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Biomedical subjects

A Piepsz

Publications and source records attributed to A Piepsz.

At least 109 records · Page 6Linked to original sources
PubMed1991

Estimation of glomerular filtration rate in infants and in children using a single-plasma sample method.

This work was undertaken to look for distribution volume-plasma clearance converting equations(s) that can be used to estimate glomerular filtration rate (GFR) in children. GFR calculated using the two-blood sample slope-intercept method was used for comparison. It was shown that the 2-hr distribution volume and the two-blood sample clearance were closely related. For all the age groups, the coefficient of correlation between these two parameters was high (range: 0.95 to 0.99) and the s.e.e. was low (range 0.76-3.86 ml/min). It was also shown that a linear equation (GFR = 2,602 V120-0,273) could be used to convert the two hour distribution volume into an accurate estimate of two-blood sample GFR whatever the age of the patient. The use of the single-sample technique for measuring GFR in children is therefore recommendable.

Adolescent↗
PubMed1991

Normative data for lumbar spine bone mineral content in children: influence of age, height, weight, and pubertal stage.

In 136 normal growing children between the ages of 1 and 18 yr, bone mineral content (BMC) at the level of the lumbar spine (L2-L4) was determined with a commercial dual-photon absorptiometer. BMC was calculated as BML (BMC per unit length) and BMD (BMC per unit surface). The mean lumbar spine BML of the studied children (2.53 +/- 0.86 gHA/cm) was significantly lower than the spinal mineral content of adults (4.26 +/- 0.57 gHA/cm). No sex difference existed in lumbar spine BMC. BML as well as BMD were highly dependent on age, body height, and body weight. During the prepubertal years, BML and BMD increased in a fairly rectilinear pattern. During puberty, BMC increased more rapidly: 40% for BMD and 77% for BML. For the entire group, the increase in BMC with age, height, and weight was best predicted by an exponential regression line analysis.

Absorptiometry, Photon↗
PubMed1990

A radiopharmaceuticals schedule for imaging in paediatrics. Paediatric Task Group European Association Nuclear Medicine.

There is no standard schedule for the amounts of radiopharmaceutical administered to children at present. Various alternative methods are currently in practice, all with some support from the literature. Optimization of the amount of radiopharmaceutical to be administered is discussed in relation to the radiation burden of such an examination. The Paediatric Task Group of the European Association of Nuclear Medicine has investigated the current situation and now suggests a method for standardization of administered amounts of radiopharmaceutical in paediatrics. The fraction of the adult amount of radiopharmaceutical to be administered should be calculated from the child's body weight according to the accompanying table. In small infants, the minimum amount of a radiopharmaceutical is discussed and suggested amounts to be administered are presented.

Body Weight↗
PubMed1990

99mTc-DMSA scintigraphy in acute urinary tract infection in children.

24 children with symptomatic urinary tract infection (UTI) underwent systematically ultrasound studies (US) and 99mTc-DMSA renal scans. Among the 15 patients considered as acute pyelonephritis (APN) on clinical grounds, the scan was abnormal in 12 cases, in contrast with only 1 abnormal scan in the clinical subgroup of the lower UTI. Among the 10 abnormal scans that were repeated later on, 6 did completely normalize. US showed only once a parenchymal appearance suggestive for APN. Our findings suggest that the DMSA scan has to be considered at present as the most sensitive imaging technique for the detection of APN.

Acute Disease↗
PubMed1990

Consolidating the role of *I-MIBG-scintigraphy in childhood neuroblastoma: five years of clinical experience.

In recent years, *I-MIBG (*I-metaiodobenzylguanidine), which is transported and stored in the chromaffin cells, has been shown to allow good visualization of neuroblastomas in children. This paper deals with 30 *I-MIBG-scans performed in 20 children: 16 with neuroblastoma, 3 with retinoblastoma, and 1 with a malignant paraganglioma. A high detection rate was found for both primary and secondary sites of neuroblastoma. *I-MIBG was generally superior to 99mTc-MDP bone scintigraphy in the detection of bone metastases. Our experience illustrates the unique place of *I-MIBG-scintigraphy compared with other imaging techniques: it makes it possible to define the nature of the tumour, particularly in cases with normal catecholamine levels; to establish how extensive the lesions are at the time of diagnosis; and to confirm complete remission. No abnormal *I-MIBG uptake was noted in the 3 cases of retinoblastoma.

3-Iodobenzylguanidine↗
PubMed1990

Unusual Tc-99m MDP and I-123 MIBG images in focal pyelonephritis.

A 6-year-old boy presented with an inflammatory syndrome. Because Tc-99m MDP bone scintigraphy revealed increased tracer uptake at the upper pole of the right kidney, further studies were oriented towards a diagnosis of renal or adrenal pathology. I-123 metaiodobenzylguanidine (MIBG) accumulated at the site of the abnormal MDP uptake. The diagnosis of neuroblastoma or allied disorder was excluded on the basis of other investigations and further evaluation, suggesting that the MIBG uptake was a false-positive. Findings on clinical imaging, laboratory findings, Tc-99m DMSA imaging, sonography, and CT scanning were highly suggestive of acute focal pyelonephritis.

3-Iodobenzylguanidine↗
PubMed1990

Caustic ingestion and esophageal function.

The aim of the present study was to investigate esophageal motor function by means of krypton-81m esophageal transit scintigraphy and to compare the results with the functional and morphological data obtained by means of triple lumen manometry and endoscopy. In acute and subacute stages of the disease, all clinical, anatomical, and functional parameters were in good agreement, revealing significant impairment. In chronic stages, the severity of the dysphagia was not correlated to the importance of the residual stenosis. Conversely, 81mKr esophageal transit and manometric's findings were in good agreement with the clinical symptoms, during the entire follow-up period ranging between 3 months to 7 years. The 81mKr test is undoubtedly the easiest and probably the most physiological technique currently available for long-term functional evaluation of caustic esophagitis.

Accidents, Home↗
PubMed1990

Cerebral palsy: initial experience with Tc-99m HMPAO SPECT of the brain.

The outlook for children with cerebral palsy is determined by the severity of motor problems and the presence of associated disabilities, in which early detection remains a medical challenge. The authors studied 13 children (aged 13 months to 12 years) with cerebral palsy by means of single photon emission computed tomography (SPECT) of the brain with technetium-99m hexamethylpropyleneamineoxime (HMPAO). In all children with hemiplegia, SPECT demonstrated hypoperfusion in the hemisphere contralateral to the motor deficit. SPECT demonstrated normal findings in patients with mild diplegia; bilateral hypoperfusion in the superior motor cortex in patients with moderate di- or tetraplegia; and bilateral reduction of perfusion in the superior motor, inferior motor, prefrontal, and parietal cortices in patients with severe di- or tetraplegia. Results suggest that Tc-99m HMPAO SPECT of the brain is a valuable complementary tool for thorough neurologic assessment in cerebral palsy.

Brain↗
PubMed1990

Effect of background correction on separate technetium-99m-DTPA renal clearance.

The estimation of the background constitutes the main difficulty in the accurate determination of the separate renal clearance, using the 99mTc-DTPA complex and the gamma camera. This is due to the low extraction rate of DTPA, giving an unfavorable signal-to-noise ratio, and to the fact that no background area can accurately represent both interstitial and vascular components of the renal curve. Several algorithms have been proposed in the literature for solving the problem of background but their effect on the calculated clearance value has not been sufficiently assessed. In this paper, it has been possible, using a theoretical approach, to predict the respective influence of the different algorithms on the renal clearance. These results were confirmed on the basis of clinical data obtained from 53 renal studies. It was shown that a double background correction, using successively the area ratio method followed by a linear fit method, is probably the most precise method and is less dependent on the choice of the background area.

Algorithms↗
PubMed1990

[I-MIBG scintigraphy in the diagnosis of neuroblastoma in children].

Since the early eighties, *I-MIBG (= *I-metaiodobenzylguanidine), which is stored in the neurotransmitter storage granules of chromaffin cells, has been increasingly used for the detection of pheochromocytomas and allied sympathoadrenal pathologies. The aim of this paper is to illustrate, by means of clinical examples, the role of *I-MIBG-scintigraphy in child neuroblastoma and to underline its original place, compared with other imaging techniques, in determining the neuro-ectodermal origin of a tumor as well as in establishing the extension of the lesions at the time of diagnosis and during follow-up.

3-Iodobenzylguanidine↗
PubMed1989

Per rectal thallium scintigraphy for the assessment of portosystemic shunt: an experimental study in the bile duct ligated rats.

Bile duct ligated rats (n = 7) have been investigated for 6 months. Two patterns of evolution have been observed: (i) progressive development of cirrhosis and portosystemic shunt (detected by 201Tl per rectal scintigraphy) in three animals, (ii) repermeabilization of the biliary tract in four animals. Despite the small number of animals investigated, the 201Tl per rectal scintigraphy seems to be a good indicator of portosystemic shunt secondary to biliary cirrhosis.

Administration, Rectal↗
PubMed1989

Muscular injury in a child diagnosed by 99mTc-MDP bone scan.

An 11-year-old boy had bone scanning to rule out an osseous lesion of the right arm. He presented progressive pain and hard swelling of the right arm. His past medical history and general physical examination were unremarkable. He trained for karate. The scan demonstrated considerable muscular uptake in both arms. CPK and CPK MB levels were both abnormally high, suggesting muscle injury. After a 10-day rest period the bone scan returned to normal.

Arm Injuries↗
PubMed1989

Prospective management of neonates with pelviureteric junction stenosis. Therapeutic strategy based on 99m Tc-DPTA studies.

A prospective therapeutic strategy based on separate glomerular filtration rate (SGFR) was evaluated in 14 prenatally detected asymptomatic neonates, suspected of having pelviureteric junction obstruction. The patients with low SGFR were referred for pyeloplasty with the hope to improve the renal function. A marked improvement occurred in only one patient, although the drainage function (furosemide test) did improve in all cases. A conservative attitude was adopted for those children with normal SGFR. In 6 of them, a progressive increase of SGFR was noted, related to the normal maturation of the function, followed by a stabilization in the normal range. In 1 patient, a sudden decrease of SGFR was observed around 1 year and the patient was shifted into the surgical group. In this patient, an initial partial response of the kidney to a furosemide injection changed into a persistent non-response, whereas in the other non-operated patients, partial or good response was always recorded, although the responses were essentially variable on successive tests. On the basis of these data, the protocol was slightly modified, the patients with persistent non-response to furosemide after 6 months of life being shifted to the surgical group.

Clinical Protocols↗
PubMed1989

Evaluation of oesophageal transit in patients with minor peptic oesophagitis.

Fifty-one adult patients with complaints suggesting peptic oesophagitis were submitted within the same week to a radionuclide swallow test (OT), an endoscopy and a manometry in order to evaluate the incidence of oesophageal peristaltic abnormalities in patients with only minor peptic oesophagitis. In all patients with normal endoscopy, OT did not show any transit abnormality. In the patients with slight (Stage I) or moderate (Stage II) oesophagitis, OT was abnormal in 60% of the cases. The results were at least as good as those obtained by means of manometry and suggest that OT is an accurate method for the detection of slight impairment of oesophageal contractility.

Adult↗