Experimental tumor scanning with intraarterial hydrogen peroxide and 131-I HSA.
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Biomedical subjects
Publications and source records attributed to F J Bonte.
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A common cause of dementia in late midlife and old age is Alzheimer disease (AD), which affects more than one in 20 individuals over the age of 65. Past studies of regional cerebral blood flow (rCBF) in patients with AD here suggested blood flow abnormalities, but findings have differed. We have studied 37 patients diagnosed as having AD with inhalation and washout of 133Xe and single-photon emission computed tomography (SPECT), obtaining evidence of abnormal rCBF patterns in 19. Flow reductions were most common in the temporoparietal regions and were occasionally found in the frontal areas. Investigators using positron-emission tomography (PET) have identified similar findings with respect to rCBF and regional oxygen, glucose, and protein metabolism. The SPECT determination of rCBF, which gives information similar to that provided by PET, may assume importance in the diagnosis of AD and in the differential diagnosis of the dementias.
PURPOSE: To describe the technique of using SPECT brain blood flow imaging to identify patients at risk for having strokes after balloon or surgical ligation of an internal carotid artery. PATIENTS AND METHODS: 29 patients underwent temporary balloon occlusion of the internal carotid artery and blood flow imaging studies were obtained prior to sacrifice of the vessel; 11 internal carotid arteries were indeed sacrificed and form the basis of our study. Follow-up of these patients ranged from 3 to 65 days. RESULTS: Three groups emerged: group I, patients with symptoms during occlusion and an abnormal blood flow study (one patient); group II, patients with no symptoms during the occlusion but with an unequivocally abnormal blood flow study (two patients); group III, patients without symptoms during occlusion and a normal or slightly abnormal blood flow study (eight patients). CONCLUSION: Carotid sacrifice without initial and temporary balloon occlusion is unnecessarily risky. Imaging of blood flow in the brains of these patients can further improve the safety of occlusion procedures in the internal carotid artery.
Using a single-photon emission computed tomographic scanner (SPECT) the authors determined regional cerebral blood flow (rCBF) with inhaled xenon-133, a noninvasive procedure. Studies were performed in 40 normal individuals, and these were compared with rCBF determinations in 51 patients with seizure disorders. Although positive results were obtained in 15 of 16 patients with mass lesions, the group of principal interest comprised 25 patients suffering from "temporal lobe" epilepsy. Only one of these had a positive x-ray computed tomogram, but 16 had positive findings on rCBF study. These findings included increased local blood flow in the ictal state and reduced flow interictally.
BACKGROUND: Adult polyglucosan body disease (APBD) is a rare disorder, presenting with varying combinations and severity of upper and lower motor neuron dysfunction, sensory deficits, dementia, and urinary incontinence. Onset is in the 40s or 50s. The diagnosis is made by finding polyglucosan bodies (PB) in histologic sections of brain or spinal cord, peripheral nerve, or dermal sweat glands. Although 2 pairs of the 22 previously reported cases were siblings, the familial nature of the disease has not been emphasized. METHODS: We report 2 adult siblings, a male and a female, each of whom had the clinical diagnosis of vascular dementia. Both were confirmed at autopsy to have APBD. We characterized the lesions in autopsy tissues using a battery of histological stains, lectin histochemistry, and electron microscopy. RESULTS: Innumerable PB were distributed throughout brain, heart, skeletal muscle, liver, and dermal sweat glands. PB were highlighted by periodic acid Schiff stain and concanavalin A lectin. Ultrastructurally, PB were composed of aggregates of filaments within axons and astrocytic processes, and lying free in the neuropil, but not within neuronal perikarya. CONCLUSIONS: It is important to consider APBD in cases of familial dementia of unknown etiology. Ante-mortem biopsy of axillary skin may be diagnostic.