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Biomedical subjects

G G Winzelberg

Publications and source records attributed to G G Winzelberg.

At least 55 records · Page 3Linked to original sources
PubMed1981

Scintigraphic detection of pulmonary hemorrhage using Tc-99m-sulfur colloid.

Pulmonary hemorrhage, whether in the form of hemoptysis or bleeding into the pleural space, may be a life threatening problem. While fiberoptic bronchoscopy and selective bronchial and intercostal angiography are the major diagnostic modalities, these techniques are not without risks. Two patients are described-one with massive hemoptysis from a bronchogenic carcinoma; another with pleural bleeding from a torn intercostal artery-in whom Tc-99m-sulfur colloid scintigraphy accurately located the source of hemorrhage. We conclude that Tc-99m-sulfur colloid scintigraphy may be a helpful noninvasive method to increase the sensitivity and specificity of fiberoptic bronchoscopy and bronchial angiography in patients with massive pulmonary bleeding.

Adult↗
PubMed1981

Radionuclide localization of lower gastrointestinal hemorrhage.

The authors prospectively evaluated the usefulness of abdominal radionuclide scintigraphy using 99mTc-labeled red cells as a means of monitoring for intermittent gastrointestinal bleeding over a 24-hour period in both control and actively bleeding populations. Of 32 patients with documented hemorrhage, 29 had positive scintiscans (sensitivity, 91%; 9% false negatives). Of 18 nonbleeding patients, 17 had negative scintiscans (specificity, 95%; 5% false positives). 12 of 29 patients bled from 6 to 24 hours after the study was begun. Scintiscans were positive in patients with transfusion requirements of greater than or equal to 500 ml/24 hr. The authors conclude that abdominal scintigraphy with 99mTc-labeled red cells is an effective method of detecting gastrointestinal bleeding.

Adolescent↗
PubMed1981

Right Ventricular function in aortic and mitral valve disease.

Radionuclide ventriculography of the right heart was performed in 56 patients within two weeks of cardiac catheterization using a gated first-pass technique. Thirteen patient served as normal controls, and 43 patients had severe aortic or mitral valve disease or both, 35 of whom subsequently underwent valve surgery. Right ventricular ejection fraction (RVEF) and the presence of central venous reflux was determined and related to catheterization findings. In normal patients, RVEF was 60 plus or minus 7 percent (mean plus or minus 1 SD). In patients with valvular disease, the RVEF was below the normal range in only 2/14 (14 per cent) when right ventricular peak systolic pressures were less than 50 mm Hg, compared with 16/29 (55 percent) with an RVEF below normal when right ventricular peak systolic pressures greater than 50 mm Hg (P less than .05). In contrast, there was no relation of right ventricular ejection fraction to ventricular filling pressure in valvular heart disease patients. There was no difference in early postoperative course in patients with normal or reduced ejection fraction. Central venous systolic reflux was not presented in normal patients, but was present in 3/12 (25 percent) and 22/25 (88 percent); P less than 0.1) of patients with right ventricular systolic pressures below and above 55 mm Hg, respectively, including all ten patients with documented tricuspid regurgitation. Radionuclide assessment of right ventricular function in patients with aortic or mitral valve disease or both provides information that cannot be inferred from right-sided pressure measurements.

Adult↗
PubMed1981

99mTc red blood cells for detection of gastrointestinal bleeding: experience with 80 patients.

Imaging was done in 80 patients with gastrointestinal hemorrhage using red blood cells labeled with 99mTc by a modified in vivo technique. Bleeding was detected in 65% of 40 patients with bright red blood per rectum, 71% of 35 patients with melena, and in none of the five patients with occult bleeding and chronic anemia. No clinical evidence of further gastrointestinal hemorrhage occurred in 26 of the 29 patients who were negative on imaging. The imaging study could be carried out for over 24 hr which increased the sensitivity of the test, since only 16% of the studies were abnormal on the initial images. Neither the need for blood replacement nor the presence of bright red blood per rectum correlated strongly with early image positivity, supporting the contention that patients with gastrointestinal hemorrhage do not necessarily bleed continuously. Labeled red cell imaging was more sensitive in the detection of bleeding than angiography. It corresponded to the overall angiographic findings in 23 of 31 cases and in 17 of the 18 patients who had demonstrable extravasation. 99mTc red blood cells may be used effectively in patients with melena as well as with bright red blood per rectum, and thus would seem to be the preferred radiopharmaceutical for imaging.

Erythrocytes↗
PubMed1980

Scintigraphic evaluation of left ventricular aneurysm.

Gated cardiac blood pool scintigraphy is a noninvasive method to assess regional and global left ventricular function in the patient with suspected true or false left ventricular aneurysm after a myocardial infarction. The procedure is easy to perform and provides reproducible, high resolution images that can accurately distinguish from diffuse contractile abnormalities often present after myocardial infarction. An overall accuracy rate of 96 percent for detection of left ventricular aneurysm can be obtained with gated cardiac blood pool scintigraphy as compared with contrast left ventriculography. The procedure also permits assessment of functional reserve of the noninvolved myocardium and thus can provide valuable information on whether enough viable myocardium will remain after aneurysmectomy. The addition of thallium-201 myocardial perfusion scintigraphy may aid in the separation of viable from scarred myocardium at the edge of the aneurysm. Both radionuclide techniques are well suited for screening the patient after infarction with persistent congestive heart failure, malignant arrhythmia or systemic emboli in whom a left ventricular aneurysm may have developed.

Cardiomyopathies↗
PubMed1980

Retinitis pigmentosa and colon cancer: a previously unreported association.

Retinitis pigmentosa, a hereditary disease characterized by progressive retinal degeneration and blindness, has been associated with numerous diseases. We report the first association between retinitis pigmentosa and colon cancer in 3 of 53 hospitalized patients with retinitis pigmentosa at the Massachusetts General Hospital and Massachusetts Eye and Ear Infirmary for the period from 1962 to 1977.

Adult↗
PubMed1980

111In oxine labeled red cells for detection of simulated lower gastrointestinal bleeding in an animal model.

111In oxine in vitro labeled red cells were evaluated in rabbits for the ability to detect gastrointestinal (GI) bleeding. A mean labeling efficiency of 81% (+/- 15.5%) was achieved. Biodistribution and translocation data demonstrated 81% of the activity within the blood pool at four hours after intravenous injection, falling to 29% by 72 hours. Peak urine excretion occurred after 60-150 minutes. Normal GI excretion was less than 1% over 72 hours. Simulated lower GE bleeding was imaged at 4, 12, and 72 hours, and amounts as small as 2 ml (1% blood volume) were seen. In rabbits the total body dose of injected 111In is 0.15 mGy/MBq (0.56 rad/mCi), and the critical organ is the spleen which received 0.49 mGy/MBq (1.82 rad/mCi). 111In oxine labeled red cells provide a sustained blood pool label without significant accumulation in the GI tract, and may have a potential use in the detection of intermitent GI bleeding in humans.

Animals↗
PubMed1980

Scintigraphic assessment of false left ventricular aneurysms.

After myocardial infarction, patients may develop congestive heart failure, arrhythmias, or peripheral emboli due to true or false left ventricular aneurysms. False ventricular aneurysms differ from true aneurysms in that has been rupture of the left ventricular myocardium into the pericardium without rupture of the pericardial sac. The diagnosis of false aneurysm is particularly important because, in addition to the problems cited, there is a high incidence of rupture that may be prevented with surgical intervention. Four patients presenting with congestive heart failure and studied by gated cardiac blood pool scintigraphy were shown to have false left ventricular aneurysms and confirmed angiographically or surgically. Technetium-99m-gated cardiac blood pool scintiscans demonstrated discrete paraventricular chambers usually posterior in position with marrow necked connections to the left ventricle. Thallium-201 rest myocardial perfusion scintiscans performed in two of the four patients demonstrated a defect corresponding to the neck of the false aneurysm in one patient and a larger defect in the second patient with both a true and false aneurysm. It was concluded that combined gated cardiac blood pool scintigraphy and 201Tl myocardial scintigraphy provide a noninvasive method for diagnosing false left ventricular aneurysms.

Aged↗