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Biomedical subjects

M I Steinhardt

Publications and source records attributed to M I Steinhardt.

At least 19 recordsLinked to original sources
PubMed1990

Parotid gland enlargement in HIV infection: clinical/imaging findings.

Parotid gland enlargement with or without facial paralysis may be the presenting clinical manifestation of AIDS. Submandibular involvement may occur as well. Failure to recognize this association may lead to inappropriate or unnecessary intervention in the investigation and treatment of the salivary gland enlargement. In this paper, we discuss the role of imaging techniques in the investigation of salivary gland enlargement, and identify the specific radiologic signs found in HIV infection. Demonstration of intraparotid or submandibular gland cysts with focal intraparotid mass lesion(s) on imaging may help to differentiate parotid gland enlargement due to HIV infection from the many other causes of parotid enlargement.

Adult↗
PubMed1987

Mediastinal lymph node metastases from bronchogenic carcinoma: detection with MR imaging and CT.

Magnetic resonance (MR) imaging and computed tomography (CT) were compared in a prospective study of 48 patients for the detection of metastatic mediastinal lymphadenopathy from bronchogenic carcinoma. The images were interpreted by three experienced radiologists using a five-point rating scale, enabling receiver operating characteristic (ROC) analysis. Imaging results were evaluated against "truth" data based on analysis of surgical specimens from mediastinoscopy and thoracotomy. All MR images were cardiac gated to reduce cardiac motion artifacts in the mediastinum. MR and CT both performed well, as indicated by similar areas under the ROC curves of 0.779 +/- 0.039 for MR imaging and 0.781 +/- 0.038 for CT scanning. No strong correlation between nodal size and metastatic involvement could be found for either MR or CT results. As long as nodal size remains the sole criterion in the detection of metastatic mediastinal lymphadenopathy, MR imaging is unlikely to enable better interpretations than CT scanning.

Adult↗
PubMed1986

Thyroid cartilage imaging with diagnostic ultrasound. Correlative studies.

In 1976, Noyek observed that the thyroid cartilage framework of the larynx could be imaged by diagnostic ultrasound; the image appeared uniquely independent of the presence or absence of calcification. It was suggested that ultrasound, with its simple, nonroentgenographic, noninvasive features, might permit screening detection of thyroid cartilage destruction. It might, therefore, give direction to better computed tomographic (CT) imaging, and, specifically, more effectively identify T4 laryngeal cancer. Since that time, with improving generations of ultrasound transducers, more than 130 clinically correlated laryngeal ultrasound examinations have been recorded. Thirty CT, ultrasound, and pathologically correlated advanced cases of laryngeal carcinoma were critically evaluated by the Departments of Otolaryngology and Radiology at Mount Sinai Hospital, Toronto. Our diagnostic imaging approach has resulted in remarkably improved thyroid cartilage imaging by CT when "directed" by preliminary ultrasound.

Carcinoma↗
PubMed1986

Bilateral multilocular renal cysts.

Multilocular renal cystic disease is a rare, benign condition thought to occur unilaterally. We report a case of asynchronous, bilateral multilocular renal cystic disease, which suggests that unilaterality is not essential for diagnosis of this lesion.

Humans↗
PubMed1986

Schwannoma of the intrasternomastoid portion of the spinal accessory nerve: sophisticated preoperative CT diagnosis and appropriate surgical management.

Neurogenic tumors of the cervical portion of the cranial nerves are rare, and hence frequently misdiagnosed and mismanaged. A unique case of an isolated schwannoma of the spinal accessory nerve was correctly diagnosed by the constellation of signs demonstrated on a CT examination. This led to appropriate surgical removal with full motor nerve preservation. The primary purpose of this manuscript is to demonstrate the qualitative and quantitative radiologic signs indicative of the diagnosis and the surgical management resulting therefrom. The second more subtle purpose is to demonstrate the sophisticated clinical implications which can result from effective high-technology imaging.

Accessory Nerve↗
PubMed1984

Congenitally absent lumbar pedicle: a reappraisal.

Three patients who had a diagnosis of congenitally absent lumbar pedicle underwent CT examination. Findings showed that each patient had an aberrant hypoplastic pedicle plus a retroisthmic defect in the ipsilateral lamina rather than an absent pedicle. Axial CT was the diagnostic modality of choice; reformated images were of little value. The nature of the anomaly explains the difficulty in diagnosis by plain film radiography or tomographic study. The differential diagnosis to be considered from findings of plain film radiography includes pediculate thinning, neoplastic disease, neurofibroma, mesodermal dysplasia associated with neurofibromatosis, and vascular anomalies.

Adult↗
PubMed1983

Thyroid tumor imaging.

Clinical assessment of a patient with a focal or diffuse thyroid tumor is but the first step in diagnostic evaluation. The diagnostic imaging process augments information obtained by the inspecting eye and the palpating hand; it allows the qualification (for example, cystic v solid) and the quantification (for example, size, extension, and assessment of physiologic function) of the thyroid tumor mass. This diagnostic input allows the establishment of a more realistic provisional diagnosis and directs a rational treatment approach to the patient. This presentation reviews the major imaging modalities available for thyroid tumor evaluation: diagnostic ultrasound, radionuclide scans, and conventional radiology and computed tomography. The applications of these various modalities and their critical potentials and limitations are placed in a contemporary clinical setting. It is hoped that an increasing familiarity with these imaging modalities will give better direction to the specialist in otolaryngology--head and neck surgery and greater surgical benefit to his or her patients.

Adenocarcinoma↗
PubMed1983

Ludwig's angina following dental extraction as a cause of necrotizing mediastinitis.

A fatal case of Ludwig's angina is reported in which penicillin was used as the sole antibiotic. Bacteroides melanogenicus resistant by virtue of production of Beta-lactamase was present. It is suggested that a combination of penicillin and an antibiotic effective against anaerobes such as metronidazole is the most appropriate initial chemotherapy pending confirmation from the bacteriology laboratory.

Adult↗
PubMed1983

Giant leiomyoma of the esophagus.

A patient with a giant leiomyoma of the esophagus (1235 g) presented with persistent cough, intermittent fever, nocturnal pyrosis, and intermittent dysphagia for solid foods. Reconstruction after extirpation of the distal esophagus, the tumor, and the proximal stomach involved a Collis gastroplasty and a Nissen fundoplication using stapling technique. This combination of operations after resection was used to assure the best functional result possible in a young man with benign disease.

Adult↗
PubMed1982

CT of the larynx.

While conventional radiographic techniques are still of value in the radiologic work-up of the patient with laryngeal disease, computed tomography (CT) has assumed a dominant role, particularly in the pretreatment staging and post-treatment evaluation of the patient with cancer. Even prior to the present generation of high resolution, fast scan equipment, images were being generated that revealed information available in no other non-invasive way, offering two major advantages. Initially, CT's ability to depict cross-sectional (axial) anatomy allows the radiologist and surgeon to build a clear three dimensional image of the site and extent of disease. Secondly, CT discriminates small soft tissue density differences. Also, this latter capability allows a separation of lymph nodes and blood vessels if the study is done with intravenous contrast enhancement. These two outstanding imaging properties allow informed decisions to be made regarding the feasibility and/or extent of conservation or radical surgery in malignant disease and provide unique and critical information regarding cartilage and deep structures. Other advantages of varying importance include the speed of the examination, its noninvasive nature, and the comfort to the patient. This paper reviews normal CT anatomy and discusses, with illustrations, the major diagnostic applications of CT in laryngeal disease.

Carcinoma↗
PubMed1981

Spontaneous hypoglycemia associated with hemangiopericytoma of the kidney.

We report the third case of renal hemangiopericytoma associated with spontaneous hypoglycemia. The clinical and pathological features suggest that excessive glucose storage by the tumor is an important factor in the pathogenesis of the hypoglycemia. Other possible mechanisms producing hypoglycemia associated with mesenchymal tumors are reviewed.

Adult↗