Chemodectoma secreting carotid glomus: characteristics and contribution of magnetic resonance imaging. Apropos of 2 cases

Nurses must become aware of the high number of women affected by substance abuse during the childbearing years and the related health consequences. Health care providers also need to develop and maintain a positive attitude toward mothers who use cocaine, assess the needs of each individual mother and her infant, and become familiar with a wide range of available resources to address the identified needs of these multirisk families. Finally, nurses can assist families with a history of maternal cocaine use by supporting the development of appropriate parenting skills. Part 2 will describe strategies for nurses to work with mothers and children in the next issue of Pediatric Nursing.     

The clinical utility of magnetic resonance imaging in 3-dimensional treatment planning of brain neoplasms

Results of the clinical experience gained since 1986 in the treatment planning of patients with brain neoplasms through integration of magnetic resonance imaging (MRI) into computerized tomography (CT)-based, three-dimensional treatment planning are presented. Data from MRI can now be fully registered with CT data using appropriate three-dimensional coordinate transformations allowing: (a) display of MRI defined structures on CT images; (b) treatment planning of composite CT-MRI volumes; (c) dose display on either CT or MRI images. Treatment planning with non-coplanar beam arrangements is also facilitated by MRI because of direct acquisition of information in multiple, orthogonal planes. The advantages of this integration of information are especially evident in certain situations, for example, low grade astrocytomas with indistinct CT margins, tumors with margins obscured by bone artifact on CT scan. Target definitions have repeatedly been altered based on MRI detected abnormalities not visualized on CT scans. Regions of gadolinium enhancement on MRI T1-weighted scans can be compared to the contrast-enhancing CT tumor volumes, while abnormalities detected on MRI T2-weighted scans are the counterpart of CT-defined edema. Generally, MRI markedly increased the apparent macroscopic tumor volume from that seen on contrast-CT alone. However, CT tumor information was also necessary as it defined abnormalities not always perceptible with MRI (on average, 19% of composite CT-MRI volume seen on CT only). In all, the integration of MRI data with CT information has been found to be practical, and often necessary, for the three-dimensional treatment of brain neoplasms.     

Clinical correlation of neuropsychological tests with 1H magnetic resonance spectroscopy in hepatic encephalopathy

The mortality from coronary and cerebrovascular diseases is higher in Finnmark County than in other Norwegian counties. In a population-based cohort study, we compared the incidence of myocardial infarction, stroke, and diabetes mellitus in different ethnic groups in Finnmark. A total of 10,622 subjects of Norse, Sami, and Finnish origin were followed for 14 years. During approximately 150,000 person-years, we identified 509 and 84 cases of myocardial infarction, 107 and 75 cases of stroke, and 96 and 73 cases of clinical diabetes mellitus among men and women, respectively. A total of 533 men and 199 women died. Norse subjects born outside of Finnmark had the most favorable risk factor levels and, in general, the lowest incidence of disease. Men of Finnish origin had a higher incidence rate of all endpoints than other men, and Finnish women had a higher incidence rate of myocardial infarction than other women. Sami women were more obese but did not have a higher diabetes mellitus incidence than other women. After adjustment for major cardiovascular risk factors and height, most ethnic differences were attenuated.     

Blount''s disease: magnetic resonance imaging

He often begins to answer before you have finished asking your question, but his replies are to the point. He speaks with emotion about the people he hopes to help, particularly children with fatal genetic diseases. 'I prefer to do something: the outcome of doing nothing is perfectly clear', he says. He began sequencing human genes while others were discussing how and when to do so. His methods have been called inelegant, redundant, wasteful, and too 'industrial'. Will his method fail to detect some infrequently transcribed genes? That's all right with him. He is not concerned with finding all the human genes, but rather with the fastest possible route to a useful catalog of most human genes.     

Computerized tomography and magnetic resonance in the diagnosis of recurrent rectal neoplasms: comparison of reliability and errors of both methods

From two areas in the Province of Padova, we selected 2,283 male farmers who worked either in cattle raising or in crop/orchard cultivation. There were 422 cohort deaths from 1970 to 1992. Using the regional population as a reference, the standardized mortality ratio (SMR) was calculated, with 95% confidence intervals (CI) based on the Poisson distribution. Cancer mortality was significantly reduced among the 1,561 dairy farmers (SMR = 0.65; CI = 0.53-0.81); there was a significant decrease in lung cancer (SMR = 0.49; CI = 0.31-0.74), whereas a significant increase from brain tumors was found (SMR = 2.83; CI = 1.04-6.17). Neither overall cancer mortality nor the lung cancer SMR deviated significantly from unity for the 722 crop/orchard farmers. Among dairy farmers, moreover, lung cancer SMRs showed a significant downward trend across the quartiles of increasing length of work, 0.96 in the first quartile, and 0.48, 0.40, and 0.25 in the second, third, and fourth quartiles, respectively. Moreover, lung cancer risk decreased with increasing farm land area, with SMRs in the quartiles of 0.89, 0.37, 0.41 and 0.19. This decrease cannot be attributed to either a selection (healthy worker effect) or a confounding (lower percentage of smokers) bias. Nor was it due to an artifact introduced by differences in age distribution among the quartiles. Dairy farmers are known to be exposed to higher airborne endotoxin concentrations; reasonably, this cumulative exposure increases further with years of work and area of farm. Endotoxins may have protected the dairy farmers against lung cancer through the tumor necrosis factor produced by alveolar macrophages.     

Magnetic resonance imaging of primary skeletal neoplasms

The primary role of magnetic resonance (MR) imaging of skeletal neoplasms is that of staging. Understanding the staging process and selection of the proper imaging planes and pulse sequences is essential for proper staging. To date, image features are not specific for histologic type. In addition, there are still pitfalls with MR imaging for evaluating recurrent tumor or following therapeutic response to treatment. Dynamic gadolinium studies and spectroscopy may improve the future overall specificity for MR imaging.     

Magnetic resonance staging of neoplasms of the uterus

The treatment of patients with uterine neoplasms may be significantly altered by the stage of disease at the time of diagnosis. A noninvasive and accurate means of staging these tumors is therefore desirable. This article discusses the magnetic resonance imaging techniques and findings that are essential for the accurate staging of uterine neoplasms. The imaging findings are presented following a discussion of the histopathologic findings, clinical presentation, diagnosis and staging, pathways of tumor spread, and treatment of each neoplasm. A comparison of magnetic resonance and other imaging techniques is also provided.     

Pulmonary veins: magnetic resonance angiography anatomy

OBJECTIVES: This study was undertaken to investigate the relation between dietary fat composition and adiposity in adult men. SUBJECTS: A sample of 128 male subjects who participated in Phase 2 of the Québec Family Study. DESIGN: The association between adiposity and total dietary fat intake (TFI), saturated fat intake (SFA), monounsaturated fat intake (MUFA) and polyunsaturated fat intake (PUFA) was analyzed in the overall sample. A comparison of body fatness was also performed between consumers of high (4th quartile) and low amounts (1st quartile) of TFI, SFA, MUFA and PUFA. RESULTS: Significant positive correlations were found between the percentage of dietary energy as total fat and body fatness. Men in the upper quartile of TFI displayed significantly more adiposity than those in the lower quartile. Significant differences were also observed when quartiles were established using SFA and MUFA. However, higher intakes of PUFA had no statistical effects on adiposity. CONCLUSION: These results confirm the notion that high fat diets might lead over time to excess body fat deposition. SFA and MUFA intake also seem to be predictors of actual adiposity markers while high PUFA intake seems to exert no effect on these markers.     

Characterization of polyimides by 13C and 1H solid state nuclear magnetic resonance

The polyimides LaRC-TPI, LaRC-IA and LaRC-SI and related model compounds were investigated using 13C and 1H nuclear magnetic resonance (NMR). Magic angle spinning was used to acquire 13C isotropic chemical shift spectra of these materials. The spectra were assigned as completely as possible. In addition, the principal components of some shielding tensors were measured using variable angle correlation spectroscopy (VACSY). Of those studied, LaRC-SI is the only polymer that is soluble. However, after it is heated past its glass transition temperature, LaRC-SI becomes insoluble. Experiments were performed in an attempt to identify causes of this behavior. When magnetization from nuclei in rigid regions of the polymer is suppressed, the 1H and 13C NMR spectra of soluble LaRC-SI are significantly different from those of insoluble LaRC-SI. Hydration studies of LaRC-SI show that absorbed water plasticizes the polymer.     

Torsion of an accessory hepatic lobe in a child: ultrasound, computed tomographic, and magnetic resonance imaging findings

A case of acute epigastric pain resulting from torsion of an accessory hepatic lobe is reported. Sonographic, computerized tomographic, and magnetic resonance findings are illustrated and the surgical management is discussed.     

Cardiac magnetic resonance spectroscopy

The article reviews cardiac magnetic resonance spectroscopy (MRS) in Canada. 31P MRS has been used to study cardiac energetics and intracellular pH in hearts subjected to ischemia-reperfusion and to evaluate the effects of pharmacological interventions. 23Na, 87Rb, and 7Li MRS have provided unique probes to study ion balance and fluxes in intact tissue under normal and stressful physiological conditions. 1H MRS has been used to monitor the accumulation of lactate and lipids in hearts subjected to ischemia-reperfusion and follow the effects of diet on cardiac lipid levels and function. The isolated rat heart has been used most commonly to study the effects of pharmacological agents on energy balance, pH, ion fluxes, and contractile function of the heart subjected to ischemia-reperfusion. The pig heart has been developed as an alternative to the rodent heart because its metabolism is more similar to that of the human heart. Human atrial appendages have been useful in evaluating the effects of preservation strategies (temperature, composition of preservation solutions) on energy levels. The pig heart model has been useful in evaluating the effects of preservation solutions on cardiac function of hearts destined for transplantation. An isolated blood-perfused pig heart model has been developed to assess the effects of cardioplegic strategies on the preservation of contractile function of hearts following surgery on the heart. An in vivo canine model has been used to study myocardial infarction and the effects of therapies to reduce the infarct zones and areas of the heart at risk of infarction. Studies of human hearts in vivo have provided insight into the metabolic adaptations that occur in individuals living at high altitudes.     

Breast magnetic resonance imaging

Breast MRI is becoming an important tool for the improved management of breast cancer. The technical attributes of high contrast, high-resolution breast MRI acquisitions are summarized. The fundamentals of image interpretation are outlined, including lesion enhancement, morphological features, and extent categories. The indications for breast MRI include compromised mammography, staging of disease within the breast and adjacent structures, difficult histology, and other special diagnostic situations. Patients with compromised mammography include previous surgery, radiographically dense breasts, and silicone augmentation. The improved determination of disease extent aids in the management of breast conservation treatment. Certain lesions, particularly lobular carcinoma and ductal carcinoma in situ, can be better managed with the information available with breast MRI. Other potential indications are also discussed, including patients presenting with positive axillary nodes and no known primary, women with a high risk of malignancy, and recently postoperative breasts with positive margins. The need for MRI stereotaxis is reviewed, with indications and potential solutions. The potential future roles for MRI-directed interstitial hyperthermia are outlined.     

Principles of magnetic resonance angiography

A strongly fluorescing 7-hydroxycoumarin (umbelliferone, U) oxidized in dilute (10 mumol/L-O, 1 mol/L) aqueous solution with CIO- or CIO- + H2O2 (but not with H2O2 alone) produces a strong chemiluminescence (CL). Light emission kinetics depends on the pH of solution (4.0-10.5) and the reaction has a low activation energy Ea = 31 +/- 2 kJ/mol (285-310 K). The spectrum covers the fluorescence of umbelliferone (400-550 nm, lambda max 460 nm). No red emission typical of 1 delta g, 1 sigma g, 1 sigma+g (O2)2 is observed either in the umbelliferone+CIO- or the umbelliferone +CIO- + H2O2 solution. The possible mechanism of CL and concomitant degradative oxidation of umbelliferone is discussed.     

The role of dynamic contrast magnetic resonance tomography in the complex radiation diagnosis of focal hepatic lesions

The results of complex radiation study of 269 patients with various focal hepatic diseases were analyzed. Present day methods of radiation study were used. Dynamic contrast magnetic resonance imaging (DCMRI) was made in 62 patients. It is concluded that DCMRI is higher sensitive in detecting focal hepatic diseases than other techniques. The time course of changes in signal intensity in different abnormalities greatly differs in quantitative and qualitative parameters, which differentiates the nosological nature of the revealed changes to a high accuracy.     

Idiopathic hypophyseal hyperplasia: diagnosis by magnetic resonance

INTRODUCTION: Hypophyseal hyperplasia is an uncommon disorder in which the gland increase in size due to excessive proliferation of strings of normal cells, which usually secrete prolactin. Different aetiologies may cause this disorder of the hypophyseal gland. However, in a small number of cases the hyperplasia is not due to any of these aetiologies and is therefore known as idiopathic hypophyseal hyperplasia. There are few references in the literature to idiopathic hypophyseal hyperplasia with hyperprolactinaemia. Usually diagnosis is reached after treatment for a hypophyseal adenoma, since the clinical features are similar. CLINICAL CASES: We present three cases seen in our department, in which hormone and endocrine studies were done to exclude known causes of hyperplasia, together with CT and MR scans. We analyzed the behaviour of hypophyseal hyperplasia by using imaging techniques, and the differential aspects with regard to hypophyseal adenomas. Firm diagnosis is only made on anatomopathological study of the hypophysis. However, we consider that sound knowledge of the characteristics of this condition may help to establish the correct diagnosis and thus avoid unnecessary surgery. CONCLUSIONS: We review the information published in the literature on this subject, emphasizing the importance of differential diagnosis by means of imaging techniques.     

Cat scratch disease: magnetic resonance imaging findings

Cat scratch disease is an infectious lymphadenitis frequently occurring in children and adolescents. We present the magnetic resonance imaging findings of two patients with this disease. In both cases, lymphadenopathy was characterized by extensive stranding of the surrounding soft tissues, consistent with the inflammatory nature of this condition. Magnetic resonance imaging can be diagnostic and may obviate the need for invasive means of evaluation in patients suspected of having cat scratch disease.     

Mastocytosis: magnetic resonance imaging patterns of marrow disease

To investigate the validity of the prediction of body water compartments by multi-frequency impedance in Indonesians, 42 adults (19 males and 23 females) were recruited in Jakarta, the capital of Indonesia. Extracellular water (ECW) and total body water (TBW) were measured with dilution techniques and predicted from body impedance at 1 and 100 kHz, respectively, using prediction formulas developed in a Dutch population. Furthermore, body weight, body height and body density were measured and as a measure of body build TBW/height and ECW/height were calculated. Percent ECW of body weight in both males (26 +/- 3%) and females (23 +/- 2%) was higher compared to the Dutch reference population, and also the body water distribution (ECW/TBW) was higher (0.46 +/- 0.04) compared to the reference population. TBW/height and ECW/height appeared to be considerably lower in the Indonesian group compared to the reference group, indicating a more slender body shape. TBW was overestimated by 1.8 +/- 2.4 and 2.5 +/- 1.3 kg in males and females, respectively. ECW was underestimated in males by 0.1 +/- 1.2 kg and slightly overestimated in females (0.1 +/- 1.0 kg). After corrections for differences in body build and body water distribution the bias of the predicted TBW was markedly reduced from 2.2 +/- 1.9 to 1.3 +/- 1.8 kg (males and females combined). For ECW the bias after correction for body water distribution and body build was 0.3 +/- 0.6 kg (males and females combined). It is concluded that multi-frequency impedance is suitable for the prediction of body water compartments at the population level but, due to differences in body build and body water distribution, validation in a larger group of Indonesian subjects is needed to avoid systematic prediction errors.