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Biomedical subjects

L Hann

Publications and source records attributed to L Hann.

16 recordsLinked to original sources
PubMed2001

Advances in the detection of residual thyroid carcinoma.

The challenge of detecting and anatomically localizing metastatic thyroid cancer deposits has become less daunting with the recent developments in radionuclide technology. The use of serum Tg measurements and the whole body radioiodine scan remain the mainstays of the diagnostic evaluation. The advent of recombinant human TSH makes the preparation for a diagnostic scan much less burdensome and appears to have excellent sensitivity for serious metastatic lesions. The dilemma of an elevated serum Tg associated with a negative DxWBS has been ameliorated somewhat with the newly discovered ability of FDG-PET scanning to localize these less well-differentiated lesions. The real challenge lies in the development of new therapeutic agents to treat metastatic lesions that do not concentrate radioiodine.

Carcinoma↗
PubMed1998

Hepatic outflow obstruction and liver failure due to leukemic cell infiltration in chronic lymphocytic leukemia.

We report a patient with advanced progressive CLL who presented with liver failure and hepatic venus outflow obstruction (HVOD) due to lymphocytic leukemic infiltrates. Initiation of antileukemic therapy resulted in a rapid and prompt resolution of these life-threatening complications. This is apparently the first report of a CLL patient with HVOD and liver failure, attributable to liver infiltration by leukemic cells.

Hepatic Veno-Occlusive Disease↗
PubMed1994

Phase II trial of docetaxel in patients with platinum-refractory advanced ovarian cancer.

PURPOSE: This phase II study was conducted to evaluate the efficacy and toxicity of docetaxel in the treatment of patients with platinum-refractory ovarian cancer. PATIENTS AND METHODS: Twenty-five patients with platinum-refractory advanced ovarian cancer were treated. Twenty of the patients had failed to respond to platinum-based front-line chemotherapy and five had failed to respond to platinum-based therapy repeated at relapse. One patient had received prior pelvic radiation therapy. Patients were required to have bidimensionally measurable disease. Docetaxel was administered at a dose of 100 mg/m2 intravenously (i.v.) over 1 hour every 21 days. Twenty patients received no corticosteroid premedication and five received premedication with corticosteroids and antihistamines. RESULTS: Eight of 23 assessable patients (35%) had a partial response (PR; 95% confidence interval, 16% to 57%). The median response duration was 5 months. Hospitalization for toxicity, predominantly neutropenic fever, occurred in 12 patients (48%) and 16% of courses. Anemia was common in the study population. Nonhematologic toxicities included alopecia, rash, fluid retention, diarrhea, peripheral neuropathy, and hypersensitivity reactions. CONCLUSION: Docetaxel demonstrates significant activity in patients with platinum-refractory advanced ovarian cancer. Routine premedication is recommended. Further investigations of this agent in ovarian cancer, including combinations with other active agents, appear indicated.

Adult↗
PubMed1993

Use of digital mammography in needle localization procedures.

OBJECTIVE: With digital technology, images can be displayed rapidly and manipulated. This study was undertaken to assess the duration and accuracy of needle localizations performed with digital vs film-screen technology. These two technologies also were compared with respect to radiation doses and ability to image a standard phantom. SUBJECTS AND METHODS: A prototype digital mammographic system with both a 512 x 512 matrix and a 1024 x 1024 matrix was evaluated by using the American College of Radiology mammography accreditation phantom, and these results were compared with testing done on commercially available, dedicated, analog mammography equipment. Duration, accuracy of needle placement, and number of exposures needed to perform localization were recorded for 157 consecutive needle localizations done with digital technology, and these results were compared with data collected from 103 needle localizations done with film-screen technology. Another 33 localizations attempted with digital imaging were aborted because of technical factors. Average glandular doses were calculated for those women who had a compressed breast thickness of 4-5 cm. RESULTS: The time to complete needle localization was reduced by almost 50%, from 20 to 11 min, when digital technology was used. Because of the small (5 x 5 cm) field of view of the digital system, an additional mammogram obtained at the onset of the procedure was found to be helpful in localization, but otherwise the number of images was the same regardless of imaging receptor. Mean glandular dose was reduced by about 50% with digital imaging from 0.219 to 0.120 cGy. In those 17% (33/190) of needle localizations that could not be completed with digital imaging, failure was due to a variety of factors. Despite improved detectability of fibrils, specks, and masses on digital images, digital systems did not show some fine calcifications or soft-tissue masses during needle localizations. Difficulty in imaging lesions near the chest wall or in the axilla and the small field of view also caused procedures attempted with digital imaging to be aborted and completed with film-screen systems. CONCLUSION: The time to complete needle localization was reduced by 50%, with a similar reduction in patients' radiation dose, when digital mammography was used. These findings should be applicable to stereotaxic procedures done with digital mammography. Factors limiting the use of digital mammography equipment included inability to image some fine calcifications and some masses, difficulty in imaging near the chest wall and in the axilla, and a small field of view.

Breast Neoplasms↗
PubMed1990

How thoroughly should needle localization breast biopsies be sampled for microscopic examination? A prospective mammographic/pathologic correlative study.

To investigate the relationships between mammographic calcifications and pathologic lesions, and to develop guidelines for specimen sampling, we prospectively studied 157 consecutive needle localization breast biopsies (NLBB) using a technique in which radiographic findings in sectioned specimens were correlated with the histologic findings. All NLBBs were performed because of mammographic microcalcifications without a soft tissue density, and macroscopic examination in each case failed to reveal a gross lesion. All specimens were submitted in their entirety. Microscopically, 32% of the cases showed carcinoma, 12% demonstrated atypical hyperplasia, and 56% consisted of benign breast tissue without atypia. Forty-nine of the 50 cancers (98%) and 14 of the 19 atypical hyperplasias (74%) were associated with the radiographic calcifications. If histologic examination had been restricted to areas of the specimens containing the radiographic microcalcifications and the remaining tissue submitted only for cases of carcinoma or atypical hyperplasia on the initial sections, 38% fewer tissue blocks would have been processed, but one case of noncomedo ductal carcinoma in situ and five cases of atypical hyperplasia would have gone undetected. If microscopic examination had also included all additional tissue consisting of fibrous parenchyma, all 50 carcinomas and 17 of the 19 atypical hyperplasias would have been detected and 20% fewer tissue blocks would have been submitted. We conclude that restricting histologic examination of NLBB to areas of radiographic calcifications and fibrous parenchyma results in a high level of detection of clinically significant lesions and a considerable reduction in the amount of tissue processed.

Adolescent↗
PubMed1989

Nonpalpable breast lesions: evaluation by means of fine-needle aspiration cytology.

A prospective study was undertaken to assess the utility of fine-needle aspiration (FNA) cytology in women with nonpalpable suspicious microcalcifications or masses detected at mammography. Ninety-six breast lesions were aspirated during wire localization with standard mammographic technique. Cytologic results were compared with surgical pathology results. Sixty-one of the 96 aspirates were adequate for diagnosis. Nine were positive for malignant cells; seven, suspicious; 12, atypical; and 33, negative. All lesions demonstrating positive or suspicious cytologic findings were found to be malignant at biopsy; five of the 12 with atypical cytologic findings were malignant. Of 33 lesions deemed negative by means of cytology, two were biopsy-proved carcinomas. Cytologic examination permitted accurate diagnosis of 21 of the 23 (91%) carcinomas in which an adequate sample was obtained. Insufficient cellular material was obtained from 35 lesions, 16 of which showed marked fibrosis at histologic examination. The authors conclude that FNA cytology can aid in establishing a diagnosis in many cases in which nonpalpable breast lesions are detected at mammography.

Adult↗
PubMed1989

[Acute leukemia in Dakar. Retrospective study apropos of 36 cases].

This study of acute leukaemia in adult at the two main hospitals in Dakar- the General Hospital from January 1980 to June 1986 and the A. Le Dantec Hospital from January 1978 to June 1986 - shows the progression of this ailment, which remains rare (0.85% of admissions - 5 cases per year). Certain clinical peculiarities are stressed (high frequency of infectious symptoms, considerable splenomegaly , adenopathy often present in acute myeloid leukaemia. More severe biological signs are evident than in series in the West, and (L.A.M.3) forms dominate. Grave developments are often the result of a shortage of diagnostic and therapeutic equipment. The authors stress the need to create a haematological clinic.

Acute Disease↗
PubMed1987

Sonographic biophysical profile in the postdate pregnancy.

One hundred thirty-one postdate pregnancies were evaluated by the sonographic biophysical profile. Results of prenatal testing were compared to neonatal condition. Predictive values were calculated in order to determine whether this testing scheme could be used to detect the fetus at risk for neonatal distress. The results of this study show that a normal biophysical profile score is highly predictive of normal outcome, but an abnormal test has only a 14% predictive value of poor neonatal outcome.

Female↗
PubMed1983

Significance of post-cholecystectomy subhepatic fluid collections.

A prospective ultrasound study of the right upper quadrant in 105 patients who had undergone cholecystectomy showed the incidence of fluid collection in the gall bladder fossa to be 24% 2 to 4 days after operation. In all but two patients, these fluid collections were of no clinical significance. The relationship between the presence of fluid and several other variables, such as use of drains and surgical techniques, are discussed.

Ascites↗
PubMed1982

Renal subcapsular rim sign: new etiologies and pathogenesis.

Two prior reports have described a cortical rim sign associated with renal infarction from acute renal artery obstruction. This paper adds four additional cases of a thin outer (subcapsular) cortical nephrogram due to renal vein thrombosis (two cases), acute tubular necrosis (one case), and renal artery embolization (one case). An acute vascular compromise from differing etiologic mechanisms appears to be the common denominator of the rim nephrogram. The nephrogram probably represents an intact subcapsular renal cortex (2-4 mm thick) perfused by the perirenal capsular collateral circulation. To date, the rim nephrogram has been visible only on high dose nephrotomography. Its smooth inner margin is sufficiently distinct to differentiate it from the shell nephrogram of severe hydronephrosis.

Adult↗
PubMed1979

Gray scale ultrasound in adnexal thickening: correlation with laparoscopy.

A retrospective comparison between ultrasound and subsequent laparoscopy was made in 70 female patients to evaluate the sonographic features of minimal pelvic disease (in particular, adnexal thickening). The overall accuracy of sonography as compared with laparoscopy was 75 percent (53 of 70), with a true positive rate of 72 percent (40 of 51) and a true negative rate of 68 percent (13 of 19). In this study the concept of clinical or sonographic adnexal thickening did not correlate with observations at laparoscopy. Of the 7 patients diagnosed by ultrasound as having adnexal thickening, only 1 had pelvic inflammatory disease, whereas the other 6 showed no abnormalities at laparoscopy.

Adnexa Uteri↗