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Biomedical subjects

K A Frankel

Publications and source records attributed to K A Frankel.

51 records · Page 3Linked to original sources

Metastatic cystosarcoma phyllodes. A report of 2 cases presenting with neurological symptoms.

Two cases of cystosarcoma phyllodes of the breast are presented with central nervous system (CNS) metastases appearing several years after mastectomy for the primary lesion. Unusual features in these cases include the widespread metastases themselves, neurologic symptomatology and CNS involvement, metastases into a uterine leiomyoma and into an area of hepatic adenomatous hyperplasia, and glomus-like structures in one of the primaries with similar structures resembling glomus cells in metastases. The distant metastases were of stromal cells only and frequently surrounded epithelial cells to isolate the indigenous glandular structures. The concept that cytosarcoma is a peculiar stromal neoplasm rather than a tumor of dual neoplastic origin is discussed.

Breast Neoplasms↗

Soft tissue ameloblastoma in a 92-year-old woman.

Ameloblastoma is a rare epithelial neoplasm that most commonly is found within the bony structure of the jaw. Soft tissue ameloblastomas are rarer. Only nine well-documented cases are found in the reviewed world's literature. It is our purpose to report the clinical and morphological features of a gingival ameloblastoma in a 92-year-old woman.

Aged↗

The pathology of the heart in progressive muscular dystrophy: epimyocardial fibrosis.

The gross and microscopic appearance of the hearts from eight patients with Duchenne's progressive muscular dystrophy are described. Seven hearts had gross evidence of myocardial fibrosis, five of these demonstrating distinctive fibrosis of the epimyocardial portion of the free wall of the left ventricle, often with a striking band-like appearance. On the basis of mapping studies of the myocardial fibrosis, a theory regarding the progression of myocardial fibrosis in Duchenne's progressive muscular dystrophy is presented. Correlation of the pathologic anatomy, electrocardiograms, and vectorcardiograms in these patients and the family studies of others suggests that Duchenne's progressive muscular dystrophy represents a generalized cardiomyopathy that has its gravest and most distinctive effect on the epimyocardial portion of the free wall of the left ventricle.

Adolescent↗

Ground-based simulations of cosmic ray heavy ion interactions in spacecraft and planetary habitat shielding materials.

This paper surveys some recent accelerator-based measurements of the nuclear fragmentation of high energy nuclei in shielding and tissue-equivalent materials. These data are needed to make accurate predictions of the radiation field produced at depth in spacecraft and planetary habitat shielding materials and in the human body by heavy charged particles in the galactic cosmic radiation. Projectile-target combinations include 1 GeV/nucleon 56Fe incident on aluminum and graphite and 600 MeV/nucleon 56Fe and 290 MeV/nucleon 12C on polyethylene. We present examples of the dependence of fragmentation on material type and thickness, of a comparison between data and a fragmentation model, and of multiple fragments produced along the beam axis.

Cosmic Radiation↗

A helium-ion beam for stereotactic radiosurgery of central nervous system disorders.

A new radiation beamline configuration for stereotactic heavy-ion Bragg peak radiosurgery of patients with intracranial deep arteriovenous malformations, including carotid-cavernous fistulas, has been developed using the 230 MeV/u helium ion beam at the 184-in. Synchrocyclotron at the University of California, Berkeley. The modified beam has five characteristics: uniform field between 10 and 40 mm in diameter; variable depth of penetration between 40 and 140 mm; stopping region for primary ions that can be broadened up to 40 mm; sharply defined lateral and distal borders; and dose rate greater than 2 Gy/min. It is adapted to the ISAH (irradiation stereotactic apparatus for humans) at the 184-in. Synchrocyclotron, with effective stereotactic localization of defined volumes within the brain, and is designed to reach all intracranial targets. It has proven suitable for all patients with intracranial vascular disorders treated with stereotactic radiosurgery at our laboratory.

Biophysical Phenomena↗

ASCUS diagnoses.

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Cervix Uteri↗

Cerebral blood flow evaluation of arteriovenous malformations with stable xenon CT.

Twenty patients with supratentorial arteriovenous malformations (AVMs) were evaluated with angiography, conventional CT, and stable xenon CT to determine cerebral blood flow. Contralateral and ipsilateral regions of interest relative to the AVM were evaluated from cerebral blood flow maps and correlated with angiography. A significant decrease in cerebral blood flow was observed in the ipsilateral cortical gray matter adjacent to the AVM relative to the corresponding contralateral cortex (mean difference = 9.52 ml/100 g/min, p less than .01). The larger AVMs (greater than 8 cm3) were associated with a more marked decrease with a mean difference of 12.22 ml/100 g/min (p less than .02). Regions of interest were also chosen on the basis of angiographic findings, which suggested areas of decreased flow. Comparison of these areas with analogous contralateral areas also showed a significant decline in cerebral blood flow (mean difference = 8.86 ml/100 g/min); this decline was greater with larger AVMs (volume greater than 8 cm3), which had a mean difference of 11.38 ml/100 g/min (p less than .01). Our correlative study enabled us to pinpoint the regions most likely to have reduced flow from an AVM.

Adolescent↗

Endovascular treatment of cerebral arteriovenous malformations following radiosurgery.

PURPOSE: Previous reports of embolization of cerebral arteriovenous malformations (AVMs) have evaluated the technique as adjunctive therapy prior to surgery or radiosurgery; our aim is to assess the role of embolization following radiosurgery. PATIENTS: Six patients previously treated with radiosurgery and showing no response as judged by cerebral angiography were embolized 24 to 55 months (mean 34.3 months) after initial radiosurgery. RESULTS: In five of six, a significant volume reduction was achieved ranging from 60%-100% (mean 74%). One patient was treated with embolization alone and the AVM has remained fully thrombosed 2 years after treatment. Three patients underwent surgical resection for cure after embolization, and two patients had repeat radiosurgery to a significantly smaller AVM volume. One patient had an asymptomatic carotid dissection at embolization; however, no clinically apparent complications occurred in the treatment group. CONCLUSION: Embolization can be used after radiosurgery to assist in the management of those AVMs that have not responded to initial treatment.

Adolescent↗