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Biomedical subjects

M Herman

Publications and source records attributed to M Herman.

At least 73 records · Page 4Linked to original sources
PubMed1997

[Magnetic resonance in cardiology--a new alternative in noninvasive diagnosis].

The authors describe their initial experience with examination of the heart by magnetic resonance (MR) and discuss its position in the diagnostic algorithm of cardiac examinations:. They made 31 MR examinations of the heart in 30 patients. Echocardiography preceded 29 examinations. MR proved to be particularly useful where echocardiography did not lead to a decisive conclusion and called for confirmation by another method, or where it could not be carried out or its result was not consistent with the patient's clinical condition or the results of other examinations. The quality of the MR image was influenced most by the possibility of ECG gating. The latter was not possible in 16 patients (51.6%). In three of these (18.8%) the images were of such poor quality that they did not provide adequate diagnostic information. Images suitable for evaluation were obtained in 28 examinations (90.3%)--in these patients the MR information was valuable for establishment of the diagnosis. Magnetic resonance is a new possible method in the non-invasive diagnosis of heart disease. In the majority of cases it follows after echocardiographic examination which remains due to its accessibility the basic non-invasive method for examination of the heart.

Adolescent↗
PubMed1996

[Neurosarcoidosis. Role of new examination methods for early diagnosis and therapy].

BACKGROUND: Affection of the nervous system is one of the most serious forms of sarcoidosis. The objective of the present work was to evaluate the prevalence and manifestations of this disease, contemporary opportunities of its diagnosis and the importance of early adequate therapy. METHODS AND RESULTS: Neurosarcoidosis was diagnosed in seven patients (4 men and 3 women) from a total number of 211 patients with sarcoidosis in 1977 to 1993. The mean age of the patients with neurosarcoidosis was 47 years. In six patients affection of the nervous system was the first clinical manifestation of the disease. In four patients it was paresis of the facial nerve, in two instances diabetes insipidus, in two instances affection of the spinal cord with subsequent spastic triparesis or paraparesis of the lower extremities, in one instance the disease was manifested by neuralgia of the trigeminal nerve. The serious character of the disease is apparent from the fact that only in two instances complete regression of symptoms occurred. In three patients regression was partial, in one instance the affection persisted without changes and in one instance it progressed to metabolic breakdown with a fatal outcome. In the differential diagnosis examination of the nervous system by computed tomography, magnetic resonance and possibly perimyelography proved to be helpful. In all instances there was a typical finding in cerebrospinal fluid. Lymphomonocytic pleocytosis was present, a raised protein content, elevated gammaglobulin levels. The diagnosis was assisted by radiograms of the chest and biopsy. The latter was made from intrathoracic or subcutaneous nodes, in one instance from muscle. As auxiliary methods the following were used: tuberculin test, bronchoalveolar lavage, pulmonary gallium scintigraphy, serum level of angiotensin converting enzyme and immunological examination. CONCLUSIONS: The authors emphasize the necessity of early diagnosis and intensive initial treatment with corticoids or antimalaria drugs, which may prevent the development of irreversible changes. Magnetic resonance appears to be the most promising examination method in neurosarcoidosis.

Adult↗
PubMed1996

CT and MRI findings after stereotactic resection of brain lesions.

OBJECTIVE: To describe postoperative CT and MRI findings and their time course in uncomplicated cases after stereotactic volumetric resections of brain lesions. MATERIALS AND METHODS: One-hundred twenty-eight imaging studies (CT, 86; MRI, 42), performed 6 h to 2 years after 52 stereotactic operations, were retrospectively reviewed and analyzed in relation to time of surgery in cases without complications. RESULTS: The extent of resection bed did not change during the first week after operation; reduction of size then began and continued up to 3-6 months. Mass effect and edema showed no changed during the first 4 days, then later regressed gradually. Pneumocephalus was found in 58% of cases in the first 3 weeks, but never later. Benign, surgically-induced enhancement appeared at the margins of encephalotomy and retractor at the end of the first postoperative week, became more prominent during the following weeks, and lasted up to 3-5 months. In the majority of cases enhancement prevented recognition of the residual tumor. Dural enhancement was observed at the craniotomy site very early after the operation and persisted up to 1 year. Meningeal enhancement over convexities was found in 44% of MRI studies. CONCLUSION: Extent of the resection bed, mass effect, edema, and pneumocephalus show, in uncomplicated cases, a regular regression during the postoperative period. The time course of enhancement is complex and can be a source of diagnostic misinterpretation.

Brain↗
PubMed1996

Osteochondroma of the thoracic spine: an unusual cause of spinal cord compression.

A 24-year-old man with hereditary multiple exostoses had numbness of the lower extremities and difficulty walking. CT displayed a calcified extradural mass lesion within the spinal canal at T-8 causing cord compression. MR imaging showed it to be contiguous with the upper endplate of T-8, suggesting the diagnosis of osteochondroma, a rare cause of cord compression, and distinguishing the lesion from a calcified disk fragment.

Adult↗
PubMed1995

Relationship between the gas composition of the middle ear and the venous blood at steady state.

Concomitant continuous measurements of the steady-state gas composition of the middle ear and of the venous blood were recorded by mass spectrometry in four guinea pigs. The following mean values were obtained for the partial pressures of middle ear gases; nitrogen + argon, 606.4 mm Hg; oxygen, 46.2 mm Hg; and carbon dioxide, 60.2 mm Hg. The corresponding values for the venous blood were as follows: Nitrogen + argon, 563.4 mm Hg; oxygen, 38.0 mm Hg; and carbon dioxide, 61.4 mm Hg. The similarity of the steady-state gas composition of the middle ear to that of the venous blood suggests that the partial pressures of the gases in the middle ear are controlled by interchange with gases present in the blood.

Animals↗
PubMed1995

Direct demonstration of gas diffusion into the middle ear.

The gas composition of the middle ear differs from that of air, and resembles the gas composition of mixed venous blood. This observation suggests the existence of a bi-directional route for gas diffusion between the middle ear and blood. In an attempt to demonstrate this route in a direct way, we tracheotomized guinea pigs in such a way that they breathed freon-22 directly into the distal part of their tracheostomy. The proximal part of the trachea was sealed so that air by-passed the oropharynx and nasopharynx, thus preventing freon-22 from making contact with the eustachian tube orifice. At the same time middle ear gases were monitored with a mass spectrometer, through a measuring probe which was inserted into a hole in the bulla. The appearance of freon-22 in all middle ears--after 8 min on the average--demonstrated direct gas diffusion from the blood into the middle ear, since freon-22 could reach the middle ear only from the blood stream, i.e., by diffusion. Differences in gas diffusion rates into and from the middle ear may therefore play a role in regulating middle ear gas economy, and therefore in middle ear pressure.

Animals↗
PubMed1995

[Congenital dyserythropoietic type II anemia complicated by extramedullary hematopoiesis in the posterior mediastinum].

In a 48-year-old woman investigated on account of congenital dyserythropoietic anaemia type II (HEMPAS) on the X-ray of the chest a polycystic sharply defined shadow in the posterior mediastinum was detected and extramedullary haematopoiesis was suspected. The diagnosis was confirmed cytologically. According to the authors' knowledge this is the second case of this rare complication in CDA-II in the world and the second case of EMH in the mediastinum in this country. In the discussion the authors summarize the diagnostics of congenital dyserythropoietic anaemias. They discuss also the pathogenesis of extramedullary haematopoiesis, diagnosis and differential diagnosis of EMH in the posterior mediastinum, possible complications and treatment.

Adult↗
PubMed1994

[Prenatal cytogenetic diagnosis of trisomy 21 using amniotic fluid cells].

BACKGROUND: Trisomy 21 is the most frequent chromosomal disorder which is associated with advanced maternal age. OBJECTIVES: The aim of our work was to examine the risk of trisomy 21 occurrence in a group of pregnant women subdued to prenatal cytogenetic examination. METHODS: The examined group consisted of 1128 pregnant women. The cells for cytogenetic analysis were obtained by means of transabdominal amniocentesis during the second trimester of pregnancy. Cultivation of amniocytes lasted 15-20 days. The chromosomes were stained by a conventional and G-striping method. RESULTS: Cytogenetic analyses have indicated that the aberrant karyotype was present in 32 (2.82%) out of 1128 fetuses. In addition the results have confirmed that trisomy represented the most frequent chromosomal aberration (60%) detected by means of prenatal cytogenetic diagnostic examinations and the risk of its incidence increased exponentially in women who were older than 35 years of age. CONCLUSIONS: The prenatal cytogenetic diagnosis represents a significant role in the prevention of hereditary conditioned chromosomal disorders. (Tab. 1, Fig. 1, Ref, 13.)

Amniocentesis↗
PubMed1994

Integrated ambulatory care resource scheduling in oncology.

In a modern managed-care environment, the scheduling of ambulatory care activities must be viewed as a series of closely related activities rather than a group of unique and independent events. These activities must be sequenced in a logical manner, and linked with a variety of information on other clinical, operational, and administrative activities. This article focuses on such an integrated scheduling system which supports the ambulatory care services at the Johns Hopkins Oncology Center.

Ambulatory Care Information Systems↗
PubMed1993

Interaction of cycloalkanoprogesterones with mammalian progesterone receptor: binding of pregna-D'-pentaranes in the calf uterine cytosol.

Pregna-D'-pentaranes (pentaranes) are modified progesterones with demonstrable progestational activity and contraceptive effect. We have examined the steroid binding characteristics of the two newly synthesized progesterone analogs, Pentarane A (16 alpha, 17 alpha-cyclohexanoprogesterone) and Pentarane B (6 alpha-methyl, 16 alpha, 17 alpha-cyclohexanoprogesterone), and studied the nature of their interaction with progesterone receptor (PR) from the chicken oviduct and the calf uterine cytosols. Pregna-D'-pentaranes exhibited no affinity for the chick PR but interacted with the calf uterine PR as did R5020. The pentaranes, however, bound PR less tightly. R5020- or pentarane-bound PR sedimented as an 8S moiety in 8-30% linear glycerol gradients. Thermal transformation of receptor resulted in the reduction of the 8S form, and caused an increase in the binding of R5020- and progesterone-bound PR complexes to DNA-cellulose. The pentarane-bound PR bound poorly, if at all, to DNA-cellulose. Our data suggest that pentaranes exhibit both similarities and differences with natural and synthetic progestins with respect to their interaction with calf uterine PR. The lack of pentarane binding to chicken PR is reminiscent of the general phenomenon that antiprogestins (RU486, ZK98299, and Org 31710 and Org 31806) do not interact with chicken PR. Pentaranes, therefore, represent unique steroid analogs to investigate the molecular mechanism of steroid hormone action.

Animals↗
PubMed1993

High-resolution CT in the assessment of bronchiectasis in children.

To assess the possibilities and limitations of high-resolution CT (HRCT) in the evaluation of bronchiectasis in children, we conducted a prospective study of 20 children with clinical and/or chest film findings suggestive of this diagnosis. The 2-mm collimation, 4.3-s HRCT scans with 10 mm interslice spacing were obtained in areas of suspected bronchiectasis; in nonsuspect areas 25-30 mm interslice spacing was used. No preparation for examination was required. Bronchiectasis was revealed in ten patients (50%), being bilateral in four cases and unilateral in six cases. All types of bronchiectatic patterns were found. Cooperation during the examination was the only difference when compared with an investigation of adults. It was not a serious problem in children aged 7 years and older; scans in 6-year-old children were diagnostic but not ideal. Nondiagnostic scans were obtained in a 3-year-old girl. At the time of the scans only one patient had undergone surgery. Preoperative bronchography confirmed the CT findings. The authors conclude that HRCT can limit the need for bronchography in children with a CT finding of focal bronchiectasis in whom surgery is contemplated. When using longer scanning times it is not possible to obtain good results without sedation of children younger than 6 years.

Adolescent↗
PubMed1993

Diffuse interstitial lung disease--evaluation with high-resolution computed tomography.

We evaluated patterns of normal and abnormal lung parenchyma on standard 8-mm computed tomography (CT) scans, and 1-mm or 2-mm high-resolution CT (HRCT) scans in 22 subjects. There were five control subjects with no lung symptoms, and 17 patients with proved diagnosis of diffuse interstitial diseases consisting of sarcoidosis (n = 7), bronchioloalveolar carcinoma (n = 3), extrinsic allergic alveolitis (n = 2), asbestosis (n = 2), scleroderma (n = 2), and drug toxicity (n = 1). CT and HRCT scans were evaluated for specific parenchymal features particularly the distribution in secondary pulmonary lobule; conditions of pleura, mediastinum, and thoracic wall were appreciated. CT and HRCT findings were described in individual disease. We believe that CT and HRCT are useful investigations in patients with suspected or known diffuse interstitial lung diseases. At present time CT, and particularly HRCT seem to be the best available method to image the lung parenchyma.

Adult↗
PubMed1993

[Prenatal cytogenetic diagnosis in older pregnant women].

The paper deals with the genetic risk of advanced age of women assessed on the basis of prenatal cytogenetic analysis during the second trimester of gestation. The examined group comprised 614 pregnant women older than 35 years. The cells for chromosomal analysis were obtained by transabdominal amniocentesis during the 16th to 18th week of gestation. Cytogenetic examination revealed that the general risk of an aneuploid foetus in women of more advanced age is 2.12% and the most frequently encountered chromosomal aberration was trisomy 21 which was confirmed in 1.30 cytogenetically examined foetuses.

Adult↗
PubMed1992

Clinical characteristics of patients in studies of left ventricular dysfunction (SOLVD).

The Studies of Left Ventricular Dysfunction (SOLVD) trials were designed to evaluate the effects of enalapril on long-term mortality in patients with severe left ventricular (LV) dysfunction. Patients with LV ejection fractions less than or equal to 0.35 and symptoms of congestive heart failure (CHF) were enrolled in the treatment trial, whereas those with no history of overt CHF and taking no treatment directed for LV dysfunction were enrolled in the prevention trial. The baseline clinical characteristics of SOLVD patients were compared to characterize differences between patients in these 2 separate but concurrent trials. From over 70,000 patients screened with LV dysfunction, 4,228 patients were enrolled in the prevention trial and 2,569 patients in the treatment trial. Ischemic heart disease was the primary cause of LV dysfunction in both prevention (83%) and treatment (71%) trial patients. Prior myocardial infarction was present in 80% of the prevention and 66% of the treatment trial patients (p less than 0.001). In the prevention trial, infarction was recent (less than or equal to 6 months) in 27% patients and remote (greater than 6 months) in 57% patients. Treatment trial patients had proportionately more women (20 vs 13%; p less than 0.001) and non-Caucasians (20 vs 14%; p less than 0.001), as well as the coexisting risk factors of hypertension (42 vs 37%; p less than 0.001) and diabetes (26 vs 15%; p less than 0.001) than did prevention trial patients. Clinical characteristics of patients in both trials were influenced by the gender and race of enrolled patients. Similarly, coronary artery bypass surgery was performed less often in women and non-Caucasians.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗