key words: seroma ; breast cancer ; mastectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005950050206
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  • 5
    Electronic Resource
    Electronic Resource
    Abdominal pain with anorexia in patients with breast carcinoma (1998)
    Springer
    Annals of oncology 9 (1998), S. 1243-1245 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; gastrointestinal metastases ; invasive lobular carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Breast cancer is the second commonest primary tumour responsible for gastrointestinal metastases after malignant melanoma. The real incidence of gastrointestinal metastases in breast cancer patients is probably underestimated owing to the non-specific presenting symptoms and death of patients caused by other more obvious metastases. The predominant histological subtype of gastrointestinal metastases of breast cancer is invasive lobular carcinoma and the median interval from diagnosis of primary breast cancer to gastrointestinal metastases is five years. We report two cases of disseminated breast cancer with gastrointestinal involvement with a rather long survival.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008287007819
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  • 6
    Electronic Resource
    Electronic Resource
    The anti-proliferative effect of suramin towards tamoxifen-sensitive and resistant human breast cancer cell lines in relation to expression of receptors for epidermal growth factor and insulin-like growth factor-I: Growth stimulation in the presence of tamoxifen (1998)
    Springer
    Annals of oncology 9 (1998), S. 205-211 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; epidermal growth factor ; insulin-like growth factor-I ; suramin ; transforming growth factor-β
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: A significant proportion of breast cancer patients receiving tamoxifen therapy relapse during treatment following acquisition of tamoxifen-resistant or oestrogen-independent phenotypes. The mechanism behind this rapid progression to oestrogen autonomy is at present unclear and further treatment modalities are limited. Suramin represents a novel potential second line therapy. The mechanism of the antineoplastic activity of suramin is not completely understood, although the drug binds to many growth factors including epidermal growth factor and insulin-like growth factors and can also dissociate growth factors from their receptors. In this study we have related suramin sensitivity to the expression of receptors for epidermal growth factor and insulin-like growth factor-I in a number of breast cancer cell lines including lines resistant to tamoxifen. Materials and methods: The anti-proliferative effects of suramin were investigated in two oestrogen dependent breast cancer lines (ZR-75-1 and MCF-7), oestrogen independent (ZR-PR-LT) and tamoxifen resistant (ZR-75-9a1) variants of ZR-75-1 and a tamoxifen resistant (LY2) variant of MCF-7. Full dose response curves were constructed and IC50values determined for each cell line. Sensitivity to suramin was correlated with the level of expressio n of receptors for epidermal growth factor (EGFR) and insulin-like growth factor-I (IGFR). On observing stimulation of cell proliferation by suramin in the tamoxifen resistant cell lines in the presence of tamoxifen we also investigated the possible role of suramin sequestration of transforming growth factor-β in mediating this effect. Results: All cell lines exhibited a dose- and time-dependent response to suramin treatment. Tamoxifen resistant ZR-75-9a1 cells (day 6 IC5085 µg ml−1) were more resistant to suramin than oestrogen independent ZR-PR-LT cells (day 6 IC5045 µg ml−1), and the parent ZR-75-1 line (day 6 IC5056 µg ml−1). Increased sensitivity to suramin was associated with increased expression of IGFR and decreased expression of EGFR. Tamoxifen resistant LY2 cells were significantly more sensitive to suramin (day 6 IC5070 µg ml−1) than MCF-7 cells (day 6 IC50350 µg ml−1). Both IGFR and EGFR expression by LY2 cells was lower than in the parent line. The antioestrogen-resistant ZR-75-9a1 and LY2 lines grown in the presence of 8 µM tamoxifen were growth stimulated by concentrations of the drug below 100 µg/ml. As growth stimulation observed in the presence of tamoxifen may have been due to suramin sequestration of tamoxifen induced TGF-β1 secretion we also investigated the response of the cells to this peptide in the presence and absence of suramin. All cell lines were growth inhibited by TGF-β1 except ZR-75-9a1 which was unresponsive. Responses to TGF-β1 were modified in the presence of 100 µg suramin ml−1 although TGF-β1 was unable to mimic the ability of tamoxifen to stimulate proliferation in the presence of suramin. Conclusions: These results suggest that for ZR-75-1 cells and variants, increased sensitivity to suramin is associated with an increase in expression of IGFR and a decrease in EGFR numbers. However, tamoxifen resistant LY2 cells, in which both IGFR and EGFR expression is reduced were considerably more sensitive than parental MCF-7 cells suggesting that there is no clear relationship between EGFR and IGFR expression and suramin sensitivity. The unexpected stimulation of cell proliferation of the tamoxifen resistant variants by suramin in the presence of tamoxifen could not be explained by suramin sequestration of transforming growth factor-β and the mechanism of this interaction remains unclear.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008241804078
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  • 7
    Electronic Resource
    Electronic Resource
    Dosage of adjuvant G-CSF (filgrastim)-supported FEC polychemotherapy based on equivalent haematological toxicity in high-risk breast cancer patients (1998)
    Springer
    Annals of oncology 9 (1998), S. 403-411 
    Details
    ISSN: 1569-8041
    Keywords: adjuvant ; breast cancer ; G-CSF (filgrastim) ; individualized chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Conventional dosages of cytostatics in mg/m2 will cause marked variations in systemic exposure, resulting in over- and under-treatment, at least with respect to side effects. Patients and methods: We are conducting a randomized adjuvant study for breast cancer patients younger than 60 years of age with ≥70% risk of recurrence within five years. The first 89 consecutive patients who have received nine courses q three weeks of individually dose-escalated and G-CSF (filgrastim)-supported FEC (5-fluorouracil (5-FU), epirubicin, and cyclophosphamide) therapy given with ciprofloxacin prophylaxis were included in this analysis. Six different FEC dose levels were used for treatment at equivalent haematological toxicity. Dose modifications were based on white blood cell and platelet counts on days 8, 11/12, 15, and 22. Results: Eighty-three of 89 patients completed all nine courses. The median epirubicin and cyclophosphamide doses were 782 mg/m2 (range 0–994 mg/m2) and 10.330 mg/m2 (range 0–14.460 mg/m2), respectively. Patients treated at the two highest dose levels experienced NCI grade 0 or 1 toxicities in 73% to 92% of the courses. Three patients have developed acute myeloid leukaemia, and two of them have demonstrated abnomalities compatible with topoisomerase II-poison-related karyotypic changes. Conclusions: Tailored adjuvant G-CSF-supported FEC polychemotherapy will make it possible for all patients to be treated at equivalent levels of haematological toxicity with significantly higher doses without a marked increase in other organ toxicities.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008252014312
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  • 8
    Electronic Resource
    Electronic Resource
    Adding adjuvant CMF chemotherapy to either radiotherapy or tamoxifen: Are all CMFs alike? (1998)
    Springer
    Annals of oncology 9 (1998), S. 489-493 
    Details
    ISSN: 1569-8041
    Keywords: adjuvant chemotherapy ; breast cancer ; CMF ; radiotherapy ; tamoxifen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The first reported effective adjuvant combination regimen for patients withoperable breast cancer comprised oral cyclophosphamide (C) days 1–14with intravenous methotrexate (M) and fluorouracil (F) on days 1 and 8,repeated every 28 days (’classical‘ CMF). These drugs have since beenextensively used with or without endocrine therapies and/or other cytotoxics,as well as with radiation therapy to the chest wall yielding conflictingresults. Although doses and schedules have varied widely, the combination ofthese three drugs has been generically referred to as CMF. Evidence existsthat reducing the dose and/or altering the schedule of CMF (’modified‘ CMF)have compromised its efficacy in metastatic breast cancer. Reduction belowstandard dose of a similar regimen also gave inferior results in the adjuvantsetting. In fact, the recently reported improved outcome of adding radiationtherapy to CMF was only demonstrated in comparisons with a ’modified‘ CMF.Furthermore, trials in women with estrogen receptor-positive breast cancer,which did not demonstrate any significant benefit for the addition of adjuvantCMF to tamoxifen compared with tamoxifen alone, also used ’modified‘ CMF.Therefore, adherence to the ’classical‘ dose and schedule is recommended whenCMF is used in adjuvant therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008236502420
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  • 9
    Electronic Resource
    Electronic Resource
    Hematopoietic progenitor cell collection and neoplastic cell contamination in breast cancer patients receiving chemotherapy plus granulocyte-colony stimulating factor (G-CSF) or G-CSF alone for mobilization (1998)
    Springer
    Annals of oncology 9 (1998), S. 913-916 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; G-CSF ; mobilization ; stem cells ; transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We compared hematopoietic progenitor cell (HPC) collection and neoplastic cell contamination in breast cancer patients given cyclophosphamide (CTX) plus granulocyte-colony stimulating factor (G-CSF) or G-CSF alone for mobilization. Patients and methods: In 57 stage II–III breast cancer patients, CD34+ cells, colony-forming units-granulocyte macrophage (CFU-GM), early HPC and breast cancer cells were counted in HPC collections obtained after CTX plus G-CSF (n = 27) or G-CSF-alone mobilization (n = 30). Results: The CD34+ cell collection was about two-fold greater after CTX plus G-CSF mobilization (11.0 ± 7.9 vs. 5.8 ± 3.5 × 106/kg, P 〈 0.001). Similarly, the total number of CFU-GM, CD34+CD38− cells and of week-5 cobblestone area forming cells (CAFC) collected was significantly higher in patients mobilized with CTX plus G-CSF. Breast cancer cells were found in the apheresis products of 22% of patients mobilized with CTX plus G-CSF and in 10% of patients mobilized with G-CSF alone (P = 0.36). Of seven patients who failed G-CSF-alone mobilization and eventually underwent chemotherapy plus G-CSF mobilization, none had cytokeratin-positive cells after G-CSF mobilization, whereas four out of seven had cytokeratin-positive cells after chemotherapy plus G-CSF (P = 0.07 by χ2 test). Conclusion: The CTX plus G-CSF mobilization protocol was associated with a significantly higher HPC collection. However, this benefit was not accompanied by a reduction in the incidence of tumor-contaminated HPC graft.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008226428543
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  • 10
    Electronic Resource
    Electronic Resource
    Minimal residual disease in autologous hematopoietic harvests from breast cancer patients (1998)
    Springer
    Annals of oncology 9 (1998), S. 821-826 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; high-dose chemotherapy ; minimal residual disease ; stem cell transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The increasing use of high-dose chemotherapy with autologous hematopoietic transplantation for the treatment of solid malignancies has raised concern about the role of tumor cells contaminating the grafts. Minimal residual disease (MRD) in autologous grafts has became a dynamic and intensively studied field in oncology. This review discusses the current status of MRD in breast cancer autografts and presents existing data on detection methodology, clinical relevance, biologic characteristics and purging techniques.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008344708061
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  • 11
    Electronic Resource
    Electronic Resource
    Recommendations for medical management of hereditary breast and ovarian cancer: The French National Ad Hoc Committee (1998)
    Springer
    Annals of oncology 9 (1998), S. 939-950 
    Details
    ISSN: 1569-8041
    Keywords: BRCA1 ; BRCA2 ; breast cancer ; guidelines ; ovarian cancer ; preventive care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background and purpose: Almost 10% of breast and ovarian cancers are familial, and the majority are linked to BRCA1 and BRCA2 germline mutations. Despite uncertainty about the management of female gene carriers, consensus guidelines have been established to assist practitioners and consultees in making health care decisions. Methodology: The Ad Hoc Committee was composed of 14 experts appointed by the French National Institute for Health and Medical Research, all of whom attended eleven workshops at which more than 3500 articles were systematically analyzed. Five additional experts critically analysed the first version of the report. Criteria and decision process: On a probability scale of the risk of developing breast or ovarian cancers, two thresholds were defined for use in determining whether an intervention would be worthwhile. The first is the threshold above which an intervention can be envisaged or recommended, and the second is the one below which an intervention can be ruled out; between the two, the decision has to be made on a case-by-case basis. Screening and preventive strategies analyzed: With respect to breast cancer: 1) hormonal interventions; 2) primary prevention (diet, family planning and chemoprevention); 3) screening (breast self-examination, clinician breast examination, tumor markers, imaging); 4) prophylactic mastectomy. With respect to ovarian cancer: 1) hormonal stimulation; 2) screening (clinical screening, ultrasound and tumor markers); 3) prophylactic oophorectomy. Main conclusions: For each strategy the following points were addressed: the information to be given to the consultee, the procedure and the indications. In addition, the committee's opinion about BRCA1 and BRCA2 mutation screening is that population-based, or even large-scale, implementation are not justified. Although no scientific evidence is available, the committee feels that specific management is indispensable and advocates the use of defined and evaluated procedures, and participation in clinical trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008389021382
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  • 12
    Electronic Resource
    Electronic Resource
    First-line chemotherapy with paclitaxel by three-hour infusion and carboplatin in advanced breast cancer (final report): A phase II study conducted by the Hellenic Cooperative Oncology Group (1998)
    Springer
    Annals of oncology 9 (1998), S. 1031-1034 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; carboplatin ; chemotherapy ; paclitaxel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: To evaluate the activity and toxicity of the combination of paclitaxel given by three-hour infusion, and carboplatin as first-line chemotherapy in patients with advanced breast cancer (ABC). Background: Paclitaxel is an active agent in ABC. Furthermore, our group has shown that the combination of paclitaxel and carboplatin is effective in anthracycline-resistant ABC. Patients and methods: From January 1996 until March 1997, 66 women with ABC were treated with paclitaxel (175 mg/m2) by three-hour infusion followed by carboplatin at an AUC of 6 mg × min/ml every three weeks. The median age of the patients was 56 years (range 28–75). A total of 39 patients had received adjuvant chemotherapy and 22 of them were treated with an anthracycline or mitoxantrone-containing regimen. Results: A total of 324 cycles (median: six) were administered, 273 (85%) of them at full dose. The median number of delivered cycles was six. The median delivered dose intensity (DI) of paclitaxel was 55.1 mg/m2/week (range 30.5–69.3) and the relative DI was 0.95 (range 0.5–1.2). Eight patients (12%, 95% confidence interval (CI): 5%–22%) achieved complete and 28 (42%, 95% CI: 30%–55%) partial responses. Grade 3–4 toxicities included anemia (5%), granulocytopenia (24%), thrombocytopenia, nausea/vomiting and allergic reaction (3% each), myalgias/arthralgias and neurotoxicity (1,5% each). Febrile neutropenia occurred in eight (12%) patients. Alopecia was universal. After a median follow-up of 17.3 (range 0.07–24.5) months, 48 (72%) patients have demonstrated tumor progression and 24 (36%) have died. Median time to progression was 8.6 (range 0.07–23+) months and median survival 20.4 (range 0.07–24.5+) months. Conclusions: The combination of paclitaxel and carboplatin has moderate activity in ABC and can be easily delivered on an outpatient basis with manageable toxicity. This regimen may be useful especially in patients to whom anthracyclines or cisplatin administration is precluded because of other concomitant diseases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008466928323
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  • 13
    Electronic Resource
    Electronic Resource
    High-resolution computed tomographic study of the retrotympanum (1998)
    Springer
    Surgical and radiologic anatomy 20 (1998), S. 215-220 
    Details
    ISSN: 1279-8517
    Keywords: Temporal bone ; Retrotympanum ; Radio-anatomy ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le but de ce travail était de définir avec précision en tomodensitométrie haute résolution l'imagerie du rétrotympanum. A partir de 66 TDMs des rochers réalisés chez 49 patients suivis en ORL, plusieurs structures du rétrotympanum ont été étudiées : éminence pyramidale, ponticulus, subiculum, crête cordale, sinus tympanique de proctor, sinus tympani et récessus du facial. Les variations morphologiques et de profondeur ont été notées ainsi que le rapport entre la pyramide et le canal facial. Dans un deuxième temps, à partir de 24 temporaux prélevés sur cadavres embaumés, explorés selon la même technique radiologique, les mêmes structures anatomiques ont été étudiées. Des corrélations anatomiques pour 6 temporaux ont été réalisées pour confirmer l'ensemble de nos hypothèse radiologiques. En tomodensitométrie la visibilité de l'éminence pyramidale était obtenue dans 100% des cas, celle de la crête cordale dans 52% des cas, du ponticulus dans 63% des cas et du subiculum dans 57% des cas. Pour ce qui est des différents récessus, le sinus tympani était visible dans 95% des cas, le sinus tympani de Proctor dans 38% des cas, la fossette de Grivot dans 47% des cas et le recessus du facial dans 80% des cas. La profondeur moyenne du sinus tympani était de 2.7 mm, le sinus tympani de Proctor mesurait 1.65 mm, la fossette de Grivot était évaluée à 2.1 mm et le récessus du facial à 2.2 mm. La meilleure connaissance de ces sinus et de leur variation aidera le chirurgien en particulier pour une tympanotomie postérieure ou un abord rétro-facial.
    Notes: Summary The aim of this study was to define the imaging of the retrotympanum precisely by means of high-resolution CT. Based on 66 scans of petrous bones performed in 49 patients observed in an otologic department, several retrotympanic structures were studied: the pyramidal eminence, ponticulus, subiculum, chordal ridge, tympanic sinus of Proctor, sinus tympani and recess of the facial n. The variations in morphology and depth were noted as well as the relationship between the pyramid and the facial canal. In a second phase the same anatomic structures were studied in 24 temporal bones removed from embalmed cadavers and investigated with the same radiologic technique. Anatomic correlations were made for six temporal bones to confirm the general applicability of our radiologic hypotheses. In CT the pyramidal eminence was visualised in 100% of cases, the chordal ridge in 52%, the ponticulus in 63% and the subiculum in 57%. As regards the different recesses, the sinus tympani was visualised in 95% of cases, the posterior tympanic sinus of Proctor in 38%, the fossula of Grivot in 47% and the facial recess in 80%. The mean depth of the sinus tympani was 2.7 mm and that of the tympanic sinus of Proctor was 1.65 mm; the fossula of Grivot was assessed as 2.1 mm and the facial recess as 2.2 mm. A better knowledge of these sinuses and their variations will aid the surgeon, particularly in a posterior tympanotomy or a retro-facial approach.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01628898
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  • 14
    Electronic Resource
    Electronic Resource
    Determination of subacromial space width and inferior acromial mineralization by 3D CT (1998)
    Springer
    Surgical and radiologic anatomy 19 (1998), S. 329-337 
    Details
    ISSN: 1279-8517
    Keywords: Shoulder ; Supraspinatus outlet syndrome ; Computed tomography ; Mineralization ; Subacromial space
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A reduction of the subacromial space and an increased subacromial pressure have been considered to play an important role in the pathogenesis of rotator cuff lesions. The objective of the current study was to develop a CT based method for measuring the acromiohumeral distance and inferior acromial mineralization. In seven patients with unilateral rupture of the rotator cuff and two with impingement syndrome, transverse CT images were obtained at a section thickness of 1 mm with muscular relaxation in a standardized position. The bones were then reconstructed three-dimensionally, and the minimal vertical distance between the acromion and the humerus was determined in three secondary frontal images on both sides. The distribution of mineralization within the inferior surface of the acromion was assessed using CT osteoabsorptiometry. Although the Constant score was significantly reduced in the diseased shoulders, the width of the subacromial space was not routinely lower than on the contralateral side. In seven cases the maximal inferior acromial mineralization was identical in both shoulders, and in two cases it was lower on the affected side. These preliminary data suggest that with muscular relaxation no narrowing of the subacromial space can be detected in secondary frontal CT images, and that a potential increase of subacromial pressure is not high enough to cause a measurable increase in inferior acromial bone density. The method presented makes it possible to investigate the pathogenesis of the supraspinatus outlet syndrome in vivo with greater precision than has so far been possible with conventional radiography.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00276-997-0329-7
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  • 15
    Electronic Resource
    Electronic Resource
    Carpal bone maturation during childhood and adolescence: Assessment by quantitative computed tomography (1998)
    Springer
    Surgical and radiologic anatomy 19 (1998), S. 395-398 
    Details
    ISSN: 1279-8517
    Keywords: Bone maturation ; Carpal bone ; Volume ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of our study was to measure the volume of each carpal bone during childhood and adolescence by image processing from computed tomography (CT) scans, and to analyze the relationship between the eight carpal bones. Thirteen CT scans were performed in nine normal prepubertal, peripubertal and post-pubertal children, six boys and three girls, aged 5-14 years. Each scan was processed in order to extract the carpal bones. The volume was computed for each bone. There was a significant correlation between carpal bone volume and age (0.55 〈 r 〈 0.79), and a very strong correlation between the volume of a given carpal bone and the volume of all the others, whatever the age (0.87 〈 r 〈 0.99, p 〈 0.01). Image processing is a potentially useful method for assessing bone maturation. The constant ratio between carpal bone volumes indicates that these bones interact with each other in wrist bone maturation
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00276-997-0395-x
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  • 16
    Electronic Resource
    Electronic Resource
    High-resolution computed tomographic study of the retrotympanum (1998)
    Springer
    Surgical and radiologic anatomy 20 (1998), S. 215-220 
    Details
    ISSN: 1279-8517
    Keywords: Temporal bone ; Retrotympanum ; Radio-anatomy ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Summary: The aim of this study was to define the imaging of the retrotympanum precisely by means of high-resolution CT. Based on 66 scans of petrous bones performed in 49 patients observed in an otologic department, several retrotympanic structures were studied: the pyramidal eminence, ponticulus, subiculum, chordal ridge, tympanic sinus of Proctor, sinus tympani and recess of the facial n. The variations in morphology and depth were noted as well as the relationship between the pyramid and the facial canal. In a second phase the same anatomic structures were studied in 24 temporal bones removed from embalmed cadavers and investigated with the same radiologic technique. Anatomic correlations were made for six temporal bones to confirm the general applicability of our radiologic hypotheses. In CT the pyramidal eminence was visualised in 100% of cases, the chordal ridge in 52%, the ponticulus in 63% and the subiculum in 57%. As regards the different recesses, the sinus tympani was visualised in 95% of cases, the posterior tympanic sinus of Proctor in 38%, the fossula of Grivot in 47% and the facial recess in 80%. The mean depth of the sinus tympani was 2.7 mm and that of the tympanic sinus of Proctor was 1.65 mm; the fossula of Grivot was assessed as 2.1 mm and the facial recess as 2.2 mm. A better knowledge of these sinuses and their variations will aid the surgeon, particularly in a posterior tympanotomy or a retro-facial approach.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00276-998-0215-y
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  • 17
    Electronic Resource
    Electronic Resource
    No evidence of significant activity of the multidrug resistance gene product in primary human breast cancer (1998)
    Springer
    Annals of oncology 9 (1998), S. 85-93 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; MDR1 gene ; multidrug resistance ; P-glycoprotein ; rhodamine 123
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The discovery of the multidrug resistance (MDR1) gene product P-glycoprotein (P-gp) has been widely seen as an important milestone in our understanding of the mechanisms underlying the clinical phenomenon of the emergence of resistant cells. MDR1 expression has been shown for numerous solid tumors and for virtually all hematologic malignancies. Nevertheless, results regarding MDR1/P-gp expression in human breast cancer have been controversial and the results of clinical trials on modulation of P-gp activity have not been encouraging. Patients and methods: MDR1/P-gp expression and the function of the P-gp pump were investigated in 61 tumor samples from patients with primary breast cancers by multiparameter analysis using MDR1-RT-PCR, immunohistochemistry with two MAbs (UIC2 and MRK 16) and the rhodamine 123 (Rh123) efflux assay. The cellular composition of the tumor cell suspension was analyzed by using specific MAbs against the P-gp expressing lymphocyte subsets CD4, CD8 and CD56, as well as against the HER-2/neu gene product, which was used to identify breast carcinoma cells. Results: UIC2 and MRK16 revealed a staining positivity in 72% and 75% of samples, respectively. A positive MDR1-RT-PCR signal was detected in 62% of the samples. Nevertheless, no correlation between immunohistochemistry and RT-PCR could be established. Furthermore, there was no correlation between HER-2/neu expression and MDR1-RT-PCR or P-gp immunohistochemical assays. A contamination by CD8+ and CD4+ lymphocytes was established in 100% and 84% of tumor cell suspensions, respectively. As assessed by the Rh123 efflux assay CD8+ and the CD4+ lymphocytes exhibited marked P-glycoprotein activity, whereas such activity was not detectable in a single instance for the breast carcinoma cells. In MDR1-RT-PCR positive samples, contamination by CD8 lymphocytes averaged 4.3%, while the contamination of CD8 cells in the MDR1 mRNA-negative samples was only 2.4% (P = 0.007). This signal vanished after elimination of the lymphocyte subpopulations by T-cell rosetting. Conclusions: In primary breast cancer detection of MDR1 gene expression by means of RT-PCR or immunohistochemical assays is not indicative for the MDR phenotype, since there is no evidence of significant activity of the P-gp pump.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008255725515
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  • 18
    Electronic Resource
    Electronic Resource
    A reduction in the requirements for mastectomy in a randomized trial of neoadjuvant chemoendocrine therapy in primary breast cancer (1998)
    Springer
    Annals of oncology 9 (1998), S. 1179-1184 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; chemotherapy ; mastectomy ; neoadjuvant ; tamoxifen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Backgound: A prospective randomised trial was undertaken to evaluate the role of neoadjuvant chemoendocrine therapy prior to surgery in primary operable breast cancer. Patients and methods: Three hundred nine women (median age 56 years, range 27–70) with primary operable breast cancer confirmed on fine needle aspiration (FNA) cytology were recruited to this study. They were treated with a combination of mitozantrone and methotrexate (± mitomycin-C) combined with tamoxifen (2MT). Patients received eight cycles of 2MT (four prior to surgery in the neoadjuvant group) and tamoxifen for five years with appropriate surgery and radiotherapy. The two groups were comparable for age, menopausal status, stage and surgical requirements. Results: The clinical response rates to neoadjuvant therapy were as follows: 22% complete response (CR), 29% minimal residual disease (MRD), 33% partial response (PR), 15% no change (NC) and only two patients had clinical evidence of progressive disease. Surgical requirements were reduced from 31 patients (22%) of the adjuvant group having mastectomy to 14 (10%) in the neoadjuvant group (P 〈 0.003). At a median follow-up of 48 months (range 10–70 months) there is no statistically significant difference between the two groups in terms of local relapse, metastatic relapse or overall survival. Symptomatic and haematologic acute toxicity was low and similar for adjuvant and neoadjuvant therapy. Conclusion: This randomised trial has shown a significant reduction in the surgical requirements for mastectomy, after treatment with neoadjuvant chemoendocrine therapy, with no deterioration in local or distal relapse.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008400706949
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  • 19
    Electronic Resource
    Electronic Resource
    Clinical course of breast cancer patients with metastases confined to the lungs treated with chemotherapy (1998)
    Springer
    Annals of oncology 9 (1998), S. 413-418 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; chemotherapy ; lungs ; metastases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: To evaluate the clinical course of patients with a metastatic breast cancer (MBC) confined to the lungs and treated with doxorubicin/cyclophosphamide-containing chemotherapy (DC-CT). Patients and methods: Between 1973 and 1985, 1581 patients with MBC were treated with DC-CT at M.D. Anderson Cancer Center. Data for 88 patients (5.6%) with metastases confined to the lungs were reviewed to correlate various clinical characteristics with response to treatment and survival. Results: The overall response rate was 76% with 33% achieving complete response (CR). The median overall survival time was 22 months (range 1–210). The 10-year survival rate was 9%. The overall response and CR rates were higher for the patients with metastases confined to the lungs (76% and 33%, respectively) than for the remainder of MBC patients (64% and 14%; P 〈 0.01). The 10-year survival rate was also higher (9% versus 3%, P 〈 0.01), but there were no differences in median overall survival rate. Conclusions: This retrospective analysis demonstrated that patients with metastases confined to the lungs treated with DC-CT had a high objective response rate, especially high CR rates, and a median survival comparable to that of our entire population of MBC patients. A small but clinically significant percentage of patients had prolonged survival. Therefore, not all visceral sites are indicators of poor prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008205522875
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  • 20
    Electronic Resource
    Electronic Resource
    New treatments for breast cancer: Breakthroughs for patient care or just steps in the right direction? (1998)
    Springer
    Annals of oncology 9 (1998), S. 973-976 
    Details
    ISSN: 1569-8041
    Keywords: adjuvant paclitaxel ; breast cancer ; Herceptin™ ; prevention ; Raloxifene ; Tamoxifen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Three areas of clinical research in breast cancer treatment led to news breaking presentations at the American Society of Clinical Oncology (ASCO) meeting, 1998, in Los Angeles. All three subjects represent important advances in cancer medicine. Prevention: Two related drugs, tamoxifen and raloxifene, were found in placebo controlled trials to significantly reduce the incidence of breast cancer for women at increased risk of developing the disease. Patterns of relapse showed that the reduced rate of breast cancer was exclusively observed for tumors expressing estrogen receptors, while the rate of tumors classified as estrogen-receptor negative was similar for the treatment and the control groups. This may indicate that the observed reduction in breast cancer incidence is due to a treatment effect on occult disease rather than its prevention. We certainly have no adequate information on mortality prevention. Adjuvant therapies: Taxol given every three weeks for four courses following an adjuvant treatment with four courses of doxorubicin and cyclophosphamide (AC) combination was found to be superior to not adding treatment after the four courses of AC in a trial involving 3170 patients. At 22 months of median follow-up, the quoted P-values were P = 0.0077 for disease-free survival and P = 0.039 for overall survival, but these did not cross the prospectively defined interim analysis boundaries for statistical significance at the 0.05 level. The difference was observed early during follow-up, and was exclusively seen in the 40% of patients who had ER-negative primaries and, therefore, did not receive tamoxifen following chemotherapy. One may thus argue that the early difference observed was primarily due to differences in the duration of the treatment regimens in the two groups and the early entry into the trial of patients with particularly aggressive neoplasia (e.g., ER-negative primaries) who would have benefited from a longer duration treatment. Treatment of advanced disease: The use of monoclonal antibodies to c-erb-B2 was found to induce responses in metastatic breast cancer. Patients with tumors expressing c-erb-B2 responded to weekly infusions of this biological agent. It was particularly impressive that the response rate for patients receiving infusion of the monoclonal antibodies together with the cytotoxics was superior to that with chemotherapy alone in a randomized trial. It is important to note that only patients with tumors overexpressing c-erbB-2 (the overall incidence is about 20%) were tested. It must still be demonstrated that the effect of these monoclonal antibodies is indeed confined to cells overexpressing c-erbB-2. Treatment related cardiac toxicity remains a problem, and the effects of treatment in various subsets of patients need to be defined before starting investigations in the adjuvant setting, which is a clear further objective of this specific research. The significant findings from clinical research opened several new questions, which must be answered before allowing them to be employed in routine patient care.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008436810268
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  • 21
    Electronic Resource
    Electronic Resource
    Extradural hematoma of the posterior cranial fossa (1998)
    Springer
    Neurosurgical review 21 (1998), S. 52-57 
    Details
    ISSN: 1437-2320
    Keywords: Computed tomography ; extradural hematoma ; posterior fossa ; skull fracture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fourteen cases of an extradural hematoma of the posterior fossa (EDHPF), are presented and the clinical and radiological findings are described. The onset of symptoms was acute in 10 patients and subacute in the other 4. Hematomas occurred in the younger age groups with a clear male predominance. Nine cases had suffered a blow to the head. A fracture of the occipital bone was seen in 86% of the patients. The bleeder could be identified in 10 cases, and in 6 of these the source was a bleeding transverse sinus. The overall mortality was 14.2%, but only patients with an acute course died (20%). All subacute cases survived. This study revealed that the most important factors influencing mortality were late diagnosis and late treatment. Coexisting intracranial lesions had no influence on mortality. According to the literature, there has been a certain decrease in mortality in the acute and subacute course patients since the introduction of computed tomography (CT) scanning. Emphasis is placed on the importance of occipital soft-tissue swelling and occipital fracture as clues to the possible presence of extradural hematomas, and of using the CT in all such patients even if no clinical symptoms are present.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01111486
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  • 22
    Electronic Resource
    Electronic Resource
    Qualitative Bewertung der Hirnstruktur im CT bei Panikstörungen (1998)
    Springer
    Der Nervenarzt 69 (1998), S. 763-768 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Panikstörung ; Computertomographie ; Neuroradiologie ; Hirnmorphologie ; Ätiologie ; Key words Panic disorder ; Computed tomography ; Neuroradiology ; Brain morphology ; Etiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary This CT study was designed to assess brain morphology in panic disorder with and without agoraphobia. Twenty-one patients and 21 normal control subjects matched for age and sex were investigated. Frontal and parieto-occipital cortex, temporal cortex, lateral ventricles and 3rd ventricle were evaluated by qualitative assessment on a 3-point scale (normal, questionable, abnormal). Patients showed significant bilateral enlargement of cortical cerebrospinal fluid (CSF) spaces (p〈0.01). The rating „abnormal” was given to none (0%) of the normal controls, but to 7 (33.3%) of the patients. Explorative analysis showed that these abnormalities were predominantly located in prefrontal regions. No qualitative differences were seen in the temporal cortex, lateral ventricles or third ventricle. These findings support the hypothesis that alterations in brain morphology are involved in the etiology of panic disorder. The lack of a correlation between CSF enlargement and duration of illness suggests that frontal CSF enlargement is a neurobiological vulnerability marker in panic disorder.
    Notes: Zusammenfassung In der vorliegenden CT-Studie wurde untersucht, ob in der Ätiologie der Panikstörung neben diskutierten psychosozialen, genetischen und biochemischen Faktoren auch hirnmorphologische Komponenten von Bedeutung sind. Anhand einer 3stufigen Skala wurde qualitativ die Hirnstruktur von 21 Patienten mit Panikstörungen mit und ohne Agoraphobie nach DSM-IV sowie von einer alters- und geschlechtsgleichen neuropsychiatrisch unauffälligen Kontrollgruppe bewertet. Folgende Hirnstukturen wurden qualitativ auf einer 3-Punkte-Skala (normal, fraglich, pathologisch) bewertet: frontaler und parietookzipitaler Kortex, temporaler Kortex, Seitenventrikel und 3. Ventrikel. Die Patienten mit Panikstörungen zeigten eine signifikante beidseitige Erweiterung des kortikalen Liquorraumes (p〈0,01). Die Beurteilung „pathologisch” wurde bei keiner Kontrollperson, aber bei sieben (33,3%) Patienten vergeben. Diese hirnstrukturellen Auffälligkeiten waren fast ausschließlich im präfrontalen Kortex lokalisiert. Keine signifikanten Gruppenunterschiede fanden sich in Bezug auf den temporalen Kortex, die Seitenventrikel und den 3. Ventrikel. Die Studienergebnisse zeigen, daß in der Ätiologie der Panikstörung auch hirnstrukturelle Veränderungen von Bedeutung sind. Da die Ausprägung dieser hirnstrukturellen Veränderungen nicht abhängig ist von der Krankheitsdauer, wird die präfrontale Liquorraumerweiterung als hirnbiologischer Vulnerabilitätsmarker der Störung interpretiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050340
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  • 23
    Electronic Resource
    Electronic Resource
    Der Kontrastmittelaustritt unter der lokalen intraarteriellen Fibrinolyse im Karotisstromgebiet (1998)
    Springer
    Der Nervenarzt 69 (1998), S. 490-494 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Fibrinolyse ; Intrazerebrale Blutung ; CT ; Kontrastmittel ; Komplikation ; Key words Fibrinolysis ; Cerebral hemorrhage ; Computed tomography ; Contrast medium ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary
    Notes: Zusammenfassung
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050302
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  • 24
    Electronic Resource
    Electronic Resource
    Torsion of an accessory hepatic lobe in a child: ultrasound, computed tomographic, and magnetic resonance imaging findings (1998)
    Springer
    Pediatric surgery international 13 (1998), S. 526-527 
    Details
    ISSN: 1437-9813
    Keywords: Key words Accessory hepatic lobe ; Torsion ; Ultrasonography ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of acute epigastric pain resulting from torsion of an accessory hepatic lobe is reported. Sonographic, computerized tomographic, and magnetic resonance findings are illustrated and the surgical management is discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050391
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  • 25
    Electronic Resource
    Electronic Resource
    Effect of normal ageing on the sites of aortic bifurcation and inferior vena cava confluence: a CT study (1998)
    Springer
    Surgical and radiologic anatomy 20 (1998), S. 63-68 
    Details
    ISSN: 1279-8517
    Keywords: Aortic bifurcation ; Vena cava confluence ; Computed tomography ; Ageing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The object of this retrospective study was to determine the sites of abdominal aortic bifurcation and inferior vena cava confluence in relation to age and sex. The study group comprised 180 subjects (90 males and 90 females) divided into 9 groups by age (in decades). The positions of the aortic bifurcation and the inferior vena cava confluence were evaluated by CT, and linear regression models were fitted to the data. The positions of the aortic bifurcation and venous confluence showed a highly significant downward shift with increasing age (p=0.0001). The shift was more pronounced in women. The mean site of the aortic bifurcation for the whole group was at lower L4 (range, upper L3 to upper S1); in males, it was at upper L4 (range, upper L3 to upper L5), and in females at lower L4 (range, upper L3 to upper S1). The mean site of the venous confluence for the whole group was at disc L4-L5 (range, lower L3 to upper S1); in males, it was at disc L4-L5 (range, upper L4 to disc L5-S1), and in females at disc L4-L5 (range, lower L3 to upper S1). Thus, the aorta and the inferior vena cava can extend as low as the level of S1. These data are of relevance in laparoscopic procedures, especially in laparoscopic lumbar discectomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00276-998-0063-9
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  • 26
    Electronic Resource
    Electronic Resource
    Effect of normal ageing on the sites of aortic bifurcation and inferior vena cava confluence: a CT study (1998)
    Springer
    Surgical and radiologic anatomy 20 (1998), S. 63-68 
    Details
    ISSN: 1279-8517
    Keywords: Aortic bifurcation ; Vena cava confluence ; Computed tomography ; Ageing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le but de cette étude rétrospective était de déterminer la topographie de la bifurcation de l'aorte abdominale et de la confluence cave caudale en fonction de l'âge et du sexe. Le groupe étudié comprenait 180 sujets (90 de sexe masculin et 90 de sexe féminin) divisés en 9 groupes d'âge (9 décennies). Les positions de la bifurcation aortique et de la confluence veineuse cave caudale ont été évaluées par tomodensitométrie, et des modèles de régression linéaire ont été appliqués aux données recueillies. Un déplacement caudal des positions de la bifurcation aortique et de la confluence cave caudale était hautement corrélé à l'âge (p=0.0001). Le déplacement était plus prononcé chez les femmes. La position moyenne de la bifurcation aortique pour le groupe entier était la partie caudale de L4 (extrémités : partie supérieure de L3, partie supérieure de S1) ; chez les sujets de sexe masculin, elle se situait à la partie supérieure de L4 (extrémités : partie supérieure de L3, partie supérieure de L5), et dans le sexe féminin à la partie caudale de L4 (extrémités : partie supérieure de L3, partie supérieure de S1). La situation moyenne de la confluence cave caudale pour le groupe entier était au niveau du disque L4–L5 (extrémités : partie caudale de L3, partie craniale de S1) ; dans le sexe masculin elle se situait en regard du disque L4–L5 (extrémités : partie craniale de L4, disque L5–S1) et dans le sexe féminin au niveau du disque L4–L5 (extrémités : partie caudale de L3, partie craniale de S1). Ainsi, l'aorte et la veine cave caudale peuvent s'étendre aussi bas qu'au niveau de S1. Ces données trouvent leur application dans les procédures laparoscopiques, en particulier dans la discectomie lombaire.
    Notes: Summary The object of this retrospective study was to determine the sites of abdominal aortic bifurcation and inferior vena cava confluence in relation to age and sex. The study group comprised 180 subjects (90 males and 90 females) divided into 9 groups by age (in decades). The positions of the aortic bifurcation and the inferior vena cava confluence were evaluated by CT, and linear regression models were fitted to the data. The positions of the aortic bifurcation and venous confluence showed a highly significant downward shift with increasing age (p=0.0001). The shift was more pronounced in women. The mean site of the aortic bifurcation for the whole group was at lower L4 (range, upper L3 to upper S1); in males, it was at upper L4 (range, upper L3 to upper L5), and in females at lower L4 (range, upper L3 to upper S1). The mean site of the venous confluence for the whole group was at disc L4–L5 (range, lower L3 to upper S1); in males, it was at disc L4–L5 (range, upper L4 to disc L5–S1), and in females at disc L4–L5 (range, lower L3 to upper S1). Thus, the aorta and the inferior vena cava can extend as low as the level of S1. These data are of relevance in laparoscopic procedures, especially in laparoscopic lumbar discectomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01628118
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  • 27
    Electronic Resource
    Electronic Resource
    Primary heart angiosarcoma detected by computed tomography and magnetic resonance imaging (1998)
    Springer
    European radiology 8 (1998), S. 66-68 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Heart angiosarcoma ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We report a case of primary heart angiosarcoma and its appearance on plain and post-contrast computed tomography and magnetic resonance imaging in 21-year-old woman. The tumour involved the right atrium, expanded superiorly among the superior vena cava, ascending aorta and innominate vein, and infiltrated the pericardium. The tumour was disseminated into lungs, liver and bones at the time of its clinical presentation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050341
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  • 28
    Electronic Resource
    Electronic Resource
    Perineurioma (storiform perineurial fibroma) of the kidney in a child (1998)
    Springer
    European radiology 8 (1998), S. 770-771 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Perineurioma ; Nerve sheath tumor ; Computed tomography ; Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Perineurioma is an extremely rare benign tumor of the peripheral nervous system composed exclusively of perineurial cells. Imaging findings of this tumor are non-specific and the diagnosis is based on histologic studies. We report a case of perineurioma of the kidney in a 7-year-old girl discovered incidentally during the evaluation of a urinary tract infection. This is the first case of renal perineurioma reported in a child. We present the ultrasound and computed tomography findings of this histologically confirmed neoplasm.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050470
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  • 29
    Electronic Resource
    Electronic Resource
    Anomalous vessel in the middle ear: the role of CT and MR angiography (1998)
    Springer
    Neuroradiology 40 (1998), S. 748-751 
    Details
    ISSN: 1432-1920
    Keywords: Key words Internal carotid artery ; Stapedial artery ; Computed tomography ; Magnetic resonance angiography ; Middle ear
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An 8-year-old child was examined because of conductive hearing loss with a retrotympanic mass on otoscopy. CT and MR angiography showed a large inferior tympanic artery traversing the hypotympanum and joining a thin, irregular internal carotid artery with a normal middle meningeal artery. These investigations, coupled with knowledge of the embryological development allowed a diagnosis of a complex vascular anomaly in the middle ear and avoided potential surgical complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050677
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  • 30
    Electronic Resource
    Electronic Resource
    Primary intracranial leiomyoma: case report (1998)
    Springer
    Neuroradiology 40 (1998), S. 238-241 
    Details
    ISSN: 1432-1920
    Keywords: Key words Leiomyoma ; brain ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a case of intracranial parenchymal leiomyoma in a 20-year-old woman with a chief complaint of numbness and a painful sensation over the right limbs for several years. CT and MRI revealed an intensely enhancing calcified mass. The patient was well, without recurrence, 2 years after surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050574
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  • 31
    Electronic Resource
    Electronic Resource
    Trans-sphenoidal treatment of postsurgical cerebrospinal fluid fistula: CT-guided closure (1998)
    Springer
    Neuroradiology 40 (1998), S. 690-694 
    Details
    ISSN: 1432-1920
    Keywords: Key words Surgery ; trans-sphenoidal ; Cerebrospinal fluid fistula ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebrospinal fluid (CSF) leakage after trans-sphenoidal surgery is a troublesome complication with a risk of meningitis and pneumocephalus. We suggest CT-guided intrasphenoidal injection of fibrin sealant through a 12-gauge needle as a simple alternative to surgical management of CSF fistulae. We treated eight patients, operated via the trans-sphenoidal route (five pituitary adenomas, three craniopharyngiomas), for a postoperative CSF leak by CT-guided intrasphenoidal injection of fibrin sealant alone in three cases and fibrin sealant and autologous blood in 5. CT was obtained 10 days after the procedure in all cases. In four patients, the CSF leak was closed successfully at the first attempt. The procedure was repeated on the four remaining patients because only a reduction in leakage was obtained at the first attempt. This procedure preserves olfaction and avoids the risk of frontal lobe damage. It could therefore represent the treatment of choice in many cases of anterior cranial fossa postsurgical CSF leaks.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050666
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  • 32
    Electronic Resource
    Electronic Resource
    Cerebral perivenous calcification in neuropsychiatric lupus erythematosus: a case report (1998)
    Springer
    Neuroradiology 40 (1998), S. 583-586 
    Details
    ISSN: 1432-1920
    Keywords: Key words Brain ; Calcification ; perivenous ; Lupus erythematosus ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a case of neuropsychiatric lupus erythematosus with granular calcification in the basal ganglia and cerebral white matter on CT. Histopathologically, these were identified as perivenous necrotising lesions, with loss of axons and myelin sheaths and prominent dystrophic calcification.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050649
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  • 33
    Electronic Resource
    Electronic Resource
    MRI of enlarged endolymphatic sacs in the large vestibular aqueduct syndrome (1998)
    Springer
    Neuroradiology 40 (1998), S. 167-172 
    Details
    ISSN: 1432-1920
    Keywords: Key words Inner ear ; Aqueduct ; vestibular ; Endolymphatic duct ; Hearing loss ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied ten inner ears of five patients with a bilateral large vestibular aqueduct syndrome, using CT and MRI. Although the large vestibular aqueduct varied in size, a markedly dilated endolymphatic sac extending to the sigmoid sinus was demonstrated bilaterally on MRI in all patients. The cause of hearing loss in this syndrome is unclear. However, it is suggested that reflux of the protein-rich, hyperosmolar endolymph from the enlarged endolymphatic sac (EES) into the cochlea through a widely patent endolymphatic duct may damage the neuroepithelium. CT density and spin-echo MRI signal intensity of the endolymph in EES were markedly higher than those of CSF in eight inner ears of four patients. Increased density and high signal may indicate protein-rich, hyperosmolar endolymph. In some patients with sensorineural hearing loss and EES, the vestibular aqueduct may not appear dilated on CT. MRI is therefore necessary for correct diagnosis of this syndrome, which should more correctly be termed “large endolymphatic duct and sac syndrome”. Prominent EES may predict poor prognosis in this syndrome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050561
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  • 34
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    Laryngeal amyloidosis with laryngocele: MRI and CT (1998)
    Springer
    Neuroradiology 40 (1998), S. 401-403 
    Details
    ISSN: 1432-1920
    Keywords: Key words Amyloidosis ; larynx ; Laryngocele ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of laryngeal amyloidosis associated with a laryngocele is reported. Preoperative CT showed diffuse thickening of the epiglottis, aryepiglottic folds and false vocal cords with well-defined calcific foci. MRI revealed contrast enhancement and increased signal intensity on T2-weighted images.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050611
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  • 35
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    Electronic Resource
    CT of the temporal bone in the CHARGE association (1998)
    Springer
    Neuroradiology 40 (1998), S. 462-465 
    Details
    ISSN: 1432-1920
    Keywords: Key words Temporal bone ; abnormalities ; CHARGE association ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the CT examinations of the temporal bone, performed with 1-mm-thick contiguous sections, of seven patients with the CHARGE association. We found abnormalities of the incus and stapes, with ossicular chain fixation, absence of the stapedius muscle and oval window, hypoplasia or dysplasia of the vestibule and absence of the semicircular canals in all ears. The pyramidal eminence and tympanic sinus were absent and there were anomalies of the cochlea in 13 of 14 ears. Absence of the semicircular canals is the most specific change in patients with the CHARGE association.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050625
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  • 36
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    Electronic Resource
    Imaging of huge lingual thyroid gland with goitre (1998)
    Springer
    Neuroradiology 40 (1998), S. 335-337 
    Details
    ISSN: 1432-1920
    Keywords: Key words Thyroid ; lingual ; Goitre ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the CT and MRI findings in a 75-year-old woman with a huge pathologically proven lingual thyroid which underwent goitrous degeneration. CT and MRI showed a midline, tongue-based, exophytic mass with areas of necrosis and heterogeneous contrast enhancement, as seen in large goitres in the normal thyroid gland.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050595
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  • 37
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    Electronic Resource
    Radiological assessment of necrosis in glioblastoma: variability and prognostic value (1998)
    Springer
    Neuroradiology 40 (1998), S. 150-153 
    Details
    ISSN: 1432-1920
    Keywords: Key words Glioblastoma ; necrosis ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a previous study, we found that the extent of necrosis was the only radiological feature which correlated significantly with survival in patients with glioblastoma. The aim of this paper was to evaluate the variability and prognostic value of the extent of the necrotic area as seen on contrast-enhanced MRI and CT in a larger series. We studied 72 patients who underwent surgical removal of supratentorial glioblastomas and had CT and/or MRI with contrast medium before surgery; 38, all undergoing the same treatment (surgery plus radiotherapy), were followed clinically. Necrosis within the tumour varied greatly, ranging from none (only 1 case) to involvement of 76 % of the tumour. Survival data in the subgroup suggested that only patients with a small area of necrosis (less than 35 % of the tumour) had a significantly longer survival time. When necrosis involved more than 35 % of the mass, patients had a shorter survival time, without any further correlation with the extent of necrosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050556
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  • 38
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    Electronic Resource
    Giant arachnoid granulation mimicking dural sinus thrombosis in a boy with headache: MRI (1998)
    Springer
    Neuroradiology 40 (1998), S. 181-183 
    Details
    ISSN: 1432-1920
    Keywords: Key words Arachnoid granulations ; Computed tomography ; Magnetic resonance imaging ; Magnetic resonance venography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report MRI and angiographic findings of an unusual giant arachnoid granulation in the left sigmoid sinus in a boy with headache. Its signal intensity was lower than that of cerebral cortex on T1-weighted images and higher on T2 weighting, mimicking dural sinus thrombosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050564
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  • 39
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    Electronic Resource
    Synovial sarcoma of the parapharyngeal space: CT and MRI (1998)
    Springer
    Neuroradiology 40 (1998), S. 261-263 
    Details
    ISSN: 1432-1920
    Keywords: Key words Head and neck ; neoplasms ; Sarcoma ; synovial ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the CT and MRI findings of a histologically proven synovial sarcoma arising in the left parapharyngeal space of a 21-year-old man. CT was useful for confirming the presence of calcification within the tumour, which may be a favourable prognostic sign, and in excluding involvement of cortical bone. The CT and MRI findings were, however, nonspecific. MRI was superior to CT for assessing the topographical relationships of the tumour to the vessels and the invasion of neighbouring structures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050581
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  • 40
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    Electronic Resource
    Intracranial gas on CT after Cardiopulmonary resuscitation: 4 cases (1998)
    Springer
    Neuroradiology 40 (1998), S. 154-157 
    Details
    ISSN: 1432-1920
    Keywords: Key words Cardiopulmonary resuscitation ; Intracranial gas ; Computed tomography ; postmortem
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report four patients in whom gas was seen in the head on CT shortly after cardiopulmonary resuscitation. The gas was in the posterior cranial fossa, presumably within veins, or in the cavernous sinus. The cause of the cardiac arrest was myocardial infarction in three patients and hanging in one. All had peripheral or central venous lines. The mechanism by which gas appeared in the intracranial veins is discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050557
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  • 41
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    Electronic Resource
    CT and MRI of microcephalia vera (1998)
    Springer
    Neuroradiology 40 (1998), S. 332-334 
    Details
    ISSN: 1432-1920
    Keywords: Key words Microcephalia vera ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract CT and MRI findings in three patients, two of them siblings, with microcephalia vera are presented. In this rare entity, a very small brain with an extremely thin, smooth cortex and increased surrounding cerebrospinal fluid are observed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050594
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  • 42
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    Electronic Resource
    Sedimentation level in acute intracerebral hematoma in a patient receiving anticoagulation therapy: an autopsy study (1998)
    Springer
    Neuroradiology 40 (1998), S. 380-382 
    Details
    ISSN: 1432-1920
    Keywords: Key words Anticoagulants ; Cerebral hemorrhage ; Autopsy ; Computed tomography ; Hematoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report the first case in which a fluid-blood interface was identified at autopsy in a patient with acute intracerebral hematoma on anticoagulant therapy. Anticoagulation may be one of the major factors contributing to the production of an intracerebral blood sedimentation level.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050604
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  • 43
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    Electronic Resource
    Growth rate of multiple intracranial hydatid cysts assessed by CT from the time of embolisation (1998)
    Springer
    Neuroradiology 40 (1998), S. 387-389 
    Details
    ISSN: 1432-1920
    Keywords: Key words Hydatid cysts ; growth ; Echinococcus granulosus ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report the case of a 25-year-old man with multiple bilateral hydatid cysts of the brain in whom we were able to assess the growth rate of the cysts on repeated examination. On average, the cysts increased in diameter by 1 cm per month.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050607
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  • 44
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    Electronic Resource
    The need for repeat angiography in subarachnoid haemorrhage (1998)
    Springer
    Neuroradiology 40 (1998), S. 6-10 
    Details
    ISSN: 1432-1920
    Keywords: Key words Subarachnoid haemorrhage ; Angiography ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study was designed to assess the necessity for a second angiogram study in patients in whom initial angiography after primary subarachnoid haemorrhage (SAH) was negative. During a 12-year period, 122 of 694 patients (17.5 %) had negative initial angiograms. CT, available for 98 patients, showed a preponderance of subarachnoid blood in the perimesencephalic cisterns in 50 of 73 patients (68.5 %) in whom blood was visible on CT. Angiography, repeated in 67 patients, revealed an aneurysm in 4 (6 %): 2 had an aneurysm of the anterior communicating artery, 1 of the posterior inferior cerebellar artery, and 1 of the P2 segment of the posterior cerebral artery. CT showed subarachnoid blood in the interpeduncular and ambient cisterns in this last case, and a preponderance of subarachnoid blood outside the perimesencephalic cisterns in the remaining 3 patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050528
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  • 45
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    Electronic Resource
    Albendazole treatment of cerebral hydatid disease: evaluation of results with CT and MRI (1998)
    Springer
    Neuroradiology 40 (1998), S. 36-39 
    Details
    ISSN: 1432-1920
    Keywords: Key words Echinococcosis ; brain ; Hydatid disease ; brain ; Albendazole ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of cerebral hydatid disease demonstrated by CT and MRI, treated with albendazole. Follow-up showed complete dissapearance of the cysts with residual focal calcification on CT and presumed gliosis on MRI.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050535
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  • 46
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    Electronic Resource
    Lipomatous secretory meningioma: case report and review of the literature (1998)
    Springer
    Neuroradiology 40 (1998), S. 656-658 
    Details
    ISSN: 1432-1920
    Keywords: Key words Secretory meningioma ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Secretory meningioma is a rare entity which may be characterised by imaging features unusual for other subtypes of meningoma, such as low attenuation on CT, high (fat-tissue equivalent) signal intensity on T1-weighted MRI, marked surrounding oedema, and irregular contrast enhancement. We report a case of secretory meningioma and review the literature.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050658
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  • 47
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    Electronic Resource
    Radiology of an atypical fibro-osseous lesion confined to the nasal cavity (1998)
    Springer
    Neuroradiology 40 (1998), S. 752-754 
    Details
    ISSN: 1432-1920
    Keywords: Key words Nasal cavity ; Fibrous dysplasia ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fibro-osseous lesions of the sinonasal region are relatively frequent, but those strictly confined to the nasal cavity are rare. We report an atypical fibro-osseous lesion in the nasal cavity and describe its radiological features. The differential diagnosis is discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050678
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  • 48
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    Electronic Resource
    Ossified retroperitoneal malignant Schwannoma with spinal leptomeningeal metastases (1998)
    Springer
    Neuroradiology 40 (1998), S. 48-50 
    Details
    ISSN: 1432-1920
    Keywords: Key words Schwannoma Malignant ; Leptomeningeal metastasis ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A malignant retroperitoneal schwannoma in a patient without von Recklinghausen's disease is reported. Ossification in the tumour, shown on CT and MRI in this previously untreated patient is exceptional. MRI demonstration of spinal leptomeningeal metastases supports the hypothesis of haematogenous metastatic spread of systemic malignant tumours to the leptomeningeal spaces.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050538
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  • 49
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    Electronic Resource
    Imaging of giant pituitary adenomas (1998)
    Springer
    Neuroradiology 40 (1998), S. 651-655 
    Details
    ISSN: 1432-1920
    Keywords: Key words Pituitary adenoma ; Suprasellar tumour ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present five proven giant pituitary adenomas studied by CT and MRI, and review the clinical and imaging findings. Our aim was to examine the radiologic appearances and to search for criteria useful in distinguishing these tumors from other sellar and suprasellar tumours, mainly craniopharyngioma. The main differences from small adenomas were high prevalence of macrocysts, a more invasive behaviour and a clinical picture dominated by mass effect rather than endocrine disturbance. Factors supporting the diagnosis of pituitary adenoma in a giant intra- and suprasellar mass include: infrasellar extension, absence of calcification and presence of low-signal cysts on T1-weighted images.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050657
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  • 50
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    Electronic Resource
    Marble brain syndrome: osteopetrosis, renal acidosis and calcification of the brain (1998)
    Springer
    Neuroradiology 40 (1998), S. 662-663 
    Details
    ISSN: 1432-1920
    Keywords: Key words Marble brain syndrome ; Osteopetrosis ; Renal acidosis ; Calcification intracranial ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebral calcification in children is frequently associated with systemic metabolic disease. We present a case of “marble brain syntrome”, which showed this abnormality.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050660
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  • 51
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    Electronic Resource
    Chondromyxoid fibroma of the ethmoid sinus (1998)
    Springer
    Neuroradiology 40 (1998), S. 577-579 
    Details
    ISSN: 1432-1920
    Keywords: Key words Fibroma ; chondromyxoid ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Only a smal proportion of cases of this rare neoplasm occur in the skull. We present an unusually extensive tumour in a young man.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050647
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  • 52
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    Electronic Resource
    Problems of bone analysis in childhood and adolescence (1998)
    Springer
    Pediatric nephrology 12 (1998), S. 420-429 
    Details
    ISSN: 1432-198X
    Keywords: Key words: Osteoporosis ; Bone density ; Growth ; Renal insufficiency ; Ultrasound ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The monitoring of bone metabolism and skeletal development during childhood and adolescence is becoming increasingly important in the prevention of osteoporosis. This is especially important in patients with chronic disorders. The predominant changes in the skeletal system during growth occur as geometric adaptation processes which lead to an increase in bone mass and bone strength. These changes can be measured with linear absorption methods (single-photon absorptiometry, dual-photon absorptiometry, dual-energy X-ray absorptiometry), computed tomographic procedures (peripheral quantitative computed tomography, quantitative computed tomography), and sonographic procedures. The aim of this review is to explain the problems of interpretation of the investigations due to growth-dependent changes. Almost all methods and their parameters, such as bone density, spongiosa density, cortical density, ultrasound transmission velocity, etc., are influenced, in varying degree, by growth-dependent skeletal changes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004670050479
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  • 53
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    Electronic Resource
    Samenblasenzysten bei ipsilateraler Nierenagenesie Bildgebende Diagnostik, Klinik und Langzeitverlauf (1998)
    Springer
    Der Radiologe 38 (1998), S. 766-773 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Samenblasenzysten ; Nierenagenesie ; Langzeitverlauf ; Computertomographie ; Magnetresonanztomographie ; Key words Seminal vesicle cysts ; Renal agenesis ; Long-term results ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Congenital seminal vesicle cysts associated with ipsilateral renal agenesis or dysplasia are rare malformations. Even though they are more often diagnosed today due to the introduction of advanced, sectional imaging techniques as CT and MRI, no reliable data about the prevalence of this malformation are available. This study reports seven consecutive cases, with long-term follow-up in five cases (26–119 months, mean 52 months). All patients underwent sonography, excretory urography, CT and MRI. Only two of seven patients presented nonspecific symptoms of the lower urinary tract; five were asymptomatic. In all cases sonography revealed the cystic character of the retrovesical enlargement. The anatomy of the lower pelvis was most accurately shown on MRI, which depicted the ectopic insertion of the ureter into the seminal vesicle in five cases. Cysts demonstrated high signal intensities in T1- and T2-weighted spin-echo images. In five cases the CT density was over 40 HU. Whereas one patient (15 years) presented significant enlargement of the cysts 10 years after primary diagnosis with compression of the urinary bladder, four patients showed no changes of their malformation in the follow-up examinations. The present data therefore support the concept of treating only symptomatic patients.
    Notes: Zusammenfassung Kongenitale Samenblasenzysten mit ipsilateraler Nierenagenesie oder -dyplasie sind seltene angeborene Mißbildungen. Seit Einführung moderner Schnittbildverfahren werden sie jedoch zunehmend häufiger diagnostiziert. Dennoch fehlen bislang genaue Angaben über die Prävalenz dieses Mißbildungsmusters. Diese Studie berichtet über 7 konsekutive Fälle und dokumentiert in 5 Fällen Langzeitbeobachtungen (26–119 Monate, Mittel 52 Monate). Von allen Patienten liegen Ultraschalluntersuchungen, Ausscheidungsurographien sowie Computer- und Kernspintomographien vor. Nur 2 von 7 Patienten wiesen unspezifische Symptome des unteren Harntraktes auf, alle anderen waren asymptomatisch. Von allen bildgebenden Verfahren zeigte die Kernspintomographie am genausten die Veränderungen im kleinen Becken und ihre Beziehungen zum Urogenitalsystem. Die Zysten wiesen eine hohe Signalintensität in T1- und T2-gewichteten Spin-Echo-Sequenzen auf. Computertomographisch fanden sich in 5 Fällen Dichtewerte über 40 HE. Während ein Patient (15 Jahre alt) 10 Jahre nach Erstdiagnose eine erhebliche Vergrößerung der Zysten mit Verdrängung der Harnblase aufwies, zeigten 4 Patienten bei der Nachuntersuchung keine Veränderung der Fehlbildung. Die vorliegenden Daten stützen somit das Konzept, nur symptomatische Patienten zu therapieren.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050423
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  • 54
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    Subperiostales Orbitahämatom und epidurales Hämatom bei Patienten mit Schädel-Hirn-Trauma (1998)
    Springer
    Der Radiologe 38 (1998), S. 954-957 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Epidurales Hämatom ; Orbita ; Trauma ; Hämatom ; Computertomographie ; Key words Extradural hematoma ; Orbit ; Trauma ; Hematoma ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Subperiostal hematomas (SPOH) of the orbit are mostly of traumatic origin, but may occur spontaneously. In patients with frontal and temporal extradural hematomas, concomitant SPOH of the ipsilateral orbit have sporadically been observed. We report clinical and radiological findings of a patient and a review of the literature and discuss the development of SPOH.
    Notes: Zusammenfassung Subperiostale Hämatome der Orbita (SPOH) treten überwiegend posttraumatisch, selten auch spontan auf. Gelegentlich wurde bei Patienten mit einem frontalen oder temporalen Epiduralhämatom ein SPOH der ipsilateralen Orbita beobachtet. Wir stellen anhand einer eigenen Patientin und einer Literaturübersicht die klinischen und radiologischen Befunde vor und diskutieren die Entstehung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050448
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  • 55
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    Electronic Resource
    Bone age determination based on the study of the medial extremity of the clavicle (1998)
    Springer
    European radiology 8 (1998), S. 1116-1122 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Clavicle ; Medial clavicular epiphysis ; Computed tomography ; Bone age determination
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The development of the medial clavicular epiphysis and its fusion with the clavicular shaft have been a subject of medical research since the second decade of this century. Computed tomography provides the imaging modality of choice in analyzing the maturation process of the sternal end of the clavicle. In a retrospective study, we analyzed normal development in 380 individuals under the age of 30 years. The appearance of an epiphyseal ossification center occurred between ages 11 and 22 years. Partial union was found from age 16 until age 26 years. Complete union was first noted at age 22 years and in 100 % of the sample at age 27 years. Based on these data, age-related standardized age distributions and 95 % reference intervals were calculated. Compared to the experience recorded in the relevant literature, there are several landmarks that show no significant change between different ethnic groups and different periods of publication; these are the onset of ossification, the time span of partial union, and the appearance of complete union. Despite the relatively long time spans of the maturation stages, bone age estimation based on the study of the development of the medial clavicular epiphysis may be a useful tool in forensic age identification in living individuals, especially if the age of the subject is about the end of the second or the beginning of the third decade of life (e. g. in determining the applicability of adult or juvenile penal systems). Another possible use is in identifying human remains whose age is estimated at under 30 years.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050518
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  • 56
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    Mature teratoma of the posterior mediastinum (1998)
    Springer
    European radiology 8 (1998), S. 100-102 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Teratoma ; Posterior mediastinum ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The vast majority of germ cell tumors in the thorax arise at or near the thymus. We report a case of a 41-year-old man with mature teratoma of the posterior mediastinum. He was asymptomatic and was incidentally found to have a posterior mediastinal mass. Computed tomography was helpful in suggesting a diagnosis of mature teratoma by demonstrating the presence of fat and calcification. The differential diagnosis included neurogenic tumors, liposarcoma, and extramedullary hematopoiesis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050347
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  • 57
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    Ultrasonography versus computed tomography in evaluation of the femoral trochlear groove morphology: a pilot study on healthy, young volunteers (1998)
    Springer
    European radiology 8 (1998), S. 244-247 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Knee ; Femoral trochlea ; Ultrasonography ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of the study was to verify the efficacy of ultrasonography (US) in evaluating the morphology of normal trochlea, especially the sulcus angle and the trochlear depth, in comparison with computed tomography (CT) (gold standard). The knees of 11 asymptomatic volunteers were subjected to US and CT evaluation of the same section planes and the results were compared. For statistical evaluation Spearman's correlation coefficient analysis was used. A statistically significant correlation was found between the two diagnostic procedures (sulcus angle: r = 0.820; trochlear depth: r = 0.802; Spearman's correlation coefficient) and the intra-observer variability for the US measurements (sulcus angle: r = 0.966; trochlear depth: r = 0.914; Spearman's correlation coefficient). The mean value of sulcus angle and trochlear depth was 132 ° and 5.6 mm, respectively, similar to those reported in the literature. We conclude that evaluation by US of both sulcus angle and trochlear depth is as reproducible and sensitive as that performed with CT.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050372
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    Electronic Resource
    Non-invasive imaging of the great vessels of the chest (1998)
    Springer
    European radiology 8 (1998), S. 1099-1105 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Aorta ; Pulmonary arteries ; Computed tomography ; Magnetic resonance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Several excellent imaging modalities are available for studying the great vessels of the chest noninvasively. Besides computed tomography (CT), magnetic resonance imaging (MRI) and echocardiography (in particular the transesophageal approach) can accurately depict abnormalities of the thoracic vasculature, and are a valuable substitute for contrast angiography in most circumstances. The aim of this paper is to provide a comprehensive review of the current contribution of CT and MRI to the diagnosis of great vessel pathology of the chest.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050516
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  • 59
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    Electronic Resource
    A recurrent left atrium leiomyosarcoma (1998)
    Springer
    European radiology 8 (1998), S. 97-99 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Gated MRI ; Computed tomography ; Heart ; Left atrium ; Neoplasms ; Leiomyosarcomas
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Cardiac leiomyosarcoma is a rare tumour which can grow either intramurally or extramurally. Its prognosis is dismal. Surgery lengthens survival, but recurrences usually occur in the short term. Gated MRI is useful for the assessment of cardiac masses since it provides fine spatial and contrast resolution. We present the case of a left atrial leiomyosarcoma whose recurrence was diagnosed by gated MRI. Our patient underwent a second resection but died soon after.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050346
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  • 60
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    Electronic Resource
    Retroperitoneal lymphangioleiomyomatosis: CT appearance (1998)
    Springer
    European radiology 8 (1998), S. 471-473 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Lymphangioleiomyomatosis ; Retroperitoneum ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Lymphangioleiomyomatosis is a rare disease involving the lung, lymphatic trunk and lymph nodes. Sometimes it appears in the retroperitoneum with or without subsequent development in the lungs. We present a 52-year-old woman with retroperitoneal location of the disease. We discuss the abdominal CT appearance, the cytologic and immunophenotypic features and a preoperative differential diagnosis is attempted.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050417
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  • 61
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    Electronic Resource
    Intracranial vascular involvement of brain pathologies and venous occlusions (1998)
    Springer
    European radiology 8 (1998), S. 1106-1115 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Stroke ; Venous occlusions ; Computed tomography ; MRI ; Diffusion ; Echoplanar imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. In this paper, the authors present the contribution of CT and MRI to the diagnosis of acute stroke caused by arterial or venous occlusion. The term “early” used in this context means within 6 h of the onset of symptoms. Signs of early ischemic edema are subtle and sometimes difficult to detect by CT or MRI. The purpose of this presentation is to familiarize the clinician and the radiologist with the subtle brain parenchymal changes seen within the first 6 h after onset of symptoms, in order to improve detection of early ischemic infarction and to improve patient care.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050517
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  • 62
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    Electronic Resource
    Primary choriocarcinoma of the stomach and pancreas: CT findings (1998)
    Springer
    European radiology 8 (1998), S. 1425-1428 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Choriocarcinoma ; Stomach ; Pancreas ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. In this report we present the CT findings of two non-gestational,extragonadal choriocarcinomas, one arising within the stomach and one in the pancreas. These are rare tumours and a pancreatic primary site has not been previously described.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050567
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  • 63
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    Electronic Resource
    Intraosseous lipomata of adjacent vertebral bodies (1998)
    Springer
    European spine journal 7 (1998), S. 344-347 
    Details
    ISSN: 1432-0932
    Keywords: Key words Lipoma ; Computed tomography ; Magnetic resonance imaging ; Radiography ; Vertebral
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Osseous lipomata of vertebral bodies are rare. We present a very unusual case where adjacent vertebrae are involved and the plain radiographic and scintigraphic appearances gave cause for some concern. The findings on plain films, scintigraphy, computed tomography and magnetic resonance imaging are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005860050086
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  • 64
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    Electronic Resource
    Parosteal osteoma of the iliac bone (1998)
    Springer
    Skeletal radiology 27 (1998), S. 161-163 
    Details
    ISSN: 1432-2161
    Keywords: Key words Parosteal osteoma ; Iliac bone ; Computed tomography ; Magnetic resonance imaging ; Partial regression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A 33-year-old patient with a 2-year history of intermittent pain in the right gluteal region and thigh presented with a large sclerotic lesion of the iliac bone. From the findings on radiography, scintigraphy, CT and MRI, a giant parosteal osteoma was suspected. The histological examination confirmed the diagnosis. Since the lesion was extensive it was observed with periodic follow-up examinations. At present, 5 years after the diagnosis, the patient is asymptomatic and imaging studies show that the lesion persists with reduction of sclerosis and size. The tumor was on the surface as well as intramedullary – only one other case with such a distribution is known to us – and it was also in the iliac bone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050357
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  • 65
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    Posterior cranial fossa surgery in 454 children Comparison of results obtained in pre-CT and CT era and after various types of management of dura mater (1998)
    Springer
    Child's nervous system 14 (1998), S. 426-438 
    Details
    ISSN: 1433-0350
    Keywords: Key words Posterior cranial fossa surgery ; Tumours ; Childhood ; Computed tomography ; Duraplasty ; Paediatric neurosurgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract At the Department of Neurosurgery, Hradec Králové, 454 children (aged under 18 years) were operated on for posterior cranial fossa lesions in a period of 49 years (1948–1996). The majority (402) had tumours: cerebellar astrocytomas 149 (37.1%), medulloblastomas 139 (34.6%), brain stem gliomas 46 (11.4%), ependymomas 28 (7.0%), and others 40 (9.9%). Postoperative mortality was compared for the pre-CT era (1948–1977) and the CT era (1978–1996): astrocytomas (8.6%:4.7%), medulloblastomas (14.9%:2.9%), brain stem gliomas (21.7%:19.0%), ependymomas (18.2%:6.3%), and others (40.0%:7.4%). The initially high mortality was due to insufficient intracranial decompression, brain oedema and disturbances of cerebrospinal fluid circulation. Obstructive hydrocephalus was treated in 53 children with tumours and 25 with aqueduct stenoses, by Torkildsen's drainage in 5.5%, and/or by catheterisation of aqueduct in 12.3%. The main postoperative complications of medial posterior fossa surgery in 429 children operated on were: pseudomeningocele (12.3%), active hydrocephalus (6.2%) and CSF leakage (4.6%). Only 8.2% had shunts placed for these complications. We presume that this low percentage of shunts used results from a frequent use of duraplasties and drains installed at the primary operation. The dura mater was initially (1948–1954) left open (50 cases), and later (1955–1958) also sutured (37 cases), and from 1958, onward, and especially from 1961, reconstructed by a medial approach by means of various grafts (377 cases). In all, duraplasty was performed in 81.6% of cases. The grafts used for dura mater reconstruction were prepared from autogeneic (1.6%), allogeneic (72.3%), xenogeneic (24.8%), or synthetic (1.3%) material. They were successful in 99.2% of cases (all materials). Our own suture technique for posterior fossa duraplasty is presented.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050255
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  • 66
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    Diffuse bilateral thalamic astrocytomas as examined serially by MRI (1998)
    Springer
    Child's nervous system 14 (1998), S. 384-388 
    Details
    ISSN: 1433-0350
    Keywords: Key words Diffuse astrocytoma ; Bilateral thalamic astrocytomas ; Computed tomography ; Magnetic resonance imaging ; Hyperfractionated radiotherapy ; Chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report the case of a 13-year-old girl with diffuse bilateral thalamic astrocytomas. Incoordination was observed at the onset. Cranial computed tomography (CT) showed enlarged thalami, and magnetic resonance imaging (MRI) revealed these lesions to be symmetrically enlarged with high intensity on the T2-weighted image. Owing to these atypical findings in the neuroimaging studies, we had difficulty in making the correct diagnosis of a brain tumor. After the diagnosis of diffuse bilateral thalamic astrocytomas was obtained, we performed hyperfractionated radiotherapy followed by chemotherapy. Radiation therapy was effective for a while, but the girl's condition deteriorated again and she died 8 months after admission. Although diffuse bilateral thalamic astrocytomas are difficult to diagnose because they do not resemble most other neoplasms on neuroimaging studies, pediatricians should keep this entity in mind in order to arrive at a precise and prompt diagnosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050250
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  • 67
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    Abbildungseigenschaften der Elektronenstrahl-CT Continuous-Volume-Scan im Vergleich zur Spiral-CT (1998)
    Springer
    Der Radiologe 38 (1998), S. 993-998 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Computertomographie ; Elektronenstrahlcomputertomographie ; Dosis ; Key words Computed tomography ; electron-beam ; Computed tomography ; dose ; Computed tomography ; helical
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary To compare patient dose and image quality of electron-beam-CT vs. spiral-CT by means of phantom measurements. An EBCT scanner (C-150 XP) and a spiral-CT scanner (GE HiSpeed Advantage) were used to scan three different phantoms. Administered dose, high contrast (HC) resolution, low contrast (LC) lesion detectability and the width of the radiation beams were measured. EBCT showed 25–35% lower HC resolution in comparison to spiral-CT. LC lesion detectability showed equivalent results for S/N vs. patient dose using 3 mm collimation with EBCT and spiral-CT, whereas spiral-CT was superior for 1,5 and 6 mm collimation. Dose measurements revealed a 2 fold higher patient dose using EBCT with 1,5 mm or 6 mm collimation compared to spiral-CT using equivalent scan parameters. No differences were seen using 3 mm collimation. Differences were due to insufficient beamside collimation of the EBCT. The use of EBCT with 6 mm collimation should be avoided, because of impaired performance. Using 3 mm collimation, EBCT showed comparable performance like state of the art spiral-CT despite lower HC resolution.
    Notes: Zusammenfassung Die vorliegende Untersuchung nimmt einen Vergleich der applizierten Dosis und der resultierenden Bildqualität der Elektronenstrahl-CT (EBCT) im Volumenmodus und der Spiral-CT anhand von Phantommessungen vor. Mit EBCT (C-150 XP) und Spiral-CT (GE HiSpeed Advantage) wurden Messungen zur Niedrigkontrast- und Hochkontrastauflösung, Dosismessungen und Messungen der Röntgenstrahlbreite mit verschiedenen Phantomen durchgeführt. Die Hochkontrastauflösung liegt in der EBCT im Volumenmodus ca. 25–35% unter den Werten der Spiral-CT. Die Niedrigkontrastauflösung zeigt für 3 mm Kollimation bei EBCT und Spiral-CT ähnliche S/N Werte, bei 1,5 mm und insbesondere 6 mm Kollimation ist die Spiral-CT deutlich überlegen. Bei der EBCT mit 1,5-mm- und 6-mm-Kollimation ergibt sich eine doppelt so hohe Patientendosis wie bei der SCT, während bei 3-mm-Kollimation die Patientendosis gleich groß ist. Als Ursache hierfür wurde eine ungenügende strahlseitige Kollimation der EBCT gefunden. Die 6-mm-Kollimation am EBCT sollte wegen der schlechteren Niedrigkontrastauflösung und der höheren Dosis nicht verwendet werden. Bei einer Kollimation von 3 mm haben EBCT und Spiral-CT eine ähnliche Performance bei geringerer Hochkontrastauflösung der EBCT.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050453
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  • 68
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    Radiologisches Notfallmanagement polytraumatisierter Patienten (1998)
    Springer
    Der Radiologe 38 (1998), S. 637-644 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Notfalldiagnostik ; Polytrauma ; Schockraum ; Computertomographie ; Key words Emergency ; Multiple trauma ; Trauma emergency room ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The management of multiple trauma patients has improved recently. Surgeons’ education, preclinical rescue structures, initial clinical survey and therapeutic strategies, as well as diagnostic imaging, have progressed. Plain film imaging is increasingly being abandoned in favor of CT. Fast imaging techniques (spiral CT) have led to the inclusion of CT in the primary survey. To minimize the risk to the patient during prolonged diagnostic time, algorithms have to be defined concerning structures, emergency room equipment and quality. Basics, state of the art and suggestions concerning management of multiple trauma patients are presented and discussed from the radiologist’s point of view.
    Notes: Zusammenfassung Das Management schwerverletzter Patienten hat in den letzten Jahren viele Verbesserungen erfahren. Neben Ausbildungsspezialisierungen (Unfallchirurgie), präklinischen Strukturveränderungen (Notarzt- und Rettungswesen), frühklinischen Ablaufoptimierungen (Handlungsleitlinien) und Änderung klinischer Behandlungsstrategien (konservativ/operativ/interventionell) ist auch die initiale bildgebende Diagnostik bei polytraumatisierten Patienten im Wandel. Die bislang im Vordergrund stehende konventionelle Röntgendiagnostik tritt im Verhältnis zu der modernen Schnittbilddiagnostik (insbesondere CT) zunehmend in den Hintergrund. Vor allem seit Einführung der Spiral-CT-Technik ist auch in Deutschland die Tendenz zu ausgedehnter, primärer CT-Diagnostik zu verfolgen. Um Gefährdungen des kritischen Patientenguts zu minimieren müssen aber sowohl strukturelle, räumliche als auch qualitative Voraussetzungen als Standard definiert werden. Grundlagen, Stand der Dinge sowie Verbesserungsvorschläge zum Notfallmanagement polytraumatisierter Patienten aus radiologischer Sicht werden vorgestellt und diskutiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050404
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    Radiologische Diagnostik des abdominellen Traumas (1998)
    Springer
    Der Radiologe 38 (1998), S. 693-701 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Abdominaltrauma ; Ultraschall ; Computertomographie ; Key words Abdominal trauma ; Ultrasonography ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In Europe ultrasonography has displaced diagnostic peritoneal lavage (DPL) in the primary survey of polytraumatized patients with suspected abdominal trauma. Hemodynamically unstable patients who are brought to the emergency room with blunt abdominal trauma will go directly to the operating room after a rapid ultrasonography examination with evidence of hemoperitoneum. In hemodynamically stable patients, in addition to ultrasonography, computed tomography can be done. This is especially efficient if evaluation with sonography is not completely possible or shows little pathology (e.g. small amounts of hemoperitoneum).
    Notes: Zusammenfassung Die Sonographie hat die diagnostische Peritoneallavage in Europa als primäres diagnostisches Verfahren beim Abdominaltrauma abgelöst. Wird beim kreislaufinstabilen Patienten im Schockraum bei der Sonographie freie Flüssigkeit nachgewiesen, ist die bildgebende Diagnostik beendet, der Patient wird laparotomiert. Bei hämodynamisch stabilen Patienten läßt sich neben der Sonographie auch die Computertomographie einsetzen. Dies ist in der Akutphase der Versorgung („erste Stunde”) besonders dann sinnvoll, wenn die Sonographie nicht sicher beurteilbar oder auffällig ist (z.B. geringe Mengen freier Flüssigkeit).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050410
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  • 70
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    Epithalamus calcifications in schizophrenia (1998)
    Springer
    European archives of psychiatry and clinical neuroscience 248 (1998), S. 272-276 
    Details
    ISSN: 1433-8491
    Keywords: Key words Schizophrenia ; Epithalamus ; Habenula ; Pineal gland ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the prevalence and the size of epithalamus calcifications (EC) and choroid plexus calcifications (CPC) on computed tomography (CT) scans in a group of 64 schizophrenic patients and in a group of 31 healthy controls. The associations between cerebral calcifications, demographic variables, and other brain morphological characteristics (particularly cerebral ventricular size and cortical atrophy) in both, patients and controls, were also considered. A significant increase in size of the epithalamic-region calcifications in schizophrenic patients was found, whereas there was no evidence of increase in both, dimension and prevalence, of choroid plexus calcification. Such dimensional increase was unrelated to the duration of illness and therefore did not seem to be iatrogenic or secondary to the disease. A correlation was found between epithalamus calcifications and cortical atrophy and third-ventricle enlargement, suggesting that calcifications of this cerebral region may be associated with lesions of third-periventricular areas and of circuitries hypothesized to be involved in the pathophysiology of schizophrenia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004060050049
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  • 71
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    Electronic Resource
    Effect of the vastus medialis obliquus on the patellofemoral joint (1998)
    Springer
    Knee surgery, sports traumatology, arthroscopy 6 (1998), S. 173-180 
    Details
    ISSN: 1433-7347
    Keywords: Key words Patellofemoral joint ; Computed tomography ; Electromyography ; Quadriceps ; muscle ; Vastus medialis obliquus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract In this study, the effect of dynamic stabilizers on the patellofemoral (PF) joint was investigated in normal volunteers (group I) and in patients with patellar pain (group II) or instability (group III) by using computed tomography (CT) analysis and integrated electromyography (iEMG) of the quadriceps muscle. Nine subjects (16 knees) from group I, 10 patients (12 knees) from group II and 8 patients (12 knees) from group III were included in the study. CT scans of the PF joint with quadriceps contracted (QC) and uncontracted (QU) and iEMG of vastus medialis obliquus (VMO), vastus lateralis (VL) and rectus femoris (RF) were obtained with the aid of a specially designed jig at 0°, 15°, 30° and 45° of knee flexion. The same muscle contraction pattern simulating closed kinetic chain exercise was used for both CT and iEMG. The difference between the congruence angles (CA) and tilt angles (PTA) in QC and QU positions and VMO:VL ratio from the iEMG were calculated separately for each flexion angle. CA was increased in all groups with quadriceps contraction at 0° and 15° of flexion. PTA was decreased in group I and increased in groups II and III with quadriceps contraction at the same flexion angles. This difference was statistically significant in group III at 0° and 15° of flexion. Quadriceps contraction did not affect the patellar position significantly even in the instability group at 45° of flexion. In all flexion angles the balanced VMO:VL activity ratio was observed only in group I. In the other goups, VL activity was higher than VMO activity except at 45° of flexion. These findings do not support the hypothesis of dominant centralizing effect of VMO on the patella in extension, but the effect of the VMO may be more clearly demonstrated by measuring PTA in both QC and QU positions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001670050095
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  • 72
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    The changing landscape of breast cancer clinical research (1998)
    Springer
    Annals of oncology 9 (1998), S. 133-138 
    Details
    ISSN: 1569-8041
    Keywords: breast cancer ; clinical research ; molecular biology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Clinical research for breast cancer is moving in three new directions following: 1) a critical analysis of three decades of randomized clinical trials for early disease; 2) increasing awareness of this lethal disease among women, generating women's associations which are pressing for improved breast cancer education, screening and treatment; 3) an exponential growth in our understanding of breast cancer molecular biology, leading to a number of innovative therapies with new targets in the cancer cell or its environment. It is the remarkable work of the Oxford Group which has finally vindicated the use of our three main weapons against breast cancer micro-metastases, namely tamoxifen, chemotherapy and ovarian ablation. There is now consensus that clinical research in the adjuvant setting may gain speed and efficiency through intergroup collaboration. Such an 'Intergroup' has been recently created in Europe and will collaborate with the American–Canadian Intergroup. Women's associations have only recently stepped forward to demand better care, and more effective therapies: they are becoming new partners in identifying critical issues in breast cancer research. Medical oncologists involved in breast cancer research are facing a new challenge: the optimal integration of traditional breast cancer therapies, namely endocrine treatments and chemotherapy, and entirely new strategies targeting signal transduction, apoptosis or angiogenesis. In view of the above, there is no doubt that we are entering a new and exciting era in breast cancer clinical research.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008257824361
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  • 73
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    Staging of breast cancer: What standards should be used in research and clinical practice? (1998)
    Springer
    Annals of oncology 9 (1998), S. 1173-1177 
    Details
    ISSN: 1569-8041
    Keywords: bone scan ; breast cancer ; chest radiography ; liver ultrasonography ; risk groups ; staging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Bone scan (BS), chest X-rays (CXR), liver ultrasonography (LUS) and laboratory parameters (LP) are frequently used as routine staging procedures for breast cancer patients. These procedures are not always appropriate in either clinical or research settings, regardless of the stage. The aim of this study was to identify groups of patients with differing risks for metastases in order to select more precise standard staging procedures. Patients and methods: The staging data relating to 406 breast cancer patients consecutively referred to our institution between November 1989 and October 1996 were analysed including pathological TNN grading and biological parameters. All of the cases with a positive or suspicious pre-operatory staging and who proved to have metastatic disease before surgery or during the first six months of follow-up were considered true- positive; all of the other cases with a positive or suspicious initial staging but with no evidence of distant metastasis before surgery and with a disease-free survival longer then six months were considered false-positive. In the same way all cases with negative initial staging who relapsed during the first six months of follow-up were considered false-negative and those with negative initial staging and with a disease-free survival longer then six months were considered true-negative. Statistical analysis was performed using Fisher's exact test. Results: BS, CXR and LUS, 388, 399 and 398 examinations respectively, were considered available, and 17 (4.38%), six (1.5%) and four (1%), respectively, proved to be true-positive. A statistically significant difference was observed when our cases were grouped according to T status (T4 vs. T1–T2–T3, P 〈 0.01) and nodal status (N0–N1 cases with less than three involved nodes and N1 with more than three positive lymph nodes N2 patients, P 〈 0.01). Conclusions: The present study suggests that breast cancer patients can be divided into three subgroups with different detection rates for distant metastases at staging (0.59%, 2.94% and 15.53%), and that the standard practice should be changed. In the first (T1N0 and T1N1 patients with ≤3 positive lymph nodes – 41.13% of the patients) and the second group (T2N0, T2N1 with ≤3 positive lymph nodes, T3N0 and T3N1 patients with ≤3 positive lymph nodes – 33.49% of the patients) there is no need for a complete set of staging procedures, whereas full procedural staging is needed in the third group of patients (T4, N1 with 〉3 lymph nodes and N2, 25.37% of the patients).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008483806113
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  • 74
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    Timing of dietary fat exposure and mammary tumorigenesis: Role of estrogen receptor and protein kinase C activity (1998)
    Springer
    Molecular and cellular biochemistry 188 (1998), S. 5-12 
    Details
    ISSN: 1573-4919
    Keywords: breast cancer ; estrogen ; dietary fat ; polyunsaturated fatty acid ; estradiol ; pregnancy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Notes: Abstract The possible association between a high fat diet and increased breast cancer risk has remained controversial. This largely reflects the conflicting data obtained from migrant, case control and animal studies, which generally support this association, and cohort studies which often fail to show a link between fat and breast cancer. The mammary gland is particularly sensitive to estrogens during the fetal development, leading us to hypothesize that dietary fat levels during this period may significantly influence breast cancer risk. Using chemically-induced mammary tumors in rats as our experimental model, we have demonstrated the ability of a maternal diet, high in the polyunsaturated fatty acid (PUFA) linoleic acid, to alter mammary gland differentiation, accelerate the onset of sexual maturation, and increase breast cancer risk. The mammary glands of female rats exposed to a highfat diet in utero have more of the undifferentiated structures (terminal end buds) and fewer of the differentiated structures (alveolar buds) than the glands of rats exposed to a low-fat diet in utero. Furthermore, these mammary glands contain lower levels of total estrogen receptors and have reduced total protein kinase C activity. These effects appear to be mediated by an increase in tne serum estradiol levels of pregnancy, which are elevated at least 30% in pregnant dams fed a high fat diet. Furthermore, the administration of estradiol to pregnant dams produce effects on mammary gland development, onset of puberty and sensitivity to chemical carcinogenesis comparable to those seen in the offspring of rats fed a high fat diet during pregnancy. Our results, thus, support the hypothesis based on epidemiological data that high maternal estrogen levels increase daughters' breast cancer risk. The results also suggest that a high-fat diet may be an important factor in increasing pregnancy estrogenic activity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006827229431
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  • 75
    Electronic Resource
    Electronic Resource
    The salubrious effect of tamaxifen on serum marker enzymes, glycoproteins, and lysosomal enzymes level in breast cancer women (1998)
    Springer
    Molecular and cellular biochemistry 185 (1998), S. 85-94 
    Details
    ISSN: 1573-4919
    Keywords: tamoxifen ; breast cancer ; marker enzymes ; glycoproteins ; lysosomal enzymes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Notes: Abstract Tumour markers correlate strongly with prognosis based on tumour burden and surgical resectability. If chemotherapy is extremely effective in certain stage of the disease, the sensitive marker may be of great use in monitoring disease response and drug treatment. Hence, this study was launched to evaluate the changes in tumour marker enzymes like lactate dehydrogenase (LDH), glumate oxaloacetate transaminase (SGOT), glutamate pyruvate transaminase (SGPT), alkaline phosphatase, and acid phosphatase in before and after 3 and 6 months tamoxifen treated breast cancer patients. In addition, the changes in serum glycoproteins viz., hexose, hexosamine, and sialic acid and lysosomal enzymes such as N-acetyl-beta-D-glucosaminidase, beta-D-galactosidase, and beta-D-glucuronidase were analysed in these patients. These values were compared with their age matched healthy control subjects. At 6 months evaluation, the tamoxifen treated postmenopausal breast cancer women showed a statistically significant decreased (p 〈 0.001, 0.05 respectively) levels of LDH, SGOT, SGPT, alkaline and acid phosphatases than their baseline values. Similarly, the levels of hexose, hexosamine, and sialic acid and N-acetyl-beta-D-glucosaminidase, beta-D-galactosidase, and beta-D-glucuronidase were decreased significantly (p 〈 0.001 ) in tamoxifen received postmenopausal women. The result of this study suggested that tamoxifen potentially retard the metastasis of breast cancer as well as the bone demineralisation in postmenopausal breast cancer women. Thus, tamoxifen may also have its antitumour activity through its beneficial effects on tumour marker enzymes and serum proteins in breast cancer women.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006874005764
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  • 76
    Electronic Resource
    Electronic Resource
    Estrogen activates raf-1 kinase and induces expression of Egr-1 in MCF-7 breast cancer cells (1998)
    Springer
    Molecular and cellular biochemistry 189 (1998), S. 119-125 
    Details
    ISSN: 1573-4919
    Keywords: estrogen ; breast cancer ; raf-1 kinase ; early growth response gene-1
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Notes: Abstract We have investigated whether the raf-1 kinase, a downstream mediator of both receptor tyrosine kinase and protein kinase C signalling, is activated by estrogen (E2) in an estrogen receptor positive human breast cancer cell line. Autophosphorylation of raf-1 kinase was studied after treatment of MCF-7 cells with E2. E2-deprived cells contained low levels of raf-1 kinase activity. Treatment of cells for 1 min with E2 resulted in raf-1 autophosphorylation which was maximal within 5 min. Western blot analysis showed that raf-1 undergoes an electrophoretic mobility shift following E2 treatment. Egr-1 is a zinc finger-containing transcription factor which is expressed in association with raf-1 activation. Untreated MCF-7 cells expressed low levels of Egr-1 while E2 treatment resulted in an induction of egr-1 mRNA expression. These kinetics followed closely behind the E2 induction of c-myc mRNA. Egr-1 protein was similarly low in E2-deprived MCF-7 cells and was transiently increased following E2 treatment. Several studies have suggested that kinase activity may play a role in estrogen receptor (ER) activation. While activated v-raf failed to augment ER activation of transcription in transient transfection assays, a dominant negative mutant of raf-1 inhibited E2-induced transcription by 50% primarily as a result of increased baseline levels of E2 independent transcription. The results show that E2 can induce raf-1 kinase activity in MCF-7 breast cancer cells associated with the expression of an early growth response gene and modulation of ER signalling.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006827015320
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  • 77
    Electronic Resource
    Electronic Resource
    Whole-body positron emission tomography using fluorodeoxyglucose for staging of lymphoma: effectiveness and comparison with computed tomography (1998)
    Springer
    European journal of nuclear medicine 25 (1998), S. 721-728 
    Details
    ISSN: 1619-7089
    Keywords: Key words: Lymphoma staging ; Computed tomography ; Whole-body positron emission tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of this study was to evaluate whole-body positron emission tomography (WB-PET) as a staging modality in Hodgkin’s disease (HD) and non-Hodgkin lymphoma (NHL) and to compare it with computed tomography (CT) in a retrospective study. Seventy-one WB-PET studies using fluorodeoxyglucose (FDG) and 49 CT examinations were performed in 19 women and 31 men. Transaxial images were acquired and reformatted coronally and sagittally in PET. CT sections were obtained from the skull base to the pelvic floor. The written reports of the imaging data were compared with a reference standard constructed on the basis of all the data on the individual patients, including clinical follow-up of at least 6 months. The sensitivity and specificity of PET were, respectively, 86% and 96% for HD (n=53), and 89% and 100% for NHL (n=18). For CT sensitivity and specificity were 81% and 41% for HD (n=33) and 86% and 67% for NHL (n=16). Differences between PET and CT sensitivities were not significant, while in HD there was a significant difference in the specificity of PET and CT examinations, mainly because CT was unable to distinguish between active or recurrent disease and residual scar tissue after therapy. FDG tumour uptake was found in high- as well as low-grade NHL patients. In conclusion, PET appears to be highly sensitive and specific for staging of lymphoma. It is at least as sensitive as CT, and more specific, particularly in patients undergoing restaging, where a well-recognized diagnostic dilemma in CT is the presence of a post-therapeutic residual mass.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002590050275
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  • 78
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    Electronic Resource
    Preoperative evaluation of hepatic functional reserve following hepatectomy by technetium-99m galactosyl human serum albumin liver scintigraphy and computed tomography (1998)
    Springer
    European journal of nuclear medicine 25 (1998), S. 1377-1382 
    Details
    ISSN: 1619-7089
    Keywords: Key words: Technetium-99m galactosyl human serum albumin ; Hepatic functional reserve ; Hepatic resectability ; Occlusion of the unilateral portal vein ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. It is extremely important to have a good grasp of the acceptable limit of hepatectomy before operation because postoperative liver failure can take a fatal course; however, baseline data on the limit of hepatectomy have not been clearly defined. We therefore evaluated and compared the predicted remnant liver function obtained by computed tomography(CT) and technetium-99m diethylenetriamine penta-acetic acid-galactosyl human serum albumin (99mTc-GSA) liver scintigraphy in order to obtain precise data regarding remnant liver function before hepatectomy. We investigated 20 patients undergoing hepatectomy using the clearance rate of indocyanine green (KICG) as a parameter, and compared the predicted postoperative KICG obtained by CT and by transaxial single-photon emission tomographic (SPET) images acquired by 99mTc GSA liver scintigraphy before hepatectomy. In GSA studies, based on time-activity curves for the heart and liver, we compared HH15 (heart activity at 15 min divided by heart activity at 3 min), LHL15 (liver activcity at 15 min divided by heart plus liver activity at 15 min) and KL (obtained from the time-activity curve for the liver) in 103 patients. In 58 patients without increased serum bilirubin, KL was compared with KICG. In four patients, occlusion of the right portal vein was performed with the aim of carrying out secondary hepatectomy, and changes in liver volume were compared between CT and 99mTc GSA liver scintigraphy. The correlation coefficient between the postoperative KICG predicted by CT and the actual postoperative KICG was rather poor, at r = 0.569 (P〈0.05); that between the postoperative KICG predicted by 99mTc GSA liver scintigraphy and the actual postoperative KICG was good, at r = 0.788 (P〈0.01); correlations between KL and HH15 and between KL and LHL15 in 103 patients were very good or good, at r = 0.906 (P〈0.001) and r = 0.807 (P〈0.001), respectively, and that between KL and KICG in 58 patients was very good, at r = 0.916 (P〈0.001). In all four cases of right portal vein occlusion, the remnant liver volume ratio was markedly increased after occlusion in GSA compared with CT, and the postoperative KICG predicted by GSA after occlusion was closer to the actual postoperative KICG than that predicted by CT. It is concluded that 99mTc GSA liver scintigraphy is useful for predicting remnant liver function before hepatectomy and for evaluating changes in regional liver function after occlusion of the portal vein unilaterally.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002590050311
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  • 79
    Electronic Resource
    Electronic Resource
    Development and characterization of new immortalized human breast cell lines (1998)
    Springer
    Cytotechnology 26 (1998), S. 207-218 
    Details
    ISSN: 1573-0778
    Keywords: breast cancer ; breast cell lines ; drugscreen target ; immortalized cell lines ; serum-free medium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Process Engineering, Biotechnology, Nutrition Technology
    Notes: Abstract New human breast cell lines were developed from metastatic breast cancer tissues and normal breast tissues. Primary cultures were initiated from cellular outgrowths of explanted tissues or from mechanically isolated cells in two serum-free media. Cell cultures derived from both cancer and normal tissues were immortalized with pRSV-T plasmid to generate permanent breast cell lines that exhibited an epithelial morphology. Cell lines generated in this study were characterized with respect to morphology, growth rate, karyotype, presence of specific genes, and the expression of epithelial and breast markers. The cell lines expressed the epithelial cell markers, cytokeratins 8 and 18, and retained the capacity to produce human milk fat globulin. They also express the BRCA-1, erbB2, and EGF receptor genes and possess the H-ras, K-ras, and p53 genes. Preliminary data showed that one of the new cancer cell lines was highly sensitive to the cytotoxic action of taxol. It is envisioned that the new breast cell lines will be useful as targets for identification of therapeutic agents against breast cancer and as models for carcinogenesis studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1007953429252
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  • 80
    Electronic Resource
    Electronic Resource
    Molecular Analysis of Two Mammary Carcinoma Cell Lines at the Transcriptional Level as a Model System for Progression of Breast Cancer (1998)
    Springer
    Clinical & experimental metastasis 16 (1998), S. 129-139 
    Details
    ISSN: 1573-7276
    Keywords: breast cancer ; differential gene expression ; new mitochondrial transcript ; new receptor ; tumor progression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract As a model system for the identification of genes involved in the progression of human breast cancer, differential gene expression in cell lines MCF-7 and MCF-7ADR was investigated. The latter cell line is derived from the former. Cell line MCF-7 is estrogen receptor-positive, vimentin-negative and uninvasive in the Matrigel outgrowth assay and in the nude mouse, while MCF-7ADR is estrogen receptor-negative, hormone-resistant, vimentin-positive, invasive in the Matrigel outgrowth assay and in the nude mouse and resistant to adriamycin due to overexpression of glycoprotein gp170. We have shown that tumor progression in this model system is mediated by transcriptional regulation of mitochondria-related genes, proteases, transmembrane receptors and cell cycle-related gene proteins. Among the genes differentially regulated at the transcriptional level in the cell lines MCF-7 and MCP-7ADR are a new mitochondrial transcript, mitochondrial creatine kinase, matrix metalloproteinase-1, stromelysin-3, urokinase and its receptor, tissue factor, E-cadherin, epidermal growth factor receptor, transmembrane proteins Mat-8 and progression associated protein (PAP), cyclin E, cyclin-dependent kinase-2 and cell cycle inhibitory proteins p16, p21 and p27.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1021941203905
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  • 81
    Electronic Resource
    Electronic Resource
    Regulation of tissue-degrading factors and in vitro invasiveness in progression of breast cancer cells (1998)
    Springer
    Clinical & experimental metastasis 16 (1998), S. 205-215 
    Details
    ISSN: 1573-7276
    Keywords: breast cancer ; in vitro invasiveness ; metalloproteinase system ; urokinase system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hormone-independent growth and invasiveness represent phenotypic properties acquired during early progression of breast cancer. We compared human mammary adenocarcinoma cells, MCF-7, which are estrogen-dependent and poorly metastatic, with the estrogen-independent and highly metastatic subline, MCF7/LCC1, with regard to expression of tissue-degrading factors of the matrix metalloproteinase (MMP)-and urokinase (uPA)-dependent degradative pathways, as well as for their in vitro invasive properties. Both cell lines showed low constitutive mRNA expression of the MMP inhibitor TIMP-1. Baseline expression of TIMP-2 mRNA was also very low in MCF-7 cells, whereas the MCF7/LCC1 level was much higher (~10- fold). Furthermore, both cell lines revealed low constitutive capacity to migrate in an in vitro invasion assay. Treatment with 12-O-tetradecanoylphorbol-13-acetate (TPA; 100 nM) induced the mRNAs for TIMP-1 as well as for MMP-1, MMP-9, the uPA receptor, and the uPA inhibitor PAI-1, am ongst which only the responses of MMP-9 and PAI-1 were cell-specific. The mRNA levels of MMP-9 and PAI-1 were ~10-fold and ~15-fold higher in MCF7/LCC1 cells compared to MCF-7 cells. The secretion of immuno-reactive PAI-1 was considerably elevated (. 20-fold) in TPA-treated MCF7/LCC1 cells, whereas the TPA-dependent level of 92-kDa MMP-9 was only ~2-fold higher in MCF7/LCC1 cells than in MCF-7 cells. In both cell lines treatment with TPA was associated with an increase (~10-fold) in in vitro migration, which in the MCF7/LCC1 cells was significantly attenuated by a reconstituted basement membrane extract (Matrigel). These data suggest that TPA-responsive in vitro invasive properties that are probably associ-ated with PAI-1 expression may co-vary with progression from hormone-dependent to -independent breast cancer. © Rapid Science 1998
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006584624061
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  • 82
    Electronic Resource
    Electronic Resource
    Breast cancer in Australian women under the age of 40 (1998)
    Springer
    Cancer causes & control 9 (1998), S. 189-198 
    Details
    ISSN: 1573-7225
    Keywords: Age of onset ; Australia ; breast cancer ; family history ; height ; oral contraceptives ; parity ; weight
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: A case-control-family study of breast cancer in women under the age of 40 was carried out in Melbourne and Sydney, Australia, from 1992 to 1995 to determine the risk factors for these women. Subjects included 467 incident cases identified by state cancer registries and 408 population-based controls. Methods: All participants completed a structured risk-factor questionnaire and family pedigree during an in-person interview. Where possible, cancers in first- and second-degree relatives were verified. Results: Multiple logistic regression analysis showed that the strongest risk factor for breast cancer was a family history of the disease - having at least one affected first-degree relative trebled the risk (relative risk [RR] = 3.3, 95 percent confidence interval [CI] = 1.9-5.8). Risk increased with height by three percent (standard error [SE] of one percent) per cm, and after adjusting for height, there was evidence for a decreased risk in women weighing 73 kg or more. There was an increased risk of breast cancer after the first full-term birth (RR = 1.8, CI = 1.0-3.5) but this risk fell by 30 percent (SE = 11 percent) with each subsequent livebirth. Conclusions: The effects of other reproductive factors and oral contraceptive use, although not nominally significant, were in accord with published findings from similar studies in young women. This study of Australian women has indicated that some risk factors for breast cancer in women under age 40 differ from those reported for older women either in direction (e.g., weight) or relative importance (e.g., family history).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008886328352
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  • 83
    Electronic Resource
    Electronic Resource
    Physical activity and breast cancer risk in the College Alumni Health Study (United States) (1998)
    Springer
    Cancer causes & control 9 (1998), S. 433-439 
    Details
    ISSN: 1573-7225
    Keywords: Body mass ; breast cancer ; menopause ; physical activity ; United States ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: It is unclear whether physical activity is associated with a reduced risk of breast cancer. Some studies also suggest different effects between pre- and postmenopausal women, and lean and heavy women. Methods: We followed 1,566 University of Pennsylvania alumnae (mean age, 45.5 years), initially free of breast cancer, from 1962 until 1993. Physical activity at baseline was assessed by asking women about stairs climbed, blocks walked, and sports played. We estimated energy expenditure and categorized women into approximate thirds (〈 500, 500-999, 1,000+ kcal/wk). We identified 109 breast cancer cases during 35,365 person-years from follow-up questionnaires or from death certificates. Results: After adjustment for age and body mass index (BMI) (kg/m2), the relative risk (RR) of breast cancer was 0.92 (95 percent confidence interval [CI]=0.58-1.45) among women expending 500-999 kcal/wk and 0.73 (CI=0.46-1.14) for those expending 1,000+ kcal/wk, compared with women expending 〈 500 kcal/wk (P trend=0.17). This association was modified by menopausal status, but not BMI. For postmenopausal women, corresponding RRs were 0.95 (CI=0.58-1.57) and 0.49 (CI=0.28-0.86), respectively (P trend=0.015). Increased physical activity in premenopausal women was not significantly associated with decreased risk of breast cancer. Conclusions: These data support an inverse association between physical activity and breast cancer among postmenopausal women. Cancer Causes and Control 1998, 9, 433–439
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008827903302
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  • 84
    Electronic Resource
    Electronic Resource
    Temporospatial Heterogeneity of Myocardial Perfusion and Blood Volume in the Porcine Heart Wall (1998)
    Springer
    Annals of biomedical engineering 26 (1998), S. 519-525 
    Details
    ISSN: 1573-9686
    Keywords: Angiogram ; Microspheres ; Embolization ; Fractal ; Computed tomography ; Artery: coronary ; Temporospatial heterogeneity ; Myocardial perfusion ; Blood volume ; Heart ; Pig
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: Abstract Spatial heterogeneity of myocardial perfusion has been recognized for many years. Whether this is primarily the result of heterogeneity of parameters such as myocardial metabolism, of intramyocardial mechanical forces, or of vasomotor function within the myocardial microcirculation, is not clear. A practical problem is that it has been almost impossible to measure any two of these parameters simultaneously in the same piece of myocardium so that an unambiguous correlation, much less a cause-and-effect relationship, has been difficult to establish. In this study of six anesthetized pigs, we propose that whole-body computed tomography is a method for providing the simultaneous measurement of heterogeneity of myocardial perfusion (F) and myocardial blood volume (ρ). The first finding was that the empirical relationship ρ=AF+BF0.5 between myocardial blood flow (F) and intramyocardial blood volume (ρ) is maintained over a range of sizes of regions of interest (approximately 1 to 0.125 cm3) within the myocardium of each individual animal despite the spatial heterogeneity of the F and the ρ values. The value of A ranges from 0.014 to 0.021 min and of B ranges from 0.061 to 0.076 ml0.5 g−0.5 min0.5. A second finding was that the pattern of spatial heterogeneity of F and of ρ remained reasonably stable over at least a 1 h period. © 1998 Biomedical Engineering Society. PAC98: 8745Ft, 8759Fm
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1114/1.98
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  • 85
    Electronic Resource
    Electronic Resource
    Assessment of the space for the lower wisdom teeth (1998)
    Springer
    Journal of orofacial orthopedics 59 (1998), S. 17-28 
    Details
    ISSN: 1615-6714
    Keywords: Lower wisdom tooth ; Computed tomography ; Panoramic radiography ; Space ratio ; Method of interpretation ; Unterkiefer-Weisheitszahn ; Computertomographie ; Panoramaschichtaufnahme ; Raumverhältnisse ; Auswertungsverfahren
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Von 13 Patienten standen je ein axial geschichtetes Computertomogramm (CT) des Unterkiefers und eine Panoramaschichtaufnahme (Orthophos, Programm P1) zur Verfügung. Die Platzverhältnisse für die Unterkieferweisheitszähne wurden in der P1-Aufnahme metrisch über die Quotientenbildung zweier Strecken bestimmt. Im CT wurden drei M3-Positionen unterschieden: der M3 lag vor dem Ramus mandibulae=ausreichendes Platzangebot, teilweise im Ramus=eingeschränktes Platzangebot, im kaudalen Abschnitt des Ramus=mangelhaftes Platzangebot. Diese M3-Positionen wurden den Weisheitszähnen in der P1-Aufnahme zugeordnet: in bezug zum Ramus und in bezug auf das Lot (L) (eine Vertikale zur Okklusionslinie im projektorischen Schnittpunkt des vorderen Ramusrandes mit dem Schatten der Crista temporalis). Am CT wurde zudem die mesiale Rotation der M3 gemessen und die Beziehung der M3 zu den umgebenden Knochenstrukturen beschrieben. Der Vergleich zwischen CT-Befund und dem Quotienten zeigte, daß für Weisheitszähne mit einem retromolaren Platzangebot im Quotientenbereich über 50% bis unter 100% jede der drei Weisheitszahnpositionen im CT vorkam. Beim Vergleich der M3-Befunde in bezug auf die Ramusüberprojektion in der P1-Aufnahme mit der Beurteilung im CT stimmten 60% der M3 mit dem CT-Befund überein. Wurde der M3 in bezug auf das Lot beurteilt, so erhöhten sich die mit dem CT übereinstimmenden Befunde auf 76%. Diese Befunde sowie die in der P1-Aufnahme nicht erkennbare Mesialrotation der M3 und ihre unterschiedliche Beziehung zur knöchernen Umgebungsstruktur ergaben neue Aspekte, die möglicherweise die M3-Durchbruchsprognose beeinflussen. Die dreidimensionale Betrachtungsweise mit dem CT bietet neue Möglichkeiten für weitere Untersuchungen der M3-Problematik.
    Notes: Summary From 13 patients a computed tomograph (CT-scan) and a panoramic radiograph (Orthophos, program 1, P1) were examined with respect to the spatial conditions of the lower wisdom teeth. In the panoramic radiograph the available space for the third molars of the lower jaw was determined by calculating the ratio (Q) of 2 distances: the mesiodistal crown diameter and the retromolar space. In the axial CT 3 different positions of the third molar were distinguished: third molar located anterior to the ramus mandibulae=sufficient space, partially within the ramus=restricted space, totally within the ramus=deficient space. These positions were compared with the findings in the panoramic radiograph, firstly in relation to the ramus and secondly in relation to a line (L) perpendicular to the occlusal plane at the intersection of the anterior border of the ramus and the crista temporalis. Furthermore, the mesial rotation of the third molar was measured and the relation of the bony structures surrounding the teeth were described. Comparison of the CT results with the quotients of the P1 showed that, for those wisdom teeth molars with an available space above 50% to under 100%, any of the 3 CT gradings was found. Assessing the projection of the ramus over the third molar as seen in the P1, 60% of the P1- and CT-results corresponded. The relation between the line L and the third molar showed coincidence in 76% of all cases. These results and the mesial rotation of the wisdom teeth as well as their different relation to the bony environment are possibly important factors concerning their eruption prognosis. The three-dimensional CT-scan gives new posibilities for further investigations of third-molar problems.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01321552
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  • 86
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    Electronic Resource
    Low-dose-Computertomographie des Kieferknochens in der präimplantologischen Diagnostik (1998)
    Springer
    Mund-, Kiefer- und Gesichtschirurgie 2 (1998), S. 188-193 
    Details
    ISSN: 1434-3940
    Keywords: Schlüsselwörter Dentale Implantologie ; Computertomographie ; Genauigkeit ; Strahlendosis ; Key words Dental implants ; Computed tomography ; Radiation dose
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Absorbed radiation doses delivered by computed tomography and panoramic radiography were measured in 16 anatomic sites using a head and neck phantom and thermoluminescent dosimetry. The recommended kilovoltage and scan time for dental scanning was reduced step by step, rating the quality of the low-dose scans. A reduction of up to 76% could be achieved without loss of diagnostic accuracy. Measured absorbed radiation dose ranges from 0.30 mGy (thyroid) to 29 mGy (skin) at 187,5 mAs and 1.0 mm-slices (25 mm scanning distance for maxilla, 30 mm for mandible). After reduction to 45 mAs, 0.07 mGy (thyroid) to 6.9 mGy (skin) was measured. Distance measurements on human jaw specimens were compared with corresponding CT image measurements. Average deviation was 0.1– 0.3 mm. A dose reduction of 75% had no effect on the results. However, the doses of CT-scans reduced by 76% exceed by an average factor of 10 the doses of conventional panoramic radiography. Therefore, CT should be reserved for the planning of complex implant treatment in the direct vicinity of the maxillar sinus and nerves and for multiple implant insertion.
    Notes: Die Energiedosis der Spiralcomputertomographie sowie des Orthopantomogramms (OPG) wurde an 16 Positionen im Kopfbereich mit Hilfe von Thermolumineszenzdosimetern und eines Phantomkopfs bestimmt. Die vom Hersteller des Computertomographen empfohlene Röhrenleistung für eine dentale CT wurde schrittweise reduziert. Eine Verminderung der Strahlenbelastung um 76% wurde ohne Verlust an diagnostischer Information erreicht. Die gemessene Energiedosis der Computertomographie betrug 0,30 mGy (Schilddrüse) bis 29 mGy (Hautoberfläche im Strahlengang) bei 187,5 mAs und 1-mm-Schichten (25 mm Scanstrecke im Oberkiefer, 30 mm im Unterkiefer). Bei Reduzierung auf 45 mAs wurden 0,07 mGy (Schilddrüse) bis 6,9 mGy (Hautoberfläche) gemessen. Längenmessungen an gesägten Kieferpräparaten wurden mit korrespondierenden CT-Messungen an einer Workstation verglichen. Die durchschnittliche Meßungenauigkeit betrug hierbei 0,1–0,3 mm. Die Dosisreduzierung der CT um ca. 76% hatte keinen Einfluß auf die Längenmeßgenauigkeit. Allerdings liegen die Energiedosen der um 76% dosisreduzierten CT-Scans noch durchschnittlich um den Faktor 10 über der Energiedosis eines Orthopantomogramms. Die Computertomographie sollte daher der Planung komplexer Implantatversorgungen in Kieferhöhlen- oder Nervennähe sowie multipler Implantationen vorbehalten bleiben.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100060050057
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  • 87
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    Soluble CD44 v5 and v6 in serum of patients with breast cancer. Correlation with expression of CD44 v5 and v6 variants in primary tumors and location of distant metastasis (1998)
    Springer
    Breast cancer research and treatment 47 (1998), S. 29-40 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer ; CD44 transmembrane receptor variants ; soluble CD44 v5 and v6 ; CD44 v5 and v6 expression ; metastatic disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Primary breast cancers were shown to overexpress CD44 v5 and v6 at the plasma membrane. However, the clinical significance of this overexpression remains unclear. Overexpression of CD44 v5 and v6 in primary breast cancers was found to correlate with metastasis and poor prognosis by some investigators, yet this correlation could not be confirmed by others using different antibodies. In this study the influence of metastatic disease, the site of metastasis, and the amount of CD44 v5 and v6 expression in the primary tumor on serum levels of the soluble forms of CD44 v5 and v6 (sCD44 v5 and v6) in breast cancer patients was investigated. Soluble CD44 v5 and v6 serum levels were measured by enzyme linked immuno sorbent assay in a group of breast cancer patients who developed metastases in various organs and in another group of patients with single organ metastasis. For control, sCD44 v5 and v6 levels were measured in breast cancer patients who remained free of metastasis and in healthy blood donors. Expression of plasma membrane bound CD44 v5 and v6 in the primary tumors of the patients with metastasis in various organs was correlated to sCD44 v5 and v6 levels in serum. Furthermore the size of sCD44 v6 was analyzed by immunoblot using a monoclonal antibody directed against CD44 v6. When metastases were detected, sCD44 v5 and v6 serum levels were increased as compared to levels measured one month after tumor surgery in patients free of metastases (p = 0.0025 and p = 0.0004). Six of 19 and 6 of 20 patients had sCD44 v5 and v6 serum levels above a cut-off level of 85 and 275 ng/mL, respectively. In these cases expression of CD44 v5 and v6 in the primary cancers was also elevated. Low sCD44 v5 and v6 serum levels were associated with weak expression of CD44 v5 and v6 in the respective primary cancers. As shown by statistical analysis of sCD44 v5 and v6 levels in 57 patients with single organ metastases, elevated sCD44 v6 levels but not sCD44 v5 levels were associated with metastases in liver or bone (p = 0.0025). Immunoblot analysis of soluble CD44 proteins in serum revealed two CD44 v6 specific signals of approximately 120 and 170 kDa. Increased sCD44 v5 and v6 serum levels in patients with breast cancer were influenced by the amount of CD44 v5 and v6 expression in the primary tumor by the site of metastasis. Elevated sCD44 v6 serum levels were preferentially found in patients with metastases in liver or bone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005913514376
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  • 88
    Electronic Resource
    Electronic Resource
    Establishment and characterization of a new mammary adenocarcinoma cell line derived from MMTV neu transgenic mice (1998)
    Springer
    Breast cancer research and treatment 47 (1998), S. 171-180 
    Details
    ISSN: 1573-7217
    Keywords: mammary adenocarcinoma cell line ; MG 1361 ; MMTV-neu transgenic mice ; breast cancer ; hormone responsiveness ; apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A new murine cell line, named MG1361, was established from mammary adenocarcinomas arising in a MMTV-neu transgenic mouse lineage where breast tumors develop in 100% of females, due to the over-expression of the activated rat neu oncogene in the mammary gland. The MG1361 cell line shows an epithelial-like morphology, has a poor plating efficiency, low clonogenic capacity, and a doubling time of 23.8 hours. Karyotype and flow cytometry analysis revealed a hypotetraploid number of chromosomes, whereas cell cycle analysis showed 31.2% of cells to be in the G1 phase, 21.4% in S and 47.4% in G2 + M. This cell line maintains a high level of neu expression in vitro. The MG1361 cell line was tumorigenic when inoculated in immunodeficient (nude) mice and the derived tumors showed the same histological features as the primary tumors from which they were isolated. MG1361 cells were positive for specific ER and PgR binding which was competed by tamoxifen, making this cell line useful for the evaluation of endocrine therapy. Moreover, they were sensitive to etoposide treatment, suggesting that they could be a model for the study of chemotherapy-induced apoptosis. As the tumors arising in MMTV-neu transgenic mice have many features in common with human mammary adenocarcinomas (Sacco et al., Gene Therapy 1995; 2: 493–497), this cell line can be utilized to perform basic studies on the role of the neu oncogene in the maintenance of the transformed phenotype, and to test novel protocols of therapeutic strategies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005988715285
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  • 89
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    Electronic Resource
    The insulin-like growth factors and breast cancer — revisited (1998)
    Springer
    Breast cancer research and treatment 47 (1998), S. 197-199 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer ; insulin-like growth factor system ; IGF-I receptor ; IGF-II receptor ; binding proteins ; prognosis ; transformation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 1992, a special issue of Breast Cancer Research and Treatment was devoted to the insulin-like growth factors and breast cancer. In that issue, identification of the key components of the IGF system was reviewed and their potential role in breast cancer growth was described. In this issue, we revisit the IGF system with particular attention to data that further supports their role in the growth regulation of breast cancer. Several new facets of the IGF system are described, and several laboratories have more clearly defined how each individual component of the IGF system may influence breast cancer biology.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005938615798
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  • 90
    Electronic Resource
    Electronic Resource
    Changes in hormone receptors and proliferation markers in tamoxifen treated breast cancer patients and the relationship with response (1998)
    Springer
    Breast cancer research and treatment 48 (1998), S. 11-20 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer ; tamoxifen ; estrogen receptor ; progesterone receptor ; Ki67 ; S-phase fraction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aim: To determine the effects of tamoxifen on the levels of hormone receptors and proliferation markers in the early phase of treatment and the relationship of the changes with tumor response in patients with primary breast cancer. Methods: Twenty-one women with primary, operable breast carcinomas were treated with tamoxifen 20 mg daily. Fine needle aspiration (FNA) was used to obtain samples prior to the start and at 14 days and 8-weeks post-treatment. From these samples estrogen receptor (ER), progesterone receptor (PgR), and Ki67 levels were determined using immunocytochemistry and ploidy and S-phase fraction (SPF) using flow cytometry. Tumor response was measured clinically according to UICC criteria. Results: There were 12 responders (2 CR, 10 PR) and 9 non-responders (2 NC, 7 PD). Responders were more likely to be ER + (p=0.002), PgR + (p=0.006), and low SPF (p=0.06). At 14 days post-tamoxifen, the median decrease in Ki67 (% cells staining) for responders was − 4.8 and for non-responders − 0.15 (p=0.005). This decrease was seen predominantly in ER + tumours. The difference in SPF was not significant. A decrease in ER was seen in 3/15 patients all of whom were responders. A rise in PgR was seen in 7/17 patients and all but one were responders. Similar changes for ER and PgR were seen at 8-weeks post-tamoxifen, although the reductions in Ki67 and SPF at that time point were not related to response. Conclusion: We have observed a decrease in Ki67 and ER and a rise in PgR after 14 days of treatment with tamoxifen that was related to subsequent response. This is the first study in which an early decrease in a proliferation marker has been shown to relate to subsequent clinical response.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005973529921
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  • 91
    Electronic Resource
    Electronic Resource
    Prostate-specific antigen induction by a steroid hormone in T47D cells growing in SCID mice (1998)
    Springer
    Breast cancer research and treatment 48 (1998), S. 73-80 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer ; LNCaP ; PSA ; SCID mice ; steroid hormones ; T47D
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previous studies revealed that prostate-specific antigen (PSA) is present in 〉 30% of human breast tumor cytosols. Survival analysis showed that patients with PSA-producing tumors have a reduced risk for relapse, suggesting PSA to be an independent favorable prognostic marker for a large subset of breast cancer patients. The present investigation established an in vivo model for the induction of PSA in human breast cancer tumors growing as xenografts in severe combined immunodeficient (SCID) mice. The human mammary cancer cell-line T47D was grown i.m. in female mice. When the tumor and leg diameter reached 10 mm, the mice were stimulated daily with norgestrel for either 5 or 7 days to produce PSA, and sacrificed on day 8. The prostate cancer cell-line LNCaP was grown in male mice and functioned as a positive control for PSA production. After T47D and LNCaP mice were sacrificed, a highly sensitive immunofluorometric assay was used to analyze the PSA concentration in the tumor, muscle, liver, and kidney cytosols. Norgestrel-stimulated T47D mice showed significantly more PSA in the tumors compared to tumors of the control mice. However, PSA levels in tumors of the stimulated mice were significantly lower than those in the LNCaP xenografts. No PSA levels above background were present in the blood and normal tissue of the norgestrel-stimulated or control T47D xenografts. This mouse model will be a valuable tool for investigating and screening new therapies for a subgroup of breast cancer patients who have significant PSA concentrations in their tumors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005947024666
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  • 92
    Electronic Resource
    Electronic Resource
    Tumor oxygenation correlates with molecular growth determinants in breast cancer (1998)
    Springer
    Breast cancer research and treatment 48 (1998), S. 97-106 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer ; oxygen partial pressure ; molecular markers ; prognostic factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hypoxic tumor cells may represent a fraction of cells that are not susceptible to radiation or chemotherapy. Intratumoral oxygen partial pressure (pO2) is the result of oxygen delivery and consumption. Cell proliferation is one factor to effect oxygen consumption and we therefore studied the correlation between tumor pO2 and histological parameters. Patients and methods: In 36 women and one man (age range 29–80 years) with suspected breast cancer. Before tumor resection, intralesional pO2 was determined with a polarographic needle electrode. Under ultrasound control, 200 tumor measurements were obtained; Hb levels, Hk, arterial blood gas parameters, and tissue temperature were determined. The median of pO2 values and the percentage of hypoxic areas (pO2 〈 10 mmHg) were calculated and correlated with the histological type, grading, ER, PR, and the expression of Ki-67, p53, EGFR, pS2, and c-erb-B2. Results: The overall median pO2 was 44 mmHg, and 1024 measurements (13.8%) represented hypoxic areas. Ductal and lobular invasive cancers showed median pO2 of 41 mmHg. The mean pO2 of G1 tumors was 59 mmHg and the hypoxic fraction 8%, in contrast to G2 tumors with 43 mmHg and 17%, and G3 tumors with 36 mmHg and 20.4% (p 〈 0.01). We observed a correlation with tumor size and an increased rate of hypoxic areas in T3–4 lesions (p 〈 0.02). Also tumors with negative nodes or positive ER had significantly higher pO2 values, as did tumors with an overexpression of c-erb-B2, p53, and cathepsin D. Conclusion: Oxygenation of human breast cancers can safely be measured in patients prior to surgical therapy. pO2 values correlate both with prognostic markers examined histologically and with molecular growth factors. As the efficacy of preoperative or adjuvant treatment in individuals may depend on oxygen partial pressure, efforts to manipulate tumor pO2 for therapeutic purpose could be promising.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005921513083
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  • 93
    Electronic Resource
    Electronic Resource
    Aneuploidy of chromosome 8 as detected by interphase fluorescence in situ hybridization is a recurrent finding in primary and metastatic breast cancer (1998)
    Springer
    Breast cancer research and treatment 48 (1998), S. 125-133 
    Details
    ISSN: 1573-7217
    Keywords: aneuploidy ; breast cancer ; FISH ; interphase cytogenetics ; metastasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previous work from our laboratory demonstrated aneuploidy for several chromosomes by interphase fluorescence in situ hybridization (FISH) in a high proportion of breast cancer specimens. In the literature, only limited data are available concerning chromosome 8 anomalies in breast cancer. To determine chromosome 8 ploidy status in primary and metastatic specimens from 81 breast cancer patients, FISH analysis with a DNA probe recognizing chromosome 8 centromeres was performed. In all primary tumor specimens (n=30), significant proportions of cells were aneuploid exhibiting gain of chromosome 8 copy numbers; in 75% of effusion specimens previously classified as malignant by cytology and/or FISH for various chromosomes (n=40), cell populations aneuploid for chromosome 8 were detected; effusions previously classified non-malignant (n=11) were diploid in 10 cases, whereas one specimen contained rare hyperdiploid cells. Among these cells complex chromosomal aneuploidy could be demonstrated by two-color FISH, suggesting malignancy. Trisomic and tetrasomic clones were predominant in the majority of samples, but a marked intratumor cytogenetic heterogeneity was observed in most cases. Primary tumors and corresponding positive axillary lymph nodes revealed similar distributions of chromosome 8 copy numbers, analogous to previous findings with other chromosomes. This implies that, by using suitable FISH probes after examination of the respective primary tumor, an efficient search for (micro)metastasis might be feasible.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005937305102
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  • 94
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    Electronic Resource
    Prevention of development of dimethylbenz(a)anthracene (DMBA)-induced mammary tumors in the rat by the new nonsteroidal antiestrogen EM-800 (SCH57050) (1998)
    Springer
    Breast cancer research and treatment 49 (1998), S. 1-11 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer ; antiestrogen ; estrogen-sensitive ; bone mineral density ; lipids ; BMD ; cholesterol ; triglycerides
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of EM-800, a new non-steroidal antiestrogen having pure antiestrogenic activity, was studied on chemical carcinogenesis induced by dimethylbenz(a)anthracene (DMBA) as well as on serum lipids and bone mass in the rat. Treatment with EM-800 orally, once daily, for 282 days (9 months), starting 3 days before DMBA administration, decreased the incidence of tumors from 95% in control animals to 60% (p 〈 0.01), 38% (p 〈 0.01), and 28% (p 〈 0.01) at the daily doses of 25 μg, 75 μg, and 250 μg, respectively. The average number of tumors per animal decreased from 4.5 ± 0.5 tumors in the control group to 0.9 ± 0.2 (p 〈 0.01), 0.5 ± 0.2 (p 〈 0.01), and 0.3 ± 0.1 (p 〈 0.01) tumors in the rats treated with the above-indicated doses of the antiestrogen. In addition, treatment with the increasing doses of EM-800 reduced serum cholesterol levels to 64%, 56%, and 48% of control, while serum triglycerides decreased to 31%, 28%, and 30% of control. Bone mineral content (BMC) and bone mineral density (BMD) of total skeleton, femur, and lumbar spine were not significantly affected following 282 days of treatment with EM-800. However, treatment with EM-800 inhibited the urinary ratio of hydroxyproline to creatinine (HP/Cr) from 14.0 ± 3.90 μmol/mmol in controls to 7.6 ± 0.8 (p 〈 0.05), 6.8 ± 0.8 (p 〈 0.01), and 6.8 ± 1.1 (p 〈 0.01) μmol/mmol, respectively, while the same treatment had no effect on serum total alkaline phosphatase (tALP) activity or urinary calcium and phosphorus excretion. The 25 μg, 75 μg, and 250 μg daily doses of EM-800 inhibited uterine weight by 35% (p 〈 0.01), 62% (p 〈 0.01), and 66% (p 〈 0.01), while vaginal weight was reduced by 8% (p 〈 0.05), 30% (p 〈 0.01), and 38% (p 〈 0.01), respectively. In agreement with the 27% increment (p 〈 0.05) in ovarian weight at the highest antiestrogen dose used, serum androstenedione (p 〈 0.05), androst-5-ene-3β,17β-diol (p 〈 0.01), testosterone (p 〈 0.05), and estradiol (p 〈 0.01) levels were increased. The present data show that EM-800 prevents the development of DMBA-induced mammary tumors while simultaneously inhibiting uterine and vaginal weight, reducing serum cholesterol and triglyceride levels, and having no adverse effect on bone mass following 9 months of treatment in the rat.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005928814521
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  • 95
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    Electronic Resource
    The intracellular histamine antagonist, N,N-diethyl-2-[4-(phenylmethyl)phenoxy] ethanamine.HCl, may potentiate doxorubicin in the treatment of metastatic breast cancer: Results of a pilot study (1998)
    Springer
    Breast cancer research and treatment 49 (1998), S. 61-68 
    Details
    ISSN: 1573-7217
    Keywords: doxorubicin ; breast cancer ; potentiation ; DPPE
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract N,N-diethyl-2-[4-(phenylmethyl)phenoxy] ethanamine.HCl (DPPE) is a diphenylmethane analog of tamoxifen that antagonizes the intracellular binding of histamine to growth-regulatory sites, a proportion of which represents P450 enzymes, in microsomes and nuclei. We previously reported increased response rates and decreased myelotoxicity in patients with prostate and other cancers who received an intensive dose/schedule of DPPE plus single-agent chemotherapy. We now report the results of a study of DPPE combined with a standard dose/schedule of doxorubicin in twenty-three patients with metastatic breast cancer, sixteen of whom had received prior non-anthracycline chemotherapy. DPPE (6 mg/kg) was infused intravenously (IV) over 80 minutes. Doxorubicin (60 mg/m2) was administered IV over the last 20 minutes of the DPPE infusion. Treatment was repeated every 3 weeks (maximum, 7 cycles). Patients achieving complete response (CR) were followed off treatment until relapse. All patients were evaluable for toxicities and efficacy. Sixteen patients (69%; 95% C.I. = 47–87%) responded (7 CR and 9 PR). Eleven responders, including 6 with CR, had prior chemotherapy. Five responders (2CR, 3PR) had a poor (ECOG 3/4) performance status pre-treatment. Median CR duration was 11 (range 5–18) months. Hematological toxicity was low; GI toxicity (nausea/vomiting/dyspepsia) appeared somewhat higher than historical experience, but responded well to anti-emetics, ranitidine, and/or dexamethasone in most patients; a mean absolute drop in left ventricular ejection fraction of 8% occurred in 17 patients who received ⩾ 300 mg/m2 doxorubicin. The observed response rate in DPPE/doxorubicin-treated patients appeared to be higher than historically reported for doxorubicin alone in this setting, suggesting a chemopotentiating effect of DPPE. A multi-centre trial of this regimen in an additional 32 patients with early metastatic breast cancer has been conducted by the Clinical Trials Group, National Cancer Institute of Canada, and a phase 3 study is planned.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005909808529
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  • 96
    Electronic Resource
    Electronic Resource
    Outcome of treatment for ipsilateral breast tumor recurrence in early-stage breast cancer (1998)
    Springer
    Breast cancer research and treatment 49 (1998), S. 69-78 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer ; ipsilateral breast tumor recurrence ; prognosis ; uncontrolled local disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Introduction: The aims of the study were to assess the outcome among patients with early breast cancer operated on with wide local excision who developed a subsequent ipsilateral breast tumor recurrence, and to identify risk factors for uncontrolled local disease. Uncontrolled local disease (ULD) was defined as the appearance of clinically manifest invasive adenocarcinoma in the remaining breast or on the ipsilateral chest wall which could not be eradicated with salvage treatment during the period of follow-up (2–18 years). Patients and methods: Eighty-five patients in a cohort of 759 patients, treated for invasive Stage I–II breast cancer with breast-conserving surgery 1976–1985 in Stockholm, with a subsequent ipsilateral breast tumor recurrence (IBTR) were reviewed retrospectively. The majority of the patients were premenopausal (58%), node negative (72%), and had received postoperative radiotherapy (79%). Median follow-up time following breast-conserving surgery was 13 (9–19) years. Multivariate Cox's hazard regression was used in the statistical analysis to identify prognostic factors for ULD. Results: The majority (n = 61) of the IBTR's were located in the original tumor quadrant and showed the same histopathological features as the primary tumor. Salvage mastectomy (n = 65) or reexcision (n = 14) were performed in 79 (93%) of the patients. Twenty-one patients developed ULD. Five years following the diagnosis of IBTR the disease-free survival was 59%, the cumulative incidence for ULD was 24%, and for death in breast cancer 34%. In the cohort of 759 patients, patients who received radiotherapy following the primary breast-conserving surgery had 1% cumulative incidence of ULD following the diagnosis of IBTR compared to 4% among patients that received no postoperative radiotherapy. The cumulative incidence at 5 years of ULD following salvage mastectomy was 12% compared to 33% after salvage reexcision. Patients operated on with breast-conserving surgery with an original tumor size 〈 15 mm, who were treated with salvage mastectomy for IBTR, had in multivariate analysis the lowest relative risk for ULD. Adjuvant chemotherapy following IBTR treatment did not seem to improve local tumor control. Following the diagnosis of IBTR, 78% (n = 21) of the patients with ULD and/or regional recurrence (n = 27), died of a disseminated breast cancer in contrast to 10% (n = 6) among the remaining 58 patients. Conclusion: Uncontrolled local disease is an important outcome measure following breast-conserving surgery. In this cohort, salvage mastectomy provided a superior local control rate compared to salvage reexcision. A higher although not statistically significant rate of ULD was also seen in patients who had not received postoperative radiotherapy as part of their primary treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005934513072
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  • 97
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    Electronic Resource
    The incidence of microsatellite instability and loss of heterozygosity in fibroadenoma of the breast (1998)
    Springer
    Breast cancer research and treatment 49 (1998), S. 165-169 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer ; fibroadenoma ; loss of heterozygosity ; microsatellite instability
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A majority of studies have shown an increase in the risk of breast cancer among women previously diagnosed with fibroadenoma (FA). At present there is conflicting evidence whether some of the chromosome abnormalities frequently found in breast carcinoma, such as loss of heterozygosity (LOH), are already present in FAs and other types of benign breast disease and, if present, whether such abnormalities are associated with the observed increase in risk. Microsatellite instability (MSI) is also recognised as a marker of genetic damage and is thought to occur when there has been damage to the cell's mismatch repair (MMR) system. We have analysed 39 cases of FA obtained from paraffin-embedded tissue for the presence of MSI and LOH at 11 loci to determine if these types of genetic alterations occur in FA. The incidence of MSI and LOH found were 4 of 395 (1.0%) and 5 of 271 (1.8%) informative loci tested respectively. Approximately 8% of cases were positive for MSI and 10% were positive for LOH, with one specimen having multiple occurences of both MSI and LOH. We conclude that these forms of genetic alteration do occur in FAs but that the incidence is low.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005930429002
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  • 98
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    Electronic Resource
    Galectin-3 and L1 retrotransposons in human breast carcinomas (1998)
    Springer
    Breast cancer research and treatment 49 (1998), S. 171-183 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer ; galectin-3 ; Line 1 retrotransposon
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Galectin-3 is a galactoside binding protein found at elevated levels in a wide variety of neoplastic cells and thought to be involved in cognitive cellular interactions during transformation and metastasis. Previously, we have shown that introduction of human galectin-3 (Mr 31,000) cDNA into the human breast cancer cells BT-549 which are galectin-3 null and non-tumorigenic in nude mice resulted in the establishment of four galectin-3 expressing clones. Three of them acquired tumorigenicity when inoculated in the mammary fat pad of nude mice. Here, we questioned what is the molecular difference between the nude mouse tumorigenic and non-tumorigenic galectin-3 expressing BT-549 cell clones. Differential display analysis and Northern blotting revealed that, unlike the tumorigenic clones, neither the parental cells nor the non-tumorigenic clone expressed a 6.5 Kb transcript. A 607 bp PCR (polymerase chain reaction) product from the differentially displayed mRNA revealed a 93% sequence homology with the human L1 retrotransposon previously suggested to play a role in the pathobiology of some breast cancers. In addition, we show that the two gene products, i.e., galectin-3 and L1, are co-expressed in breast carcinoma specimens and in other nude mouse tumorigenic cell lines.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005913810250
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  • 99
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    Electronic Resource
    Fractal analysis of mammographic lesions: A prospective, blinded trial (1998)
    Springer
    Breast cancer research and treatment 49 (1998), S. 245-249 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer ; fibroadenoma ; fibrocystic disease ; fractal analysis ; mammography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Mammography has become the mainstay of breast cancer screening. However, widespread mammography has led to an increase of the number of breast biopsies done for benign disease. Therefore, a method to better discriminate benign from malignant lesions is needed. Fractal analysis is a mathematical method which can quantify complex shapes. It has been previously shown retrospectively that the composite fractal dimensions, D, of malignant mammographic masses is higher than for benign lesions. A prospective study of 75 patients who were recommended to undergo needle localized breast biopsy by independent radiologists had the composite D calculated. Fractal analysis was done without knowledge of the biopsy results. The mean composite D of malignant lesions was higher than benign lesions, 2.545 ± 0.067 vs. 1.936 ± 0.144 (p=0.00004). Calculation of a receiver-operating characteristic curve showed that a cutoff value of 2.067 had a 100% sensitivity and 63% specificity (i.e., false positive rate of 37%). Mean D for fibroadenomas was 2.087 ± 0.054, fibrocystic disease was 1.877 ± 0.167, DCIS was 2.261 ± 0.069, and invasive cancer was 2.634 ± 0.039 (1-way ANOVA, p=0.00007). These data imply that fractal analysis may be beneficial in discriminating between benign and malignant lesions. However, further study in a larger number of patients with a variety of lesions is needed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006093309091
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  • 100
    Electronic Resource
    Electronic Resource
    Fibrotic focus in infiltrating ductal carcinoma of the breast: A significant histopathological prognostic parameter for predicting the long-term survival of the patients (1998)
    Springer
    Breast cancer research and treatment 49 (1998), S. 195-208 
    Details
    ISSN: 1573-7217
    Keywords: infiltrating ductal carcinoma ; breast cancer ; histology ; fibrotic focus ; prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The presence of fibratic fows (FF) in infiltrating ductal carcinoma (IDC) has been shown to be an important histological factor associated with high tumor aggressiveness, or early tumor recurrence or death. However, the clinicopathological significance of FF for predicting the long-term survival of the patients with IDC has not been fully investigated. In order to elucidate this aspect, we divided 140 IDCs with at least 10 years of follow up into tumors with FF and those without. IDC with FF showed significantly higher histologic grade (P=0.02), higher frequency of tumor necrosis (P=0.02), higher frequency of cases with more than three positive lymph node metastases (P=0.04), higher T classification (P=0.009), and higher pathological stage (P=0.0002) than those without FF. Relative risk (RR) of tumor recurrence and death was significantly higher in tumors with FF than in those without (RR=4.5, P 〈 0.00001 and RR=5.6, P 〈 0.00001, respectively). In cases of early stage cancer (stages I, IIA, and IIB), or in those with less than four lymph node metastases, IDCs with FF demonstrated a significantly higher risk than those without. Multivariate adjustments for other pathological factors did not change the RRs significantly. These results indicate that in long-term follow up the presence of FF is a significant prognostic parameter for IDC, and therefore strongly suggest that IDCs must be divided into those with and without FF.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006067513634
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