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E Garin

Publications and source records attributed to E Garin.

14 recordsLinked to original sources

Scintimammography: better detection of small-sized lesions with tomoscintigraphic than planar images, a phantom study.

Planar (99)Tc(m)-methoxyisobutylisonitrile ((99)Tc(m)-MIBI) scintimammography has been used for several years to detect breast cancer tumours, but with low sensitivity for small lesions. Results of tomoscintimammography studies have not been conclusive. We conducted a phantom study to compare the detection of small-sized tumours with planar versus tomoscintigraphic images. We used a data spectrum anthropomorphic fillable breast phantom with two 9.8 mm and 12.4 mm spheres superficially or deep in the breast compartment with sphere/breast activity ratios varying from 3 to 6. We acquired planar and 180 degrees tomoscintigraphic images in each configuration using a double head standard gamma camera. In certain cases we varied different parameters (64x64 matrix or 360 degrees rotation) in a second series of tomoscintigraphic acquisitions. We simultaneously used filtered back-projection reconstruction (FBP) and iterative reconstruction (IR). Planar images were shown by the sphere in 10 out of 25 cases. Tomoscintigraphic images were shown by the sphere in nine out of 25 cases with FBP and in 18 out of 25 with IR. There was a significant difference between IR and FBP (P<0.01) and between planar and IR images (P<0.01), but no significant difference between planar and IR images. The noise/signal ratio was lower with planar images than with the two types of reconstruction (P<0.05) but was not significantly different between the two types of reconstruction. Contrast was lower on planar images than on the two types of reconstruction (P<0.05) and was also better on IR than on FBP images (P<0.05). Granularity was lower for planar images than for reconstruction images (P<0.01) and also lower for IR than for FBP (P<0.01). The tomoscintigraphic reconstructions acquired with a 64x64 matrix were only positive in four out of 10 cases, while they were positive in nine out of 10 with a 128x128 matrix. We concluded that, in this phantom study, tomoscintimammography with IR provides a significant improvement in the detection of small-sized breast tumours compared with planar images. In addition, for tomoscintigraphic images, a 128x128 matrix is preferable to a 64x64 matrix. Those results have, of course, to be confirmed in vivo in a large population of patients with small-sized breast lesions.

Breast↗

Contribution of 99Tcm-DMSA scintigraphy to aetiological diagnosis in renal transplant recipients with impaired renal function.

Routine 99Tcm-dimercaptosuccinic acid (DMSA) scintigraphy was performed in a series of 24 kidney transplant recipients with impaired renal function. Diagnostic findings on planar and tomoscintigraphic acquisitions obtained 3 and 4 h after the injection of 130-140 MBq 99Tcm-DMSA were compared with the diagnosis established by fine-needle biopsy in 13 patients and by clinical course and other examinations (ultrasonography, bacteriology) in 11 patients. Renal scintigraphy demonstrated segmental defects in patients with rejection (n = 2/6), immunosuppressor nephrotoxicity (n = 2/6), acute pyelonephritis (n = 3/3), renal artery stenosis (n = 1/1) and obstructive lymphocele (n = 1/1). Diffuse lack of uptake was observed in one patient with severe renal failure. The scintigram was normal in 14 patients, including three with lesions histologically compatible with graft rejection or immunosuppressor nephrotoxicity. 99Tcm-DMSA was thus found to contribute little to the differential diagnosis between graft rejection and immunosuppressor nephrotoxicity. However, it may be useful for identifying specific disease states, particularly acute pyelonephritis, seen as well-delimited systematized defects. 99Tcm-DMSA scintigraphy could also be used in late follow-up after pyelonephritis in renal transplant recipients.

Adult↗

Comparison of Tc-99m-labelled antileukocyte fragment Fab' and Tc-99m-HMPAO leukocyte scintigraphy in the diagnosis of bone and joint infections: a prospective study.

Between January and July 1998, we conducted a prospective study to compare Tc-99m-labelled antigranulocyte monoclonal antibody fragment Fab' (LEUKOSCAN) scintigraphy versus Tc-99m-hexamethylpropyleneamine oxime (Tc-99m-HMPAO)-labelled leukocyte scintigraphy (HMPAO-LS) for the diagnosis of unselected patients with bone and joint infection. Twenty-three patients (16 men and 7 women; mean age, 67 years) with suspected bone infection were explored successively with bone scintigraphy, HMPAO-LS and LEUKOSCAN scintigraphy. Thirty-two foci were studied (diabetic foot = 11, prosthetic material = 8, joint disease = 4, others = diagnosed in 18 cases, eight on the basis of bacteriological and histological examination of surgical or puncture specimens, with or without radiographic signs, and 10 on the basis of clinical course and radiographic findings. Overall sensitivity, specificity and accuracy were 86%, 72% and 78%, respectively, for LEUKOSCAN scintigraphy (12 true positives (TP), 13 true negatives (TN), 5 false positives (FP), 2 false negatives (FN)), 93%, 100% and 96%, respectively, for HMPAO-LS (13TP, 18TN, 0FP, 1FN), and 100%, 17% and 53.3%, respectively, for bone scintigraphy. In this small series, LEUKOSCAN scintigraphy was found to be less specific for the diagnosis of osteomyelitis than HMPAO-LS. In addition, the interpretation of LEUKOSCAN scintigraphy is more difficult than HMPAO-LS for the diagnosis of bone infection in the diabetic foot, and would appear to be less discriminating for differentiating soft tissue infection from osteitis in the case of plantar perforating ulcers.

Adult↗

Contribution of technetium-99m hexamethylpropylene amine oxime labelled leucocyte scintigraphy to the diagnosis of diabetic foot infection.

We conducted a prospective study in order to evaluate the contribution of technetium-99m hexamethylpropylene amine oxime (HMPAO) labelled leucocyte scintigraphy to the diagnosis and follow-up of osteomyelitis in the diabetic foot. The study was conducted between October 1992 and November 1996 and included 42 patients (30 men and 12 women; mean age 63 years) with diabetes mellitus (type 1, n = 22, type 2, n = 20) who had a total of 56 diabetic foot ulcers. The initial exploration included standard radiography, three-phase bone scintigraphy and 99mTc-HMPAO labelled leucocyte scintigraphy (HMPAO-LS), performed within a 3-day interval. For the 56 ulceration sites, 26 cases of osteomyelitis were diagnosed: ten on the basis of radiographic and histological/bacteriological criteria after bone biopsy, 11 after radiographic follow-up and five on the basis of biopsy results alone. No osteomyelitis was present at 30 sites, there were seven cases of cellulitis. The sensitivity and specificity of 99mTc-HMPAO-LS were 88.4% and 96.6% respectively (23 true-positives, 29 true-negatives, one false-positive, three false-negatives). The accuracy of radiography, 99mTc-methylene diphosphonate and HMPAO-LS was 69.6%, 62.5%, and 92.9%, respectively. Follow-up scintigraphy (n = 14) 4 months after initial diagnosis and 1 month after antibiotic withdrawal confirmed cure of osteomyelitis despite the absence of complete clinical regression of the ulcers. In conclusion, 99mTc-HMPAO labelled leucocyte scintigraphy was found to be an excellent method for the diagnosis of osteomyelitis in the diabetic foot. It can contribute to follow-up, particularly when clinical regression of perforating ulcers is incomplete and cure of osteomyelitis must be confirmed in order that antibiotic treatment may be discontinued.

Adult↗

Use of indium-111 pentetreotide somatostatin receptor scintigraphy to detect recurrent thyroid carcinoma in patients without detectable iodine uptake.

We conducted a prospective evaluation of somatostatin receptor scintigraphy (SRS) for the diagnosis of recurrent vesicular or papillary thyroid carcinoma in 16 patients with no detectable iodine uptake. SRS was performed 1, 4 and 24 h after intravenous injection of 137-200 MBq of indium-111 pentetreotide. Results were interpreted in terms of assumed presence of tumoral tissue: there were three true-positives (19%), one false-positive (6%) and 12 false-negatives (75%). The three true-positive patients had multiple lesions visible on computerized tomography. SRS was negative in all patients with a high thyroglobulin level alone. In addition, we analyzed the consequences of interpretative criteria and somatostatin receptor expression variability for SRS positivity as well as the risk of false-positives. We conclude that when iodine uptake cannot be demonstrated in patients with suspected recurrence of differentiated thyroid carcinoma, SRS would not appear to contribute to diagnosis, and that interpretative criteria commonly used for tumours with a high receptor density may be too restrictive for tumours with a low receptor density.

Adult↗

Analysis of epidermal growth factor receptor mRNA expression by polymerase chain reaction assay in 94 human breast adenocarcinoma tumors.

It is well known that breast cancer cells can synthesize and secrete various growth factors that are able to stimulate tumor growth through autocrine and/or paracrine mechanisms. EGF is one of these growth factors involved in normal breast epithelial development and tumor proliferation. EGF and TGF alpha (EGF-like peptide) are produced in variable amounts and both bind to the EGF receptor (EGF-R). Previous investigation in the laboratory measuring free and occupied EGF-R sites by differential ligand binding assays had demonstrated that non-occupied and total binding sites were present in 54 and 90% of 216 breast tumor biopsies respectively. EGF-R appeared to be totally masked by endogenous ligand in 40 and 21% of estrogen receptor positive and negative tumors respectively. The aim of the present study was to check by a molecular method the expression of the EGF-R gene. The PCR method was applied to 94 tumor samples of the previous series. Total RNA was treated with 0.5 units of Rnase-free Dnase/mg of RNA to remove any contaminating DNA. We simultaneously reverse transcribed and amplified another transcript (beta-actin) as an internal standard. Both signals were present in 88 of the 94 samples while the presence of EGF-R was detected in 74 of them when assessed by radioligand assay. The findings indicate that 93% of the tumors analysed in this series expressed EGF-R mRNA, in agreement with our previous data on occupied EGF-R sites, i.e. two-fold more than by using the standard binding assay. No significant correlation was observed between the expression of the EGF-R gene and the estrogen receptor content.

Adenocarcinoma↗

[Latent forms of parathyroid cysts. Report of two cases].

The authors report two cases of non functional parathyroid cyst both found by a systematic clinical examination in two women of 56 and 67 years. In the first case, the cyst was associated to a thyroid dystrophy; the other patient had a history of thyroid dystrophy but also of pituitary prolactin adenoma.

Aged↗

Measurement of occupied and non-occupied epidermal growth factor receptor sites in 216 human breast cancer biopsies.

The epidermal growth factor (EGF) is one of several growth factors involved in normal breast epithelial development and tumor proliferation. EGF and EGF-like peptide TGF alpha bind and activate the same membrane receptor protein. This receptor (EGF-R) has been recently studied in breast tumor biopsies and its detectability reported as a prognostic indicator. However, normal and tumor tissue themselves produce EGF and related peptides in variable amount. This suggests that the standard measurement of EGF-R by binding assay should reflect only the number of non-occupied receptor sites. Based on this observation, the presence of occupied sites (EGF-R2) has been assessed in 216 human mammary tumor biopsies simultaneously with the direct measurement of non occupied EGF receptor sites (EGF-R1) and the results compared to estrogen and progesterone receptor status (ER, PGR). EGF-R1 and EGF-R2 were evaluated by 2 separate (125I) EGF binding assays performed on 2 aliquots of tumor crude membrane fraction, the first one directly, the other after dissociation of the endogenously bound ligand. The validity of the method has been assessed on membrane fractions prepared from human placenta. It is shown that the dissociation does not modify the binding dissociation constant. ER and PGR were measured by the dextran coated charcoal method. Results greater than 10 fmol/mg of membrane or cytosol protein were considered as positive. It is found that EGF-R1 and EGF-R2 are detectable in 54 and 90% of the cases, indicating that EGF-R is masked by endogenous ligand in 36% of the tumors.(ABSTRACT TRUNCATED AT 250 WORDS)

Binding Sites↗

Renal growth and scarring in kidneys with reflux and a concentrating defect.

A study was done to determine if kidneys with reflux and an associated renal concentrating defect grew less well and had more scars than kidneys with reflux but no renal concentrating defect. To test our hypothesis we measured renal growth and assessed radiographs for renal scars in 11 children with and 20 children without a renal concentrating defect. Kidneys with reflux and a renal concentrating defect grew less well and had more scars than those kidneys with reflux but no renal concentrating defect. A persistent renal concentrating defect may be a predictor of kidneys more likely to have impaired growth and renal scars.

Child↗

Spectrum of multicystic renal dysplasia: diagnosis and management.

Multicystic renal dysplasia represents a spectrum of pathologic states, from unilateral multicystic kidney through segmental and focal multicystic dysplasia to bilateral multicystic kidney. Diagnosis can be established with low-risk procedures with reasonable accuracy. Treatment may be nonoperative in selected cases, but the physician must be responsible for long-term follow-up of the child until more is known about the natural history of this process.

Adolescent↗

Five-hour renal functional evaluation.

Children with urogenital disease frequently require evaluation of glomerular and tubular functions. Herein is presented a practical method of performing glomerular and tubular functional studies requiring short time periods and utilizing readily availabe laboratory techniques.

Adult↗

[Not Available].

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History, Early Modern 1451-1600↗