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Biomedical subjects

E Steiner

Publications and source records attributed to E Steiner.

At least 19 recordsLinked to original sources
PubMed1995

[Spontaneous osteonecrosis of the knee joint: MRT compared to CT, scintigraphy and histology].

PURPOSE: We compared MR imaging with scintigraphy and CT in eight patients with spontaneous osteonecrosis of the knee. The histological changes accounting for the MR signal abnormalities were evaluated. METHODS: Eight patients with spontaneous osteonecrosis of the knee joint underwent MR imaging before and after i.v. administration of Gd-DTPA. Nuclear scintigraphy was performed in all 8 patients, three patients also had CT scans of the knee area. Histologic correlation was available in three patients. RESULTS: Increased radionuclide uptake was observed in all patients. In one patient, however, scintigraphy showed increased radionuclide uptake consistent with osteonecrosis only in the medial femoral condyle, while MR imaging demonstrated osteonecrosis both in the medial as well as the lateral femoral condyles. MR demonstrated areas of low signal intensity on precontrast T1-weighted images in the femoral condyle in all patients. All these areas showed high signal intensity on T2-weighted images. On postcontrast T1-weighted images, signal intensity increase was either homogeneous throughout the lesion or it was seen at the periphery of the lesion in a band-like pattern. Histologically, the areas of high signal intensity on T2-weighted and on postcontrast T1-weighted images corresponded to granulation tissue. CONCLUSION: MR imaging detects granulation tissue adjacent to the necrotic zone. Using morphological and signal intensity criteria, MR imaging can be utilised to differentiate spontaneous osteonecrosis of the knee from osteochondritis dissecans, degenerative osteoarthritis, and other conditions affecting the knee joint.

Aged↗
PubMed1995

Sonography in the postoperative evaluation of laparoscopic inguinal hernia repair.

We evaluated the use of sonography as a means of assessing hernial occlusion and possible postoperative changes such as hematomas or seromas in the inguinal and scrotal regions after 1139 laparoscopic repairs of hernias between August 1992 and November 1994. Changes after laparoscopic hernia repair were found in 307 patients (27%). Hematomas or seromas were seen in 132 patients, protrusion of the prosthetic mesh in 17, mesh infection in two, and small bowel entrapment in an insufficient peritoneal suture in two. Recurrences were diagnosed correctly in six patients, mobile preperitoneal lipomas in five. Sonography is useful in the evaluation of complications after laparoscopic hernia repair, including recurrent hernia. In the absence of symptoms, sonography is not indicated.

Adolescent↗
PubMed1992

Apolipoprotein B and A-I in relation to serum cholesterol and triglycerides in 43,000 Swedish males and females.

Automated methods for the determination of apolipoprotein B and apolipoprotein A-I were developed, tested, and applied in screening programs of large populations to improve information about the composition and degree of hyperlipoproteinemia. Apolipoproteins B and A-I, total cholesterol, and triglyceride levels were measured in 25,659 males and 18,144 females between 20 and 79 years of age, the majority subjectively healthy. The immunoturbidimetric methods used for apolipoproteins B and A-I were shown to be stable over time, and the errors of the methods were below 7%. Apolipoprotein B correlated with total cholesterol (r = 0.86, P less than 0.001) for each age decile group and for both sexes (r = 0.82-0.87, P less than 0.001). For a subsample comparable to the large population, apolipoprotein B correlated with cholesterol in low density (i.e., the atherogenic particle), r = 0.89, P less than 0.001. The mean values for apolipoprotein B increased with age for both sexes, with much higher levels in males than in females under 50 years of age. Apolipoprotein A-I was lower in males than in females in all age-groups. At all cholesterol levels males had higher apolipoprotein B, and at the same triglyceride level, also lower apolipoprotein A-I and hence a higher B/A-I ratio than females. Using apolipoprotein B and A-I (high-density lipoprotein cholesterol) particles and adopting Swedish consensus criteria for the diagnosis of risk of ischemic heart disease, examples are given showing that many individuals, especially females, with high or borderline total serum cholesterol can be excluded from further investigation/treatment for hypercholesterolemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Pituitary adenomas: findings of postoperative MR imaging.

Preoperative and postoperative magnetic resonance (MR) images obtained in 25 patients with pituitary macroadenomas (1.1-5.2 cm in diameter) were evaluated to determine normal (physiologic) and abnormal findings after transsphenoidal or subfrontal surgery. With a 1.5-T unit, T1-weighted sagittal and coronal images were obtained before and after administration of gadopentetate dimeglumine. The physiologic changes after surgery included resorption of packing material and sphenoid sinus opacifications, reexpansion of the pituitary gland, and lowering of the optic chiasm. Implanted gelatin foam appeared as an endosellar, circularly enhancing mass that was seen on follow-up studies to have decreased in size. Muscle-and-fat implants appeared as areas of high signal intensity. In 14 patients, residual tumors were found in the suprasellar (n = 4), retrosellar (n = 3), parasellar (n = 8), and/or endosellar (n = 3) space. Residual tumors were differentiated from implant materials by means of location, characteristic signal intensity, and enhancing pattern, which were identical to those of the corresponding preoperative adenoma in 13 cases (93%). Preoperative studies and clinical information are helpful in the evaluation of postoperative MR imaging examinations.

Adenoma↗
PubMed1992

High cholesterol and triglyceride values in Swedish males and females: increased risk of fatal myocardial infarction. First report from the AMORIS (Apolipoprotein related MOrtality RISk) study.

In over 300,000 Swedish males and females aged 20 to 79 years total cholesterol and triglycerides were measured consecutively between 1985 and 1989. In a subsample of about 35,000 individuals apolipoprotein (apo) B (indicating atherogenic) and apo A-I (anti-atherogenic) were also measured. In the age group 40-49 years, 24% of the males and 12% of the females had hypercholesterolemia (> or = 6.5 mmol/L) and 14% and 3%, respectively had hypertriglyceridemia (> or = 2.3 mmol/L). Combined hyperlipidemia occurred in this age group in 7% of the males and in 1% of the females and was more common in males. In the same age group, 21% of the males and 8% of the females had high atherogenic apo B values (> 1.5 g/L). Low apo A-I was found in the whole population (20-79 years) in 13% of the males and in 10% of the females and varied only little with age. In the AMORIS (Apolipoprotein related MOrtality RISk) study these individuals are followed prospectively. The relations between lipids and apo B and apo A-I levels and risk for fatal acute myocardial infarction (AMI) are analyzed to investigate which of these lipids/apolipoproteins best predict AMI either as single determinants or in combination. After a mean observation time of about 22 months there is a 3-6-fold increase in AMI in relation to increasing cholesterol levels in males of 40-59 years. The largest increase was seen in the 40-49-year age group. A similar relationship was also found for triglycerides and AMI.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[A cholecysto-enteric fistula with a gallstone ileus diagnosed by CT].

Gallstone ileus is an uncommon but severe complication of cholecystitis, which can only occur following perforation of the gallbladder and formation of a cholecystoenteric fistula. The diagnosis can be established by means of abdominal plain film when the classic triad described by Rigler (small-bowel obstruction, ectopic gallstone and pneumobilia) is observed. A patient with abdominal obstruction and equivocal findings on plain film X-ray and abdominal sonography is presented, in whom the gallstone ileus was reliably diagnosed by CT.

Aged↗
PubMed1991

Pituitary adenomas with parasellar invasion.

Pituitary adenomas with extension into the parasellar space, the so called "cavernous sinus" can be demonstrated best using MRI. To improve the delineation from the venous compartments the use of unenhanced and enhanced MRI scans is essential. In 25 pituitary adenomas with surgically proven infiltration into the space of the cavernous sinus we correlated the MRI findings with our surgical observations. When the adenoma encases the intracavernous internal carotid artery or reaches as far as to the lateral aspect of the artery, invasion was present in all cases. The critical area where invasion could not be predicted from MRI is the distance between the medial and the lateral aspect of the intracavernous internal carotid artery. By measurement with the monoclonal antibody KI-67 it could be shown, that pituitary adenomas infiltrating the parasellar space have a statistically significant higher growth rate (p less than 0.001), compared to non-invasive adenomas. This is of special interest, because surgical cure becomes unlikely, when invasion into the space of the cavernous sinus is present.

Adenoma↗
PubMed1991

The structure of the mouse lipoprotein lipase gene: a B1 repetitive element is inserted into the 3' untranslated region of the mRNA.

The catabolism of triglycerides-rich lipoproteins and the subsequent uptake of free fatty acids by muscle and adipose tissue is dependent on the enzyme lipoprotein lipase (LPL). To better understand the regulation of this enzyme, we have isolated and characterized the mouse LPL gene. The gene is 28 kb in length and comprises 10 exons which encode a 4.0-kb mRNA. In this report, almost 6 kb of DNA sequence is presented, including 1251 bp 5' to the gene, over 4 kb of exon and exon-intron junctions, and 583 bp 3' to the gene. RNA from differentiated 3T3-L1 adipocytes was used in primer extension and RNase protection assays to show that the 5' untranslated region is not interrupted by an intron and the start site of transcription is 199 bp 5' to the ATG codon that begins translation. The first exon codes for the 5' untranslated region and the signal peptide of 27 amino acids and 2 amino acids of the mature protein, exons 2-9 code for 445 amino acids of the mature protein. These exons are short and vary in length from 102 to 287 bp. The 10th exon codes for the 3' untranslated region and is 2346 bp long. This exon contains a single copy of a B1 repetitive element of 152 bp followed by a 169-bp homopurine stretch. These elements are flanked by a pair of 16-bp direct repeats. The mouse gene is similar in size to the human, which also contains 10 exons in similar locations. There is a high degree of sequence homology between the two genes, 5' region (700 bp), 75%; 5' untranslated region, 74%; coding region, 88%; 3' untranslated region, 75%. The most striking difference is the absence of the B1 repetitive element and homopurine region in the human 3' untranslated region. This information about the mouse LPL gene may lead to a better understanding of its regulation and role in plasma lipoprotein metabolism.

Amino Acid Sequence↗
PubMed1990

Relationship between uptake and elimination of toluene and debrisoquin hydroxylation polymorphism.

The toxicokinetics of toluene were studied in six healthy subjects. Three of the subjects were phenotyped as rapid hydroxylators of debrisoquin and three subjects were phenotyped as slow hydroxylators of debrisoquin. The subjects were exposed in an exposure chamber to toluene vapor (3.25 mmol/m3) for 4 hours. Solvent concentrations in blood and the metabolites, hippuric acid and o-cresol, in urine were measured during the exposure period and 3 hours after exposure. The capacity to metabolize debrisoquin was determined in three volunteers who had earlier experimentally been exposed to toluene. The uptake of toluene was about 3 mmol, or 50% of the inhaled dose in both rapid and slow hydroxylators. There were no significant differences between the two phenotypic groups with regard to concentrations of toluene in blood, apparent blood clearance of toluene, or excretion of hippuric acid and o-cresol.

Atmosphere Exposure Chambers↗
PubMed1990

[Sonography of the skeletal muscles using high-frequency ultrasound probes].

8 musculi graciles of human cadavers were examined sonographically by means of high-frequency ultrasound probes (10 MHz) to evaluate the echo texture of skeletal muscles. It could be shown that the smallest structures of skeletal muscles that may be differentiated sonographically are the primary bundles. In addition, 100 patients with clinically suspected muscular trauma and 8 patients with neuromuscular diseases were examined via high-frequency ultrasound probes (10 or 7.5 MHz). The typical signs of muscle tears and neuromuscular diseases in relation to normal sonomorphology are discussed. The special value of the method in these indications is emphasised.

Humans↗
PubMed1990

[Sonography in malignant tonsillar tumors].

In this retrospective study the value of sonography in the preoperative staging of malignant tumours of the tonsils was evaluated in 36 patients. According to our results sonography is indicated in small tumours. In greater tumours, especially if bone destruction could be expected, MR or CT should be performed additionally to sonography. Good results were achieved in assessing the infiltration of the tongue with or without crossing the midline (accuracy 92 to 97%) and the detection of cervical lymph node metastasis (accuracy 94%).

Adult↗
PubMed1990

Invasion of the carotid artery and jugular vein by lymph node metastases: detection with sonography.

Knowledge of invasion of the walls of the cervical vessels by tumor is of great clinical importance before surgery. We performed sonography on 83 patients with palpable cervical lymph node metastases in the region of the carotid bifurcation to determine the relationship of the metastases to the carotid artery and jugular vein. In all patients, the sonographic results were proved by surgery. The wall of the carotid artery was hypo-echogenic in 11 of 12 patients with surgically proved tumor invasion of the artery. Four results were false-positive. Palpation or swallowing during real-time scanning showed mobility of the tumor relative to the wall of the artery in 47 patients (57%). In these patients, tumor invasion could be excluded. Bilateral compression or invasion of the internal jugular vein was identified correctly with sonography in all five patients in whom this was confirmed surgically. These results suggest that real-time sonography is a valuable method for determining the relationship between cervical lymph node metastases and the carotid artery and jugular vein.

Carcinoma, Squamous Cell↗
PubMed1990

[Small intestine wash-out: technic and indications in acute severe chloroquine poisoning in underdeveloped surgical environments].

Authors present a simple small bowel surgical wash-out technique that can be used in the treatment of severe chloroquine poisoning. This toxicokinetic treatment can improve the prognosis of this poisoning in under-developed countries, without substitution with modern toxico-dynamic treatment. Toxico-dynamic treatment needs intensive medical care, which is unavailable in these countries. Surgical wash-out of the small bowel could also be a complement to medical treatment in very massive chloroquine poisoning.

Acute Disease↗
PubMed1990

[Clinical experiences with 50 pancreas transplantations].

Between 1979 and December 1987 a total of 50 pancreas transplants were performed, 41 of them together with a kidney from the same donor. End-stage diabetic nephropathy was the indication for the combined procedure, and progressive pre-proliferative retinopathy for a single pancreas transplant. A segment consisting of body, tail but also major parts of the head of the gland was used. Technique-related complications or prolonged hospitalization prompted three changes in surgical technique. In the first five patients the pancreatic duct was occluded at the time of transplantation and in the subsequent eleven cases the graft was anastomosed to a Roux-Y-loop of jejunum. In a series of 17 patients thereafter the pancreatic duct was occluded after stabilization of graft function, and in the most recent 17 patients the pancreatic juice was drained into the urinary bladder. Prophylactic immunosuppression consisted of steroids and azathioprine for the first two patients. From 1981 to 1986 cyclosporin and prednisolone were given and from then on azathioprine was added as a third drug. Patient survival at one year was 25% in the first group, 80% in group II, 97% in group III and 88% in group IV. Cardiovascular and septic complications were the main causes of death. None of the group I transplants functioned at one year. Graft survival rates at one year for the pancreas and the kidney in groups II, III and IV were calculated at 30%, 70%, 58.8% and 77%, 86%, 72% respectively. In 16% of the long-term survivors significant amelioration and in another 50% stabilization of diabetic retinopathy occurred.

Adult↗