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Biomedical subjects

D Margouleff

Publications and source records attributed to D Margouleff.

35 records · Page 2Linked to original sources
PubMed1991

Diagnosis and imaging of the fetal and neonatal abdominal mass: an integrated approach.

Almost all of the renal causes of NAM and adrenal neuroblastoma, the most common nonrenal cause, can be categorized as cystic or solid by sonography. Evaluation with CT is usually the most appropriate next step for assessment of solid renal tumors lacking clinical features of RVT. Renal scintigraphy and diuretic renal scintigraphy offer valuable information about relative individual kidney GFR and excretory function, whether normal, partially, or completely obstructed. Many dilated urinary tracts, especially those diagnosed in utero, are found to resolve spontaneously when serial studies are performed. The informed pediatrician should play a major role in the selection of diagnostic procedures and determination of management strategy. Only he or she has the detailed clinical knowledge of the patient that can give appropriate direction to the consultants. A tentative algorithm for imaging studies in the evaluation of NAM is presented in Figure 1 and emphasizes the functionally more informative radionuclide studies 15,25,26 over the traditional radiocontrast studies.

Abdominal Neoplasms↗
PubMed1989

A new cholescintigraphic agent: ruthenium-97-DISIDA.

These are the first human experiments with 97Ru-DISIDA, a potentially new alternative to 131I-rose bengal where delayed imaging is indicated. 97Ru has a convenient half life. A DISIDA labeling kit was utilized to prepare the radiotracer for 17 patients (age 6 weeks-84 years). The cholescintigraphic data correlated well with other imaging procedures and with clinical findings. Dosimetric calculations were carried out and were compared with the radiation burden associated with the use of 99mTc-DISIDA and 131I-rose bengal.

Biliary Tract Diseases↗
PubMed1988

Scintigraphic and magnetic resonance studies in a patient with Gaucher's disease.

In-111 chloride imaging was used in the evaluation of a patient with Type I Gaucher's disease before splenectomy for pancytopenia. This case is the first report of its use in this clinical setting. The image demonstrated the presence of adequate marrow reserve, thereby suggesting that the pancytopenia was due to hypersplenism rather than marrow replacement. Normalization of blood counts after splenectomy confirmed this interpretation. Eight months later, the patient had acute pain in the left knee. Bone imaging suggested a left lateral tibial plateau fracture that was not seen on plain radiographs or magnetic resonance imaging, but was confirmed by x-ray tomography. The significance and implications of these findings are discussed.

Bone and Bones↗
PubMed1986

Splenic hypofunction in the nephrotic syndrome of childhood.

The reticuloendothelial system, including the spleen, subserves important immunologic functions. Loss of splenic function results in an increased incidence of severe bacterial infections and is accompanied by thrombocytosis. Several nephrotic children were noted to have remarkably high platelet counts and predisposition to bacterial infection with encapsulated organisms. We, therefore, investigated the splenic function of nine children with primary nephrotic syndrome and measured the phagocytic function of the spleen by sequestration of Technetium-99-labelled heat-treated autologous RBC, administered intravenously. Four children had decreased splenic function. Repeat studies performed in two of these children after remission of the nephrotic syndrome gave normal results. There were six episodes of bacterial infection (3 peritonitis, 1 septic arthritis, 1 cellulitis, and 1 Escherichia coli urinary tract infection) among the four patients with decreased splenic function. There were no episodes of bacterial infection among the five nephrotic children with normal splenic function. Nephrotic patients with decreased splenic function had significantly increased platelet counts (921,000 +/- 196,000; mean +/- SEM) compared to those with normal function (435,000 +/- 46,000; P less than 0.001). Our findings suggest the possibility that some nephrotic children may have decreased splenic function in association with increased susceptibility to bacterial infections.

Adolescent↗
PubMed1985

Cholescintigraphic abnormality in a case of Kawasaki syndrome.

A 26-month-old girl with Kawasaki syndrome (mucocutaneous lymph node syndrome) is presented. Liver function studies were abnormal and sonographic examination revealed hydrops of the gallbladder. The Tc-99m DISIDA cholescintigraphy demonstrated both early and delayed nonvisualization of the gallbladder. A photopenic area was noted in and below the gallbladder fossa and there was medial and upward displacement of the common bile duct. It appears that Kawasaki syndrome may result in nonvisualization of the gallbladder by cholescintigraphy. Accordingly, this diagnosis should be added to the list of conditions associated with nonvisualization of the gallbladder by biliary scintigraphy.

Child, Preschool↗
PubMed1984

Dyspnea: the heart or the lungs? Differentiation at bedside by use of the simple Valsalva maneuver.

Thirty-seven patients with dyspnea, clinical chronic obstructive pulmonary disease and abnormal pulmonary function tests demonstrating an obstructive airways pattern underwent six-foot posteroanterior chest radiography, radionuclide ventriculography and sphygmomanometer-monitored arterial pressure response during a bedside Valsalva maneuver. Patients could be separated into three groups (square wave, absent overshoot, sinusoidal) on the basis of their Valsalva response which corresponded to left ventricular ejection fractions on radionuclide ventriculography of 0.19 +/- 0.05, 0.42 +/- 0.20, 0.64 +/- 0.13 (p less than 0.005 for differences between all group means). Pulmonary function test results and a detailed patient history could not accurately separate patients with primary pulmonary dyspnea from those with concomitant left ventricular dysfunction (ejection fraction less than 0.50). In this population of patients, however, both the sensitivity (88 percent) and predictive value (88 percent) for the presence of left ventricular dysfunction of an abnormal (square wave or absent overshoot) systolic arterial pressure response during Valsalva maneuver were high. Thus, in dyspneic subjects with clinical evidence of chronic obstructive airways disease, concomitant left ventricular dysfunction can be accurately diagnosed using the simple Valsalva maneuver without sophisticated equipment or highly trained personnel.

Adult↗
PubMed1980

Spleen scanning in humans with Tc-99m-labeled erythrocytes: concise communication.

Technetium-99m-labeled heat-damaged erythrocytes were evaluated as a spleen imaging agent in 14 patients. Spleen-to-liver deposition ratios were increased to such an extent that the liver was rarely visualized, and interference from the hepatic left lobe of the liver was eliminated. Information obtained was accurate and diagnostically adequate in various splenic involvements. This tracer appears to be one of the better spleen imaging agents presently available.

Adolescent↗
PubMed1980

Sequential scintiangiography of the hepato-splenic system of xiphopagus conjoined twins.

Scintiangiography of xiphopagus conjoined twins following sequential i.v. injection of Tc-99m sulfur colloid revealed the size, configuration, and anatomic point of fusion of the twins' common liver prior to surgery. Cross circulation was determined to be non-significant by this approach. The technique is presented, compared to other methods, and the benefit of sequential hepatic scintiangiography for xiphopagus conjoined twins is reviewed.

Cross Circulation↗
PubMed1979

Idiopathic hypertrophic subaortic stenosis: evaluation of anginal symptoms with thallium-201 myocardial imaging.

The evaluation of angina pectoris in patients with idiopathic hypertrophic subaortic stenosis is difficult in those in the age group prone to coronary artery disease. Ten patients with angina pectoris, normal coronary angiograms and idiopathic hypertrophic subaortic stenosis were studied with thallium-201 myocardial imaging performed in conjunction with submaximal treadmill exercise testing. The resting electrocardiogram demonstrated left ventricular hypertrophy with S-T segment abnormalities in seven patients, thereby vitiating the further increase in S-T segment abnormalities that developed in these patients during exercise or in the postexercise period. Of the three patients with a normal resting electrocardiogram, one had significant exercise-induced S-T segment depression. Thallium-201 myocardial imaging revealed no significant perfusion defects in 9 of the 10 patients (90 percent). In one patient with severe left ventricular hypertrophy significant perfusion defects developed after exercise that were not present at rest. Stress thallium-201 myocardial perfusion imaging is a useful noninvasive technique that assists in ruling out the presence of significant coronary artery disease in patients with idiopathic hypertrophic subaortic stenosis.

Adolescent↗
PubMed1979

Feasibility of total thyroidectomy in the treatment of thyroid carcinoma: postoperative radioactive iodine evaluation of 140 cases.

The objective of this study was to evaluate our experience with so-called total thyroidectomy. Fifty cases (the retrospective group) had been operated on before the start of the study and had been on thyroid replacement therapy; this was discontinued, thyroid-stimulating hormone was administered, and iodine-131 studies were performed. Ninety cases (the prospective group) were evaluated 3 or more weeks postoperatively with no thyroid hormone having been administered. All patients were given 50 microcuries of iodine-131 and uptake studies were performed 24 hours later. All the patients were evaluated at a time when it was believed that practically all circulating hormone secreted by the thyroid gland before its removal had been metabolized or excreted from the body. If the patients with iodine-131 uptakes only in the region of the pyramidal lobe are considered to have had total thyroidectomy, we find that 85.7% of the patients studied had an uptake of less than 1.5%, and 96.4% had an uptake of less than 2.5%. There is increasing evidence to indicate that total thyroidectomy is the procedure of choice in the treatment of differentiated thyroid carcinoma. The present study indicates that with proper technique, total resection of the thyroid gland is feasible in nearly all cases of thyroid carcinoma.

Adolescent↗
PubMedDate not supplied

Postoperative radioactive iodine evaluation of total thyroidectomy for thyroid carcinoma: reappraisal and therapeutic implications.

The records of 430 patients who underwent total thyroidectomy with radioactive iodine (RAI) uptake studies performed postoperatively were reviewed. Indications for the administration of an ablative dose of iodine 131 are given. The majority (85.4%) had no or low (less than 2%) evidence of focal uptake and therefore were not treated with ablative doses of iodine 131. RAI scanning is necessary postoperatively to determine the completeness of the surgical procedure and to detect residual or metastatic disease. Small foci of residual disease or occult distant metastases can be adequately treated with therapeutic doses of RAI. Nodal or distant metastases that become clinically evident following thyroidectomy are usually not successfully treated with RAI.

Adolescent↗