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Biomedical subjects

A Piepsz

Publications and source records attributed to A Piepsz.

At least 163 records · Page 9Linked to original sources

A co-operative study on the clinical value of dynamic renal scanning with deconvolution analysis.

An international project was set up to study the clinical usefulness of intrarenal transit times derived from the renogram by deconvolution. A common data sheet, to collect clinical, biochemical, radiological and isotopic information, was completed by the centres. Five hundred and ninety-one patients were studied and the results analysed. The mean transit time (MTT) in normal kidneys was found to be 3.6 +/- 1.1 min. If the MTT is greater than 7.6 min, a kidney is likely to be obstructed. In vesico-ureteric reflux, the transit times are prolonged, but they are normal in infection, hypertension, parenchymal disease and minimally irradiated kidneys. In transplantation, when the kidney is normal, the transit times are shorter than in the natural kidney; in acute rejection, transit time are prolonged.

Adult↗

Gastroesophageal scintiscanning in children.

Four patients' positions were tested in search of increased sensitivity of gastroesophageal scintiscanning for the detection of reflux in children: supine, prone, left lateral, and 30 degrees right posterior oblique. The sensitivity was highest when the child was placed in supine position. A 60-min recording period increased the sensitivity of the technique, and is thus preferred to a shorter recording time.

Child↗

Gastro-oesophageal scintiscanning in children.

99mTc colloid scintigraphy is a sensitive technique for the detection of gastro-oesophageal reflux, compared to X-ray studies. A quantification index of reflux is used and can be of value when there is concern about the significance of a positive result. Continuous monitoring during one hour increases by 25% the detection of reflux in comparison with a 30 min test. In our series, no case of lung aspiration was recognized using this technique. The scintiscanning index cannot predict the existence of an associated oesophagitis.

Barium↗

Radionuclide quantitation of left-to right cardiac shunts using deconvolution analysis: concise communication.

Quantitative radionuclide angiocardiography (QRAC) was performed with and without deconvolution analysis (DA) in 87 children with various heart disorders. QRAC shunt quantitation was possible without DA in 70% of the cases and with DA in 95%. Among 21 patients with prolonged bolus injections, quantitation of the shunt was possible in 52% of the cases without DA an in all cases with DA. Correlation between oximetry and QRAC with DA was better than between oximetry and QRAC without DA. It is concluded that QRAC with DA is a more reliable, noninvasive means for detection and quantitation of left-to-right cardiac shunts than QRAC without DA.

Adolescent↗

Bronchiectasis in childhood. Comparison of chest roentgenograms, bronchography and lung scintigraphy.

In 76 children, 102 unilateral bronchograms were compared with the results of chest radiography and Tc-99m perfusion scintigraphy to assess the presence of bronchiectasis. Additional Kr-81m ventilation lung scintigraphy was obtained in 16 patients. For the chest radiograph the sensitivity was 73% and the specificity was 76%. For lung scintigraphy the sensitivity was 92% and the specificity 60%. When both chest radiography and lung scintigraphy were considered, sensitivity reached 96% and specificity fell to 53%. Forty per cent of the bronchrograms which were performed might have been avoided on the basis of the normal chest radiograph and lung scintigraphy. The combination of lung scintigraphy and chest radiography is an excellent screening method when a decision on the advisability of bronchography is being taken in children.

Adolescent↗

Critical evaluation of lung scintigraphy in cystic fibrosis: study of 113 patients.

A long-term study has been performed on 285 lung perfusion scintigrams obtained from 113 patients with cystic fibrosis. Transverse and longitudinal comparisons with clinical and radiological scores, as well as retrospective analysis of the deceased patients, were the methods used in order to evaluate the importance of the scintigraphic images. It appears that lung scintigraphy is the best index of the regional lung impairment, and contributes, as does a chest radiograph, to the early detection of lung lesions, the two methods being complementary. The survival rate of CF patients reached 0.80 at 9 yr when initial scintigraphy was normal or only moderately impaired, but fell to 0.18 when severe lesions were seen on the first scintigrams.

Cystic Fibrosis↗

A simple method for measuring separate glomerular filtration rate using a single injection of 99mTc-DTPA and the scintillation camera.

A new technique for measuring glomerular filtration in each kidney has been developed using a scintillation camera and the 99mTc-DTPA complex. The technique has been applied to 101 children with various uropathies. Correlations with the total and separate creatinine clearance, the HgCl2 uptake test, and the maximal urinary concentration have been good. The reproducibility of the method has been satisfactory in a small number of patients. The test is particularly adapted to children because of its simplicity, reduced trauma, short duration (20 minutes) and low-radiation dose. In contrast to some other radioisotope techniques, it can be carried out in infants.

Adolescent↗

Measurement of separate kidney clearance by means of 99mTc-DTPA complex and a scintillation camera.

A new radioisotopic method of determining the separate glomerular clearance of the kidneys is described. After injection of 99mTc-DTPA, the data from a scintillation camera are recorded by computer. The renal curves are corrected for extrarenal activity and the plasma curve is obtained from a precordial curve. At each instant the slope of the renal curve divided by the corresponding plasma concentration gives the separate clearance value, in the period extending from 80 to 180 s after injection of the tracer. The error and correction factors introduced are discussed. Normal values are established on 25 patients and correspond to inulin clearance values. Left kidney: 60 ml/min (SD=13). Right kidney: 57 ml/min (SD=12). The method is simple for the patient, takes only 20 min, is not dangerous, is particularly applicable to young children and can be repeated frequently in the same patient.

Adolescent↗

Value of brain scanning in pediatric subdural collections.

Piepsz, A., Bormans, J., Segers, A., Noterman, J. and Decostre, P. (Departments of Paediatrics, Radioisotopes and Neurosurgery, University Hospital, Brussels, Belgium). Value of brain scanning in pediatric subdural collections. Acta Paediatr Scand, 64:2, 1965. Eighteen children with subdural collections were submitted to brain scintigraphy. By this method, idopathic and post-traumatic hematomas were detected in 40% of the cases, and subdural effusions in 70% of the cases. No false-negative results were noted in the 3 cases of empyema. Several false-positive images were recorded, most of them following purulent meningitis, without any satisfactory explanation. Neither the technique of scintigraphy used in the department, the dimensions of the skull, the age of hematoma, nor the presence of membranes seemed to affect the accuracy of the method. Compared with the other easily performed examinations (eye fundus, EEG, Echo), scintigraphy still remains important in the diagnosis of subdural collections in children.

Adolescent↗