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Biomedical subjects

G G Winzelberg

Publications and source records attributed to G G Winzelberg.

At least 37 records · Page 2Linked to original sources

Parathyroid adenomas studied by digital subtraction angiography.

Eighteen patients who had elevated serum calcium and parathormone levels were prospectively studied with intravenous digital subtraction angiography (DSA). Intravenous DSA of the neck and mediastinum was performed in the anteroposterior, the left anterior, and the right anterior oblique projections. The study was considered positive if an abnormal blush or blood supply was noted. Upon operation, 14 patients were confirmed to have parathyroid adenomas, of whom five had positive preoperative DSA examinations. Four patients were followed medically (three negative DSA, one positive DSA). A positive intravenous DSA may be useful to guide neck explorations for parathyroid adenomas; however, the low sensitivity of the study may limit its screening potential.

Adenoma↗

Patients with hemoptysis examined by Tc-99m sulfur colloid and Tc-99m-labeled red blood cells: a preliminary appraisal.

A prospective study of 16 patients with hemoptysis was conducted over a 2 1/2-year period. Technetium-99m sulfur colloid (Tc-SC) and technetium-99m-labeled red blood cells (Tc-RBC) were sequentially used to identify the general area of bleeding. Tc-SC accurately located the bleeding area in 3 patients and Tc-RBC identified the bleeding area in 8; there were no false-positive studies. Tc-SC scans were positive at 6-10 minutes and all patients had positive Tc-RBC studies. In general, the scans accurately located the source of bleeding as determined by bronchoscopy and/or surgery. Because of the small sample, statistically significant differences between both techniques were not ascertained. Both Tc-SC and Tc-RBC may prove to be helpful, minimally invasive imaging procedures for determining the general area of hemorrhage in patients with clinically significant hemoptysis. Although a trend suggests that Tc-RBC is a more sensitive method, further comparison is needed for corroboration.

Adult↗

Thallium-201 myocardial perfusion scanning.

This is a minimally invasive imaging technique designed to evaluate patients for suspected coronary artery disease. It is usually performed in conjunction with stress ECG testing. It can accurately determine the presence and extent of coronary artery disease and help determine whether cardiac catheterization is necessary. Thallium scanning can also be used to monitor response to aortocoronary bypass grafting, angioplasty or intracoronary streptokinase infusion.

Coronary Circulation↗

Radionuclide evaluation of nonmalignant bone disorders.

Recent advances in nuclear imaging have improved the noninvasive evaluation of patients with nonmalignant bone disorders. When bone scanning agents are combined with bone marrow scanning agents and gallium-67 scintigraphy, a more accurate diagnosis can be obtained. By selecting the appropriate imaging sequence, it is often possible to distinguish cellulitis from underlying osteomyelitis. In patients with total hip replacements, it may be possible to separate postsurgical changes from prosthetic loosening or infection. Stress fractures in joggers may be detected by radionuclide bone scintigraphy before radiographs become abnormal. These nuclear imaging procedures can be done in most hospitals.

Adult↗

Scintigraphic detection of gastrointestinal bleeding: a review of current methods.

Recent experience with radionuclide imaging has provided the clinician with several techniques to noninvasively detect and locate sources of gastrointestinal hemorrhage. These tests can be rapidly performed and often in an ICU setting. One method used Tc-99m sulfur colloid which, in an animal model, has been shown to detect acute bleeding at rates as low as 0.1 ml/min. However, because the tracer remains in the blood for a short period of time, it may be suboptimal for identifying patients with intermittent bleeding. Tc-99m red cells is a tracer that remains within the blood and permits detection of both acute and intermittent bleeding. With tagged red cells, sites of bleeding from both the upper and lower gastrointestinal tract can be found. Both of these techniques can provide important information in the patient with suspected active gastrointestinal bleeding and aid the clinician in more effective management including the use of invasive diagnostic and therapeutic techniques.

Aged↗

Detection of gastrointestinal bleeding with 99mTc-labeled red blood cells.

Using a modified in vivo Tc-99M red cell labeling technique, gastrointestinal bleeding scintigraphy was performed in 100 patients with GI bleeding. Sixty-two patients with melena or bright red blood per rectum had positive scintiscans. In comparison to results of angiography, endoscopy, surgery and contrast radiography, radionuclide scintigraphy correctly located the site of bleeding in 83% of patients. The procedures could be performed over a 24 hr period which increased the sensitivity of the test since 85% of the scintiscans were positive at one hr or greater after the onset of imaging. The procedure was more sensitive than angiography in detecting sources of GI bleeding. We conclude that GI bleeding scintigraphy 99mTc-red cells in an accurate and effective method to detect upper and lower GI bleeding in patients with acute intermittent gastrointestinal bleeding.

Adolescent↗

Hemobilia detected by Tc-99m labeled red blood cells.

Tc-99m labeled red blood cells were successfully used to determine the site of hemorrhage in a 67-year-old man with hemobilia. A false hepatic artery aneurysm was confirmed at angiography and ultimately successfully embolized. The relative merits of using Tc-99m labeled red blood cells for detecting sources of upper gastrointestinal bleeding are discussed.

Aged↗

Radionuclide imaging and ultrasound in liver/spleen trauma: a prospective comparison.

In a prospective blind study of liver/spleen trauma, 32 consecutive patients were evaluated by radionuclide imaging (99mTc-sulfur colloid) and gray-scale ultrasound. Six patients (19%) had inadequate sonograms due to injuries and pain. Thirteen (41%) were normal, 13 (41%) were abnormal with one technique or the other, and there was a discrepancy in 2 (6%). Of the 13 abnormal patients, 1 had a lacerated spleen, 2 had angiographic confirmation of a subcapsular hematoma, and 10 showed resolution on follow-up. Two patients with left-sided trauma had abnormal radionuclide scans of the liver; sonograms were initially normal in one of them, but subsequent imaging confirmed the abnormality. The authors feel that imaging with 99mTc-sulfur colloid should be the primary screening examination for liver/spleen trauma.

Adolescent↗