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Biomedical subjects

C Bekerman

Publications and source records attributed to C Bekerman.

At least 37 records · Page 2Linked to original sources
PubMed1989

Altered biodistribution of Ga-67 by intramuscular gold salts.

The authors observed a deviation from the normal scintigraphic pattern of Ga-67 citrate biodistribution. An 8-year-old black girl with juvenile rheumatoid arthritis, who had been treated with intramuscular injections of gold salts, had a Ga-67 study as part of her workup. The study demonstrated no hepatic uptake, but showed elevated skeletal and renal activity. This characteristic biodistribution of Ga-67 may be due to inhibition of lysosomal enzymes by gold and/or to accumulation of gold in lysosomes. To study these possibilities, the authors reviewed the mechanisms of Ga-67 localization and gold metabolism. Alteration of the Ga-67 citrate scintigraphic pattern due to earlier treatment with gold salts has not been reported previously.

Arthritis, Juvenile↗
PubMed1988

Gallium-67 scanning in the clinical evaluation of human immunodeficiency virus infection: indications and limitations.

This review, examines the indications for and limitations of gallium-67 (67Ga) scanning in the evaluation of patients infected with human immunodeficiency virus (HIV). The imaging protocol, as well as the normal biodistribution of 67Ga and its normal variants are discussed. The diagnostic significance of the different scintigraphic patterns that are found in acquired immune deficiency syndrome (AIDS) or AIDS-related complex (ARC) patients is reviewed. The use of 67Ga scintigraphy for measurement of the effectiveness of treatment in this patient population is also discussed, as is the likelihood that this examination could be used as a prognostic indicator in the future.

AIDS-Related Complex↗
PubMed1988

The use and diagnostic significance of thallium-201 SPECT imaging in a case of anomalous left coronary artery.

A 6-year-old female with an anomalous left coronary artery (ALCA) originating from the main pulmonary artery underwent a resting Tl-201 SPECT examination before and after surgical reimplantation. Preoperative Tl-201 SPECT images demonstrated decreased perfusion to the anterior wall and a dilated left ventricle. Post operative Tl-201 SPECT images showed marked improvement of perfusion to the anterior wall as well as a decreased left ventricular size. This is one of the few documented demonstrations of a perfusion defect due to an ALCA in a young child using Tl-201 SPECT imaging methods in conjunction with other tests.

Child↗
PubMed1987

Patterns of gallium-67 scintigraphy in patients with acquired immunodeficiency syndrome and the AIDS related complex.

Thirty-two patients with AIDS related complex (ARC) or acquired immunodeficiency syndrome (AIDS) underwent 67Ga scans as part of their evaluation. Three patterns of 67Ga biodistribution were found: lymph node uptake alone; diffuse pulmonary uptake; normal scan. Gallium-67 scans were useful in identifying clinically occult Pneumocystis carinii pneumonia in seven of 15 patients with ARC who were asymptomatic and had normal chest radiographs. Gallium scans are a useful ancillary procedure in the evaluation of patients with ARC or AIDS.

AIDS-Related Complex↗
PubMed1986

Radiation-induced thyroid carcinoma. Clinical course and results of therapy in 296 patients.

Of 5379 patients who had received radiation treatment at our institution for benign conditions of the head and neck, 318 developed thyroid cancer 3 to 42 years later. We report follow-up observations (median interval from diagnosis to recurrence or last contact, 10 years; longest interval, 31) for 296 of these patients. Three patients died of thyroid cancer and 40 had recurrences. The rate of recurrence during the 10 years after the detection of thyroid cancer, determined by life-table analysis, was 1.1%/yr. Factors that correlated with the risk of recurrence were tumor size, histologic type, number of lobes involved, vessel invasion, and lymph node metastases. The time from radiation exposure to the discovery of thyroid cancer (latency) and the age at diagnosis both inversely correlated with recurrence. The administration of thyroid hormones reduced the number of recurrences in patients with combined papillary and follicular cancer, but no reductions could be associated with the extent of surgery done or the prophylactic use of radioactive iodine ablation. We conclude that the course of radiation-induced thyroid cancer is the same as that of thyroid cancer found in other settings. We advocate a conservative approach to the treatment of small tumors that have no associated risk for thyroid cancer other than that they developed many years after the patient had been exposed to radiation.

Actuarial Analysis↗
PubMed1985

Radiation-induced tumors of the head and neck following childhood irradiation. Prospective studies.

Nodules were found in 1108 subjects who received childhood radiation for benign conditions of the cervical area at our institution. This is 37.5% of 2958 subjects, out of a total of 5379, for whom there is follow-up information. Of the 848 subjects who have had thyroidectomies, 297 (35.0%) had thyroid cancer. In addition to thyroid tumors, salivary, neural, and probably parathyroid tumors also occurred as a late consequence of childhood radiation. Prospective studies of the subjects indicate that thyroid nodules are continuing to occur at a constant rate. The measurement of serum thyroglobulin is helpful in identifying individuals for whom the risk of developing a nodule is increased. Follow-up of patients with nonsurgically-treated nodules indicates that some of their nodules are progressive. At the present time there is no indication that radiation-induced cancers behave differently than ones in other settings. However, some of their characteristics, especially their multicentricity and occurrence in younger individuals, indicate that continued follow-up is necessary. On the basis of the data generated by the follow-up program at our institution and programs elsewhere, recommendations for screening, treatment, and follow-up are made. The recommendations stress the importance of estimating risk based on radiation dose, previous tumors, and serum thyroglobulin, in arriving at clinical decisions for these subjects.

Adult↗
PubMed1985

Gastric ulcer localization by direct in vivo labeling of sucralfate. Work in progress.

We developed and evaluated a new procedure for imaging gastric ulcer disease with technetium 99m-labeled sucralfate. The new method employs direct in vivo labeling of sucralfate instead of in vitro labeling using human serum albumin, as previously reported in the literature. Tests using hydrochloric acid and a rabbit ulcer model showed the efficacy of the direct in vivo labeling technique and the ability of the tagged material to bind to ulcers, respectively. In 26 studies using humans with sucralfate labeled directly in vivo, 15 gave true-negative results and 11 gave true-positive results. Of 14 studies using humans with in vitro labeled sucralfate, three gave true-negative results, three gave true-positive results, and the results of eight were either false-negative or could not be interpreted because of high levels of activity remaining in the stomach. We suggest that the direct in vivo labeling method significantly improves the sucralfate gastric ulcer imaging technique.

Aluminum↗
PubMed1985

The value of gallium-67 scanning in pulmonary tuberculosis.

We studied 59 patients presumed to have pulmonary tuberculosis to determine whether gallium-67 citrate scintigraphy could improve diagnostic accuracy and help clinical decision making for empiric treatment pending culture results. The sensitivity of 67Ga scintigraphy was 95% and the specificity 27%. Our positive predictive value of 69% does not contribute substantially to increase the prior probability of diagnosis in settings similar to ours. The existence of a false negative rate essentially precludes the use of the scan to rule out active disease. The use of the scan for clinical decisions in pulmonary tuberculosis is not recommended.

Evaluation Studies as Topic↗
PubMed1985

Prospective serum thyroglobulin measurements in assessing the risk of developing thyroid nodules in patients exposed to childhood neck irradiation.

We examined 327 patients with a history of cervical radiation treatment for benign conditions and followed them for an average of 5.6 yr. These patients were selected because they initially had normal examinations and normal serum thyroglobulin levels. Of the 327 patients, 48 developed thyroid nodules, and an additional 30 had other clinical changes in their thyroids. Serum thyroglobulin increased by 4.0 +/- 0.6 (+/- SEM) ng/ml in those who remained normal, by 13.4 +/- 5.2 ng/ml in those who were no longer normal, and by 17.1 +/- 8.2 ng/ml in those who developed nodules. We conclude that increasing levels of serum thyroglobulin identify patients who should be examined and followed more carefully for thyroid nodules and thyroid cancer.

Age Factors↗
PubMed1984

The role of gallium-67 in the clinical evaluation of cancer.

This review is based primarily on historic data, and it examines the indications for and limitations of gallium-67 scanning in the evaluation of patients with neoplasms. The use of gallium-67 scans is discussed according to tumor type, and data from the most representative and comprehensive studies are included. The results described, some of which were obtained primarily with older imaging techniques, should be regarded as representing the minimum that can be expected from application of this imaging procedure.

Adult↗
PubMed1984

The effects of inadvertent administration of antineoplastic agents prior to Ga-67 injection: concise communication.

Alteration of the gallium-67 (Ga-67) distribution after administration of chemotherapeutic agents has been demonstrated in experiments on both normal and tumor-bearing animals. We have encountered eight patients who had Ga-67 scintigrams in which the findings were similar to those in the animals experiments: markedly increased uptake in bone, with suppressed uptake in liver, muscle, and tumor. Five of the patients had hematologic neoplasms, and three had solid tumors, and each had received one or more chemotherapeutic agents during the 24 hr preceding Ga-67 administration. In three patients while not on antineoplastic medication subsequent Ga-67 images showed a return to the usual Ga-67 distribution pattern. The altered Ga-67 distribution may result from inhibition of protein synthesis or of a serum-binding agent for Ga-67, or from competitive blockage of specific Ga-67 organ receptors by the antineoplastic agents.

Adolescent↗
PubMed1983

Thyroid imaging agents: a comparison of I-123 and Tc-99m pertechnetate.

Tc-99m pertechnetate and I-123 were used to perform thyroid scanning in 122 patients with history or clinical evidence of thyroid disease. Thyroid scans were abnormal in all patients, while thyroid palpation was abnormal in all but 19. The quality of thyroid imaging was similar with both agents in 42%, better with I-123 in 18%, and better with Tc-99m in 7%. In the remaining 33% (40 cases), there were discrepancies between Tc-99m and I-123 images. The most frequent discrepancies were "hot" or "warm" lesions on Tc-99m scans that were "cold" or normal on I-123 scans. Results from this study indicate that neither Tc-99m nor I-123 is always superior to the other as a thyroid imaging agent.

Adult↗