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Biomedical subjects

C Bekerman

Publications and source records attributed to C Bekerman.

At least 55 records · Page 3Linked to original sources
PubMed1982

Gallium 67 citrate scanning and serum angiotensin converting enzyme levels in sarcoidosis.

Gallium 67 citrate scans and serum angiotensin converting enzyme (ACE) levels were obtained in 54 patients with sarcoidosis and analyzed in relation to clinical manifestations. 67Ga scans were abnormal in 97% of patients with clinically active disease (n = 30) and in 71% of patients with inactive disease (n = 24). Serum ACE levels were abnormally high (2 standard deviations above the control mean) in 73% of patients with clinically active disease and in 54% of patients with inactive disease. Serum ACE levels correlated significantly with 67Ga uptake score (r =.436; p less than .005). The frequency of abnormal 67Ga scans and elevated serum ACE levels suggests that inflammatory activity with little or no clinical expression is common in sarcoidosis. Abnormal 67Ga scans were highly sensitive (97%) but had poor specificity (29%) to clinical disease activity. The accuracy of negative prediction of clinical activity by normal scans (87%) was better than the accuracy of positive prediction of clinical activity by abnormal scans (63%). 67Ga scans can be used to support the clinical identification of inactive sarcoidosis.

Adult↗
PubMed1982

Angiotensin-converting enzyme in serum and in bronchoalveolar lavage in sarcoidosis.

Angiotensin-converting enzyme (ACE) determinations were made in serum and in bronchoalveolar lavage fluid in 20 controls and in 28 patients with sarcoidosis. Serum ACE was significantly higher in patients with active sarcoidosis (54.3 +/- 19.0 SD nmol/ml/ min; n = 24) compared to controls (25.7 +/- 8.2; n = 20) or to patients with inactive sarcoidosis (23.6 +/- 7.3; n = 4). In contrast, ACE in bronchoalveolar lavage fluid was similar in nonsmoking controls (16.4 +/- 7.3 nmol/ml/min/macrophage; n = 8), smoking controls (10.4 +/- 11.9; n = 7); nonsmoking active sarcoidosis patients (16.7 +/- 14.6; n = 10), smoking sarcoidosis patients (17.9 +/- 8.4; n = 6) and inactive sarcoidosis patients (14.5 +/- 8.2; n = 3). Since ACE has been demonstrated by immunofluorescence in mononuclear phagocytes in granulomas, the authors speculate that macrophages recovered by alveolar lavage are not activated and do not reflect sarcoid alveolitis at the tissue level.

Bronchi↗
PubMed1982

Scintigraphic thyroid abnormalities after radiation. A controlled study with 99mTc pertechnetate scanning.

We did 99mTc-pertechnetate thyroid scintigraphy on 99 subjects with no history of therapeutic irradiation to the head or neck. They were compared with 198 irradiated patients selected from a group of over 1700 who were evaluated because of radiation treatment for benign head and neck conditions during childhood. The two groups were similar with respect to age and sex distribution. There were significantly more abnormal scintigrams in the irradiated group (55 of 198 patients versus one of 99 controls). Even after patients and controls with palpable nodules were excluded from the analysis there were still more abnormal scintigrams in the irradiated group (16 of 150 irradiated versus one of 97 control subjects). We conclude that thyroid nodules, including the smaller, nonpalpable nodules discovered by scintigraphy, are related to previous radiation therapy. For persons at substantial risk, such as those who received high-dose treatment (greater than 700 R) during childhood, the data support the use of screening scintigraphy, even with normal findings on palpation.

Adult↗
PubMed1981

Sequential scintigraphic staging of small cell carcinoma.

Thirty patients with small cell carcinoma (SCC) of the lung were sequentially staged following a history and physical exam with liver, bran, bone, and gallium-67 citrate scans. Scintigraphic evaluation disclosed 7 of 30 patients (23%) with advanced disease, stage IIIM1. When Gallium-67 scans were used as the sole criteria for staging, they proved to be accurate and identified six of the seven patients with occult metastatic disease. Gallium-67 scans proved to be accurate in detecting thoracic and extrathoracic metastases in the 30 patients with SCC, especially within the liver and lymph node-bearing area. The diagnostic accuracy of gallium-67 fell in regions such as bone or brain. Despite the limitations of gallium-67 scanning, the authors conclude that these scans are useful in staging patients with SCC and should be the initial scans used in staging such patients.

Aged↗
PubMed1981

Comparison of radionuclide brain scan and computerized tomography for the detection of intracranial infections.

The findings of radionuclide brain scans are computerized tomography (CT) were compared in 25 consecutive patients with intracranial infectious disease. Seventeen of the 25 patients had diffuse disease and eight had brain abscesses. The radionuclide scans showed abnormalities in 13 of the 17 patients with diffuse inflammatory disease, whereas th CT scans showed abnormalities compatible with inflammatory disease in five. All eight abscesses were demonstrated on the radionuclide scans, whereas the CT scans indicated abnormalities in seven cases. The authors conclude that the radionuclide brain scan is more sensitive than the CT scan for the demonstration of diffuse intracranial infectious disease.

Adult↗
PubMed1981

Continuing occurrence of thyroid nodules after head and neck irradiation. Relation to plasma thyroglobulin concentration.

We re-examined 158 subjects from a group of 226 previously normal persons who had received head and neck irradiation, 113 with elevated plasma thyroglobulin levels at their first visit and 113 with normal levels. Twenty-four subjects had thyroid scintigrams that had changed in the follow-up interval of 24 to 60 (mean = 45.3) months. Twelve subjects subsequently had thyroidectomy, and five malignancies were found. In the other 12 the changes tended to be more subtle, but in nine they very likely represented thyroid nodules. We conclude that the prevalence of radiation-induced nodules is not decreasing. More changes (17 of 24) occurred in subjects who initially had elevated plasma thyroglobulin levels (p less than 0.05). However, the difference was not significant when the analysis was limited to the almost certain development of a nodule. Longer follow-up will be needed to ascertain whether a high thyroglobulin level predicts a greater risk of developing thyroid nodules.

Child, Preschool↗
PubMed1980

Characteristics of 108 thyroid cancers detected by screening in a population with a history of head and neck irradiation.

One hundred and eight cases of thyroid cancer have been discovered as a result of screening 1712 individuals from a well defined population known to be at high risk because of prior head or neck irradiation for benign conditions. Of these 198 cancers, 43 (39.8%) were palpable, 27 (25.0%) were detectable by means of thyroid scintigraphy alone, and 38 (35.2%), referred to as incidental carcinomas, were found when the patients were operated on for lesions which approved to be benign. The most striking feature of these cancers was the high frequency of multicentricity (55%) and bilaterality (36%). This high frequency was found in clinically apparent as well as incidental cancers, and could not be accounted for by the operative pathologic techniques of investigation. Of 42 subjects reevaluated at our institution after a mean time of 38 months, 2 had definite and 2 had probable recurrent or residual thyroid disease. The postoperative thyroglobulin levels in subjects with thyroid cancer were proportional to the amount of thyroid tissue remaining. Follow-up evaluation of the entire group did not disclose any differences in the behavior of these thyroid cancers compared to those not associated with radiation.

Chicago↗
PubMed1980

The predictive value of serial bone scans in assessing response to chemotherapy in advanced breast cancer.

A retrospective analysis was made of 25 patients with breast cancer treated only with chemotherapy in order to determine the predictive value of technetium-99m bone scanning in determining response to chemotherapy. Whole-body scanning demonstrated bone healing in only 3 of 25 patients. However, the presence of stable disease on bone scan correlated with a good prognosis as 12 patients with stable scans had a significantly longer survival time than did the 13 patients who showed progression on scans (17.7 and 7.8 months, respectively P less than 0.01 greater than 0.005, Wilcoxan). Our analysis indicates that bone scans are a relatively crude technique for monitoring response to chemotherapy in patients with breast cancer.

Adult↗
PubMed1980

Gallium-67 citrate imaging studies of the lung.

In spite of localization of gallium in the lungs in a large variety of inflammatory pulmonary diseases, the chest radiograph is and will continue to be the principal diagnostic tool for evaluation of pulmonary inflammatory disease. The 67Ga-citrate scan, however, serves as a study complementary to chest radiography because it indicates the extent, localization, and degree of activity of the inflammatory disease with greater accuracy than do the radiographic studies. It also permits the physician to follow progression of the disease or response to treatment and possible to detect disseminated interstitial disease not visualized on radiographs. Gallium-67 scanning may be used in the evaluation of patients with lymphorecticular neoplasms (Hodgkin's disease and malignant lymphomas) both during initial staging and in evaluation of the response to therapy. The 67Ga-citrate scan is useful in the evaluation of patients with lung cancer provided its limitations are kept in mind. It cannot and should not replace the pathologist's microscope. The scan is useful as a screening test only in patients who have radiographic lesions not consistent with inflammatory disease and in whom invasive diagnostic procedures or exploratory surgery are contraindicated unless the probability of detecting a resectable tumor is high. However, the limited resolution of the scanning system restricts the possibility of detecting lesions before they become radiographically visible. The histologic type of the lesion appears to have no effect on the probability of detection. As a noninvasive procedure, the 67Ga-citrate scan complements mediastinoscopy by indicating which lymph nodes should be biopsied. It is also useful in evaluation of the controlateral hilar node region. The scan frequently detects clinically unsuspected extrathoracic lesions. It may therefore be a useful initial procedure in guiding the work-up of the patient with a known or strongly suspected tumor. The combination of the 67Ga scan with the chest radiograph could provide the information necessary for presurgical clinical staging in patients who have no symptoms that suggest distant metastases. Gallium-67 scans may be useful in indicating the effectiveness of treatment and the sensitivity of a tumor to radiation.

Adenocarcinoma↗
PubMed1978

Scintigraphic evaluation of sarcomata in children and adults by Ga67 citrate.

Gallium-67 scans were performed on 32 patients with adult and childhood sarcomata as part of clinical staging studies. Gallium-67 scans proved to be highly accurate in assessing sites of disease in patients with malignant schwannoma, Ewing's sarcoma, and rhabdomyosarcoma. Gallium-67 scans were inaccurate in determining sites of disease in patients with other types of sarcomata. It is concluded that Gallium-67 scanning is a useful adjunct to clinical staging in selected patients with sarcomata.

Adolescent↗
PubMed1978

The diagnostic significance of gallium lung uptake in patients with normal chest radiographs.

Nine patients were encountered with normal chest radiographs, but diffuse bilateral lung uptake of 67Ga-citrate. They were divided into three groups. The first consisted of 6 patients who had lymphoma or leukemia and had had multiple cycles of chemotherapy. Here, abnormal uptake may have resulted from a toxic effect of the drugs or from a low-grade, subclinical infectious process. The 2 patients in the second group were drug addicts and a subradiographic interstitial inflammatory reaction was probably responsible for abnormal uptake. The last patient had diffuse uptake of 67Ga-citrate throughout the lungs two weeks before lymphomatous infiltrates became radiographically visible.

Adult↗
PubMed1978

Scintigraphic evaluation of childhood malignancies by 67Ga-citrate.

The utility and limitations of 67Ga scintigraphy in children with solid tumors were evaluated. Thirty-five patients with malignancies (13 lymphoreticular neoplasms, 11 soft-tissue sarcomas, 8 neuroblastomas, and 3 primary bone tumors) had a 67Ga-citrate scan as part of their clinical evaluation. The sensitivity and specificity of the test were analyzed for the different tumor types. The overall sensitivity of the 67Ga-citrate scan for the lymphoma group was 87%. Higher values were obtained for the mediastinal and abdominal regions. Ninety-three per cent of the involved sites were correctly identified by 67Ga scintigraphy in the soft-tissue sarcoma group. Small lung metastases, however, were missed on scan. Thus, 67Ga scans should be complemented with chest radiographs and whole chest tomograms for both initial evaluation and follow-up in those patients. 67Ga had low sensitivity for neuroblastoma.

Adolescent↗
PubMed1978

Diagnostic significance of persistent colonic gallium activity: scintigraphic patterns.

One hundred and forty-eight gallium scans were reviewed to determine the diagnostic significance of colonic gallium activity and its relationship to colonic disease. Location or intensity of the activity was unchanged during the course of the radionuclide study in 25 patients imaged more than once. Of those patients who had colonic gallium activity that did not change in location or intensity during the study, 9 had proved colonic disease. The patterns of colonic activity were either focal or diffuse. These distinct patterns, however, cannot distinguish benign from malignant disease.

Adult↗
PubMed1977

Scintigraphic evaluation of lymphoma: a comparative study of 67Ga-citrate and 111In-Bleomycin.

Sequential whole-body scans with both 67Ga-citrate and 111In-bleomycin were performed for 14 patients undergoing staging for Hodgkin's disease or other lymphomas. A comparison or these scans gave a sensitivity in detecting the pathologically-proved tumor sites of 84% for 67Ga-citrate and only 56% for 111In-bleomycin. In 12 patients, the gallium scan demonstrated the lesions more clearly; in the others, the uptake of the two radionuclides was equal. In no case was a clinically diagnosed or histologically proved lesion identified by 111In-bleomycin that was not also demonstrated by 67Ga-citrate. 111In-bleomycin does not complement the 67Ga-citrate scan in the scintigraphic evaluation of lymphomas.

Adolescent↗
PubMed1976

The reflex sympathetic dystrophy syndrome. II. Roentgenographic and scintigraphic evidence of bilaterality and of periarticular accentuation.

Patchy osteoporosis is the primary roentgenologic manifestation of the reflex sympathetic dystrophy syndrome (RSDS). As recent clinical and histologic data suggested articular changes in RSDS, fine-detail roentgenograms were obtained in eight consecutive patients. Juxta-articular and soft-tissue swelling, osteoporosis and erosions of the subchondral bone were found. 99mTcO4 and 99mTc-EHDP scintigraphy showed localization of nuclide predominantly in the juxta-articular tissues. Serial roentgenographic, scintigraphic and quantitative bone densitometric measurements showed changes that reflected the clinical course of the disease.

Adult↗